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A significant part of the Healthesystems vision is to create a more integrated experience for our customers

Advocacy & Compliance

Healthesystems’ Advocacy & Compliance experts are essential in the management of pharmacy and ancillary benefits for our clients. By tracking and influencing regulatory activity, our team stays  ahead of evolving trends and identifies opportunities to advocate on behalf of our clients, their injured workers, and the broader industry.

The Advocacy & 
Compliance Team

Monitors and reports on proposed and pending regulatory changes that impact workers' comp, helping shape effective program strategies

Advocates for fair and balanced public policy through proactive engagement with regulators, customers, and other stakeholders throughout the rulemaking lifecycle

Supports operational compliance by providing guidance to internal stakeholders and external partners during the implementation of new regulatory changes

Regulatory Recap

A weekly e-newsletter informed by the Advocacy & Compliance team to help keep our clients and industry contacts in the know on the latest legislation and policy updates impacting workers’ comp.
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New York Expands Provider Access and Raises Authorization Threshold

Any licensed healthcare provider in good standing may treat injured workers, and prior auth thresholds increase from $1,000 to $1,500.
Read More →
June 22, 2026

CWCI Report: Increased Use of Unlisted Billing Codes Driving Medical Inflation

Payments for unlisted professional service more than doubled from 2017-2024.
Read More →
June 22, 2026

Florida Amends Billing Rules After Physician Dispensing Ruling

The proposed rules would align with the February 2026 ruling on physician dispensing in Publix Super Markets, Inc. v. Department of Financial Services.
Read More →
June 15, 2026

New Proposal Would Ban Cannabis Coverage in Federal Workers’ Comp Claims

If enacted, the ban would remain in effect regardless of rescheduling.
Read More →
June 15, 2026

California Proposes Contract-Based Medical Bill Reduction

If enacted, payers must identify a contact person for whom providers could reach for contract-based medical bill information.
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June 15, 2026

California Sees Increase in Cumulative Trauma Claims

Since 2020, total costs for CT claims have more than doubled, with CT claims more likely to involve medical-legal and interpreter services early on.
Read More →
June 15, 2026

Louisiana Transfers Fee Schedule Oversight to OWCA

The Office of Workers’ Compensation Administration (OWCA) must evaluate and update reimbursement rates by July 1, 2029.
Read More →
June 15, 2026

Louisiana Creates Additional Reimbursement Pathway for First Responders

This would address extraordinary medical or dental expenses not covered by workers’ comp or employer-sponsored health insurance.
Read More →
June 15, 2026

Louisiana Establishes Medical Billing Database

The rollout of data collection practices sets the stage for an updated state fee schedule in 2029.
Read More →
June 8, 2026
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 Further resources you may be interested in

Additional articles and updates from Healthesystems related to policy shaping workers’ comp.

Nevada Enacts Workers’ Comp Formulary

The state will adopt the ODG Drug Formulary by July 1, 2027, with coverage of non-formulary drugs allowed through January 1, 2028.
Read More

CWCI Publishes Report on Long-COVID

Long COVID cases made up 4.7% of COVID claims, totaling 6,000 claims, yet their medical payments totaled $105 million.
Read More

WCRI Publishes New Report on Medical Fee Schedule Design

The study compares workers’ comp fee schedules for professional services to Medicare rates within 44 states, accounting for 41% of medical costs.
Read More

Healthesystems at WCI 2025

Visit Healthe at Booth #921 to learn about our solutions and how we reduce burdens for claims professionals.
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Expert Q&A with Sandy Shtab: The Emerging Role of AI in Workers’ Comp Healthcare – and the Regulations Surrounding It

AI is increasingly being used in healthcare delivery. What are its applications in workers’ comp? What are the benefits and risks?
Read More

WCRI Publishes Medical Price Index

The study compares prices for medical services across 36 states from 2008 to 2024, representing 88% of workers’ comp benefits in the U.S.
Read More
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