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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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NCCI Reports on Remote Work and Workers’ Comp Frequency

According to the NCCI, remote work makes up 20–30% of the U.S. workforce, up from 4–7% pre-pandemic.
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November 3, 2025

Texas Releases 2026 Performance Based Oversight Assessment Plan

The assessment will be based on five key metrics of medical data reported to the DWC from January 1st to June 30th of 2026.
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November 3, 2025

South Dakota Reports on Fee Schedule and Medical Trends

2025 relative values for physicians will be incorporated, while NCCI medical data was reviewed to compare state trends to national trends.
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November 3, 2025

Nevada Clarifies Provider Choice Requirements for First Responders

Since October 1st, first responders have been able to select their own physician for heart and lung claims under certain conditions.
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November 3, 2025

Maryland Urges Accommodations for Policyholders Affected by Government Shutdown

Proposed accommodations include deferring premium payments, extending grace periods, and waiving late fees and penalties.
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October 27, 2025

California: New Standards for Third Party Settlements

Effective January 1, 2026, this new law applies to injured peace officers and firefighters.
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October 27, 2025

California Publishes 2026 Audit Standards for Claims Administrators

The audits will assess compliance with workers’ comp laws, focusing on timely and accurate payments and proper issuance of medical evaluation notices.
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October 27, 2025

Texas Proposes Rule Change for Death Investigator Claims

The DWC is accepting public comments on rules that expedite medical benefits and the dispute resolution process until November 24th.
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October 27, 2025

Maryland Provides Update on Prescription Fee Guide

The Medical Fee Guide Committee also discussed PPO practices, psychiatric IMEs, and more.
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October 27, 2025
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 Further resources you may be interested in

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

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

Potential applications, benefits, pitfalls, questions, and the matter of regulation
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Wacky Weather: How Climate Change Is Impacting Workers’ Comp

Weather-related disasters are on the rise. How do weather and climate change affect workers and workers’ comp?
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Missouri Enacts PTSD Presumption for First Responders

The national trend continues, in this case with qualifying events and the inclusion of 911 dispatchers.
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FDA Publishes Guidance on Clinical Trials for Psychedelic Drugs

These guidelines advise researchers on study design and other considerations as they develop medications that contain psychedelics.
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Connecticut Passes PTSD Presumption for All Employees

Employees who experience a qualifying traumatic event on the job can receive PTSD coverage via workers’ comp.
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Washington State Bans Pre-Employment Cannabis Screening

As other states come closer to recreational legalization, Washington State pushes the needle further.
Read More
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