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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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OSHA to Hold Public Hearing on Heat Injury and Illness Prevention

A June 16th virtual hearing will discuss proposed rules, and those interested in speaking must register by May 2nd.
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April 21, 2025

California P&T Committee to Meet on April 16th

The hybrid meeting will cover the pharmacy fee schedule, biosimilars, cannabis coverage, and payments for topical drugs.
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April 14, 2025

California Releases Report on Independent Medical Reviews

A total of 199,651 IMR applications were received in 2024, with pharmaceuticals making up 32.7%.
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April 14, 2025

Louisiana Proposes a Workers’ Comp Fee Schedule

The bill could require biennial updates, utilizing RVUs form the resource-based relative value scale (RBRVS).
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April 14, 2025

Nevada Now Considering Evidence-Based Formulary After Bill Hearing

Senate Bill 317 originally focused on provider panels, but a recent hearing amended the bill to include a workers’ comp formulary.
Read More →
April 14, 2025

Ohio Withdraws Outpatient Medication Reimbursement Rules

Filed in October 2024, the amendments aimed to adjust AWP discount rates and standardize dispensing fees.
Read More →
April 14, 2025

Wisconsin May Expand PTSD Presumption to Emergency Medical Workers and Others

The existing presumption only applies to firefighters and law enforcement officers, while this new bill would apply to other first responders.
Read More →
April 14, 2025

WCRI Publishes Study on Degenerative and Comorbid Conditions

Approximately 38.8% of claims had one or more comorbidities, based on an analysis of 930,000 claims with at least 7 days lost time across 32 states.
Read More →
April 7, 2025

California Considers Updates to Billing Disputes Over Contracted Discounts

These disputes would qualify for independent bill review, and contracts must be presented when justifying payments below fee schedule.
Read More →
April 7, 2025
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 Further resources you may be interested in

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

White House Issues Executive Order on Artificial Intelligence

The order seeks increased transparency from AI companies regarding model operations, safety and privacy standards, and consumer/worker protections.
Read More

California Bans Pre-Employment Marijuana Screening

Similar to a Washington law passed earlier this year, employees are not permitted to possess, to be impaired by, or to use cannabis on the job.
Read More

The Real Promise of Artificial Intelligence in Healthcare and Workers’ Comp

Potential applications, benefits, pitfalls, questions, and the matter of regulation.
Read More

California Enacts Skin Cancer Presumptions for First Responder and Other Occupations

This law also includes lifeguards, and certain employees in the Departments of Fish and Wildlife and Parks and Recreation.
Read More

Changing Minds? Unlocking the Potential of Psychedelics in Mental Health Therapy

Clinical research indicates the potential for strong mental health applications.
Read More

Connecticut Enacts Cancer Presumption for Firefighters

Enacted as part of the state’s budget bill, this new regulation comes with stipulations and exclusions.
Read More
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