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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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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.
Read More →
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

Texas: Key Updates from Quarterly Carrier Meeting

Findings from a gabapentin/pregabalin audit are expected in early 2026, the DWC addressed billing discrepancies, and more.
Read More →
October 27, 2025

Colorado Discusses Exclusions from Treating Provider List

Stakeholders provided feedback on the DWC’s proposed rules.
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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.

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.
Read More

Washington State Bans Pre-Employment Cannabis Screening

As other states come closer to recreational legalization, Washington State pushes the needle further.
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Marijuana Reimbursement Initiatives See Signs of Life

Three states have introduced bills or seen court cases overturned in relation to this policy.
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Fifth Annual Industry Insights Survey Reveals Evolving Needs in Workers’ Comp

Explore the top five major findings from this year’s Workers’ Comp Industry Insights Survey.
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NCCI Publishes Research Brief on Firefighter Presumptions

Beyond PTSD, cancers, heart conditions, and communicable diseases are seeing legislative activity.
Read More
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