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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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Expanding Access to Care Across the Country

Delaware reported success with a recent bill, while Washington State is undergoing rulemaking and the U.S. Senate introduced a new bill.
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December 8, 2025

Pennsylvania Supreme Court Reviews Drug Pricing Case

The case will examine the Bureau of Workers’ Compensation’s use of RED BOOK for calculating AWP.
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December 8, 2025

CMS Publishes 2026 Q1 NCCI Edits

Changes will impact DME supplier services, facility outpatient hospital services, and practitioner services.
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December 8, 2025

Delaware and Pennsylvania Expand Medical Data Call Reporting

Insurers with 0.25% of market share must begin sharing data by July 1, 2026, while those with lower market share must begin by January 1, 2027.
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December 8, 2025

Nevada Schedules Workshop to Review Reform Rule Changes

This workshop will cover rules around panel provider lists, delegating follow-up care to physician assistants, and other clerical matters.
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December 8, 2025

Texas Finalizes Designated Doctor Plan-Based Audit

The audit will evaluate the medical necessity and reasonableness of referrals and diagnostic testing ordered by designated doctors.
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November 24, 2025

Florida May Permit Older Physical to Help Establish First Responder Presumptions

Exams from previous employers could be used to demonstrate that workers had no signs of occupational illnesses prior to employment.
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November 24, 2025

California Publishes 2025 Geo Study

The study explores regional differences in claims patterns and cost drivers across the state.
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November 24, 2025

Congressional Bill Proposes Safety Standards for Wildland Firefighters

The bill would require federal agencies to determine appropriate protective equipment and under what conditions such equipment would be required.
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November 24, 2025
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 Further resources you may be interested in

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

Massachusetts Publishes Study on Opioid Overdose Deaths

Approximately 741 injured workers died of opioid overdose deaths in Massachusetts.
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New Jersey Proposes Expansion to Medical Marijuana Law

A new bill would give providers more discretion in what medical conditions could qualify a patient for medical cannabis.
Read More

California Proposes Psychedelics Pilot Program

Five treatment centers would offer psychedelic therapy for veterans and former first responders.
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Healthesystems at WCI 2024

Adjusters Assemble! Visit Healthe at Booth #921 to learn how we reduce day-to-day burdens for claims professionals.
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Child Labor Laws are Changing: How Could This Impact Workers’ Comp?

An increase in the teen workforce could impact workplace injury and claims management.
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New Jersey Proposes Worker Heat Protections, Continuing Recent Trend

As another state considers protections, WCRI publishes new data on heat’s impact on workplace accidents.
Read More
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