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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Claim Costs Industry Data

WCRI Publishes Medical Price Index

The study compares prices paid for medical services across 36 states from 2008 to 2024, representing 88% of workers’ comp benefits in the U.S.

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May 27, 2025

Tennessee Medical Advisory Committee Meeting Highlights

Topics addressed included changes to the fee schedule, utilization review, spinal therapy guidelines, and more.

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May 27, 2025

Technology

Maryland Enacts AI Bill for Health Insurance Utilization

The law requires carriers, pharmacy benefit managers, and private review agents to ensure AI decisions are based on an individual's clinical information.

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May 27, 2025

Access to Care

Colorado Provider Choice Bill Reaches Governor

If enacted, injured workers may choose from any level I or level II accredited physician through the division of workers' compensation.

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May 27, 2025

Worker Safety

DEA Releases 2025 National Drug Threat Assessment

The most common source of controlled prescription drug (CPD) misuse was a prescription from a single doctor or theft from providers.

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May 27, 2025

Industry Data

Recapping the NCCI Annual Insights Symposium

Healthesystems attended the event, summarizing major highlights from the symposium.

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May 19, 2025

Advocacy Opportunity Cost Containment

New York PBM Bill Enacted with Exemption for Workers’ Comp

The exemption reduces unnecessary burden and grows recognition that workers’ comp PBMs operate differently from traditional PBMs.

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May 19, 2025

Access to Care

New York Expands Provider Access with Residency and Fellowship Programs

Effective immediately, 20,000 residents and fellowship physicians in ACGME programs can now treat injured workers, under faculty supervision.

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May 19, 2025

Worker Classification

Oklahoma Employers Can Now Exclude Unpaid Temp Workers from Workers’ Comp

Unpaid temp workers who are working for experience will no longer be considered employees entitled to workers’ comp coverage.

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May 19, 2025

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Further resources you may be interested in

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

Changing Workforce, Claims Automation and Tech Connectivity Among Top Priorities in 2022 Industry Survey

The priorities and challenges revealed in our 2022 Workers’ Compensation Industry Insights Survey Report reflect an industry focused on moving forward.