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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Marijuana

Pennsylvania Proposes Cannabis Reimbursement Bill

If enacted, insurers would be required to reimburse up to $250 per month for qualified medical use.

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August 11, 2025

Worker Safety

Senate Introduces Federal Heat Standard Bill

If enacted, OSHA would be required to adopt a federal standard for enforceable protections.

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August 11, 2025

Cost Containment

South Dakota Approves Rulemaking for Physician Fee Schedule

The 2025 Optum RVPs for medical services and treatments will be adopted, but with current conversion factors.

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August 11, 2025

Claim Costs Industry Data

NCCI Reports on Medical Inflation Highlights

While overall medical inflation remains low, certain tariffs are still pending, which could impact long-term costs.

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August 4, 2025

Claim Costs Cost Containment Industry Data

California Publishes 2025 State of the System Report

Medical costs went up 8% in 2024, driven by increased utilization, fee schedule inflation, and growth in medical-legal services.

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August 4, 2025

Advocacy Opportunity Cost Containment

California Sees Delay to Utilization Review Regulations

The Office of Administrative Law informed the DWC that seven areas of the proposed update required additional clarification or public notice.

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August 4, 2025

Industry Data

NCCI Publishes Labor Market Insights

147,000 new jobs were reported in June, though half were driven by likely-seasonal education jobs.

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July 28, 2025

Industry Data

NCCI Publishes Industry Trends Report

While claim severity decreased across all industries, construction saw the steepest decline since 2015.

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July 28, 2025

Access to Care Claim Costs Industry Data

WCRI Reports on Advanced Practitioners and Workers’ Comp Outcomes

Initial treatment from nurse practitioners saw a 2.3% shorter time from injury to the first non-emergency service.

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July 28, 2025

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Further resources you may be interested in

Additional articles and updates from Healthesystems related to policy shaping 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.