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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Worker Safety

WCRI Report: California’s Heat Safety Standards Reduced Workplace Injuries

Work-related injuries on hot days decreased 15-17% for construction workers, 24-27% in agricultural workers, and 19-25% for transportation workers.

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October 6, 2025

Oregon Considers Stakeholder Feedback for Improving Access to Care

Stakeholders discussed inefficiencies in claim procedures, and regulators will continue to review feedback prior to finalizing recommendations.

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October 6, 2025

Advocacy Opportunity Billing & Payments

Ohio Resubmits Outpatient Medication Rules: Comments Accepted Until October 9th

BWC resubmits outpatient medication rules with unchanged compound provisions, sets February 2026 start date, and reopens public comments.

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October 6, 2025

Advocacy Opportunity Cost Containment

Arizona Study Prompts Stakeholder Feedback for High-Cost Prescription Topicals

A small group of prescribers and out-of-network pharmacies are driving utilization of costly drugs with affordable alternatives.

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October 6, 2025

Worker Classification

New Jersey Receives $19.4 Million Payment from Lyft for Worker Misclassification

Over 100,000 drivers were misclassified as independent contractors, depriving those workers of various benefits – including workers’ comp.

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September 29, 2025

Claims Procedures

Nevada CARDS Portal Down: State Issues Guidance Bulletin

There is no timeline for when the system will be back online, requiring various go-arounds for certain claims procedures.

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September 29, 2025

Claim Costs Industry Data

Florida Workers’ Comp Trends Highlighted in WCRI Webinar

The webinar covered topics ranging from claims costs to drug payments, heat-related injuries, and more.

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September 29, 2025

Advocacy Opportunity Cost Containment

Tennessee: Formulary and UR Updates from the Medical Advisory Committee Meeting

Advocacy efforts by Healthesystems helped create a prior authorization for 300mg ibuprofen, as other cost-effective doses are readily available.

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September 29, 2025

Access to Care Advocacy Opportunity Training Opportunity

Colorado Seeks Stakeholder Feedback for 2028 Comp Reform

Three listening sessions will give stakeholders the chance to comment on how to implement major workers’ comp reforms.

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September 29, 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.