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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.

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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.

Advocacy Opportunity Cost Containment Treatment Guidelines

California Shares Key Updates at CHWSC Meeting

Topics covered included recent MTUS updates, the pharmacy fee schedule update, UR and IMR updates, and more.

August 18, 2025

Advocacy Opportunity

Texas Requests Feedback for 2026 Research Agenda

Stakeholders can submit feedback on the research agenda by September 15th.

August 18, 2025

Advocacy Opportunity Cost Containment

Oklahoma Solicits Public Feedback on Medical Fee Schedule

Public comments will be accepted on the current fee schedule until September 7th.

August 18, 2025

Michigan Proposes Cancer Presumption for Medical Examiners

The presumption would cover a wide variety of cancers for medical examiners with 60 months of active duty, or exposure to certain hazardous incidents.

August 18, 2025

Access to Care Advocacy Opportunity

Colorado Meeting Reviews Workers’ Comp Reform Requirements

The DoWC discussed requirements from the recently enacted House Bill 1300, which mandates vast workers’ comp reforms.

August 18, 2025

Advocacy Opportunity Cost Containment

Alaska Finalizes 2026 Fee Schedule Recommendations

Recommended changes will be reviewed by the WCB and MSRC on August 22nd, with final adoption expected in October, and taking effect in 2026.

August 18, 2025

Claim Costs Industry Data

WCRI Publishes New Study on High-Cost Back and Shoulder Injuries

Reviewing 194,000 claims, the report found that claims with degenerative comorbid conditions are 58% more likely to become a high-cost claim.

August 11, 2025

Advocacy Opportunity Mental Health Presumptions Treatment Guidelines

Washington State Issues Draft of PTSD Clinical Guidelines

Open to public comment until September 12th, the guideline is intended to establish best practices for diagnosis and treatment.

August 11, 2025

Mental Health Presumptions

Minnesota Releases PTSD Report

At over 200 pages, this comprehensive report includes a review of PTSD claims in the workers’ comp system.

August 11, 2025

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Further resources you may be interested in

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

State of the Nation

A roundup of regulatory activity around the country

Congress Urges USPS to Adopt Department of Labor’s Proposed Heat Protections

The push comes after a letter carrier died after working without air conditioning in 95° weather.

FDA Rejects MDMA for PTSD – Clinical Research to Continue for Psychedelics

The FDA requested additional trial data, with researchers eager to continue psychedelic trials.

In Person, In Print, and On Stage: Connect with Healthe at National Comp 2024!

Stop by our educational session or visit our booth for the latest issue of RxInformer magazine.

Worker Heat Protections Continue to Make Waves

The U.S. Department of Labor proposed new rules, while other states introduce legislation.

WCRI Reports on Drug Payment Trends

Dermatologicals made up the largest share of drug payments, with NSAIDs coming in second.

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Workers' Comp Property and Casualty PBM
Expires 01/01/2028