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.

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Advocacy Opportunity Cost Containment

Florida Announces Public Meeting to Discuss Reimbursement Manual

The virtual meeting will take place April 1, 2025 at 10:00 AM to discuss outstanding issues related to the Health Care Provider Manual.

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March 10, 2025

Access to Care

California Proposes Statewide Network to Address Provider Shortage

Injured workers could utilize this network if their employer’s network cannot provide treatment within 30 days.

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March 10, 2025

Cost Containment

Arizona Medical Fee Schedule Bill Passes Senate

The fee schedule would apply to medical care, dental care, and supplies received by injured employees.

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March 10, 2025

Advocacy Opportunity Billing & Payments Cost Containment

Oklahoma Bill Could Impact Pharmacy Benefits

Among other changes, the bill would ban effective rate contracts, making it difficult to forecast drug costs.

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March 3, 2025

Industry Data

WCRI Reports on the Pandemic’s Effect on Medical Utilization

Injury frequency increased for younger and less-tenured workers, who also saw higher use of emergency departments.

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March 3, 2025

Access to Care

New York Budget Bill Could Expand Access to Providers

Among many proposed changes, the bill would automatically allow licensed physicians, chiropractors, psychologists, and others to treat injured workers.

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March 3, 2025

Access to Care

Montana Bill Would Deny Workers’ Comp Benefits for Undocumented Workers

The bill would also allow insurers to close claims when the claimant leaves the United States – regardless of citizenship status.

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March 3, 2025

Mental Health Presumptions

Montana Introduces PTSD Presumption Bill for First Responders

The bill applies to firefighters, law enforcement officers, certain prison workers, and others.

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March 3, 2025

Cost Containment

Maryland Pharmacy Fee Schedule Bill Inches Forward

Introduced in January, the bill was discussed in a February 25th hearing, with supporters and opponents voicing concerns.

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March 3, 2025

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Further resources you may be interested in

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

Clearing the Air: Marijuana Considerations for Workers’ Comp

Public support for marijuana is at an all-time high. What does this mean for workers’ comp?

State of the States

Sandy Shtab, Healthesystems AVP of Advocacy and Compliance, comments on regulatory activity across the country.

Side Effects: COVID-19-Related Healthcare and Pharmacy Trends Impacting Workers' Comp

The COVID-19 pandemic has had a profound impact on the American healthcare system, causing disruptions and driving rapid adaptations to care delivery.