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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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CMS Publishes Update to NCCI Medically Unlikely Edits

The update includes a revised MUE value for certain HCPCS codes, retroactive to October 1, 2024.
Read More →
April 21, 2025

New York Bill Would Ensure Coverage During Disputes

Employers or insurers would be required to provide immediate medical treatment. If a claim is not compensable, they could seek reimbursement.
Read More →
April 21, 2025

Montana to Allow Physician Assistants and Physical Therapists to Treat Injured Workers

Physician assistants will be able to conduct impairment ratings, while physical therapists are now included in the definition of treating providers.
Read More →
April 21, 2025

California P&T Committee Meeting Recap

Healthe attended the April 16th meeting, capturing key updates regarding the pharmacy fee schedule and drug formulary.
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April 21, 2025

Wisconsin May Expand PTSD Presumption to Emergency Medical Workers and Others

The existing presumption only applies to firefighters and law enforcement officers, while this new bill would apply to other first responders.
Read More →
April 14, 2025

Ohio Withdraws Outpatient Medication Reimbursement Rules

Filed in October 2024, the amendments aimed to adjust AWP discount rates and standardize dispensing fees.
Read More →
April 14, 2025

Nevada Now Considering Evidence-Based Formulary After Bill Hearing

Senate Bill 317 originally focused on provider panels, but a recent hearing amended the bill to include a workers’ comp formulary.
Read More →
April 14, 2025

Louisiana Proposes a Workers’ Comp Fee Schedule

The bill could require biennial updates, utilizing RVUs form the resource-based relative value scale (RBRVS).
Read More →
April 14, 2025

California Releases Report on Independent Medical Reviews

A total of 199,651 IMR applications were received in 2024, with pharmaceuticals making up 32.7%.
Read More →
April 14, 2025
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 Further resources you may be interested in

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

Making Telemedicine Work for Workers’ Comp

Applications, benefits and tips for success.
Read More

Provider Choice Bills Introduced Across the Country

More states consider allowing injured workers to choose their treating physician.
Read More

Recreational Marijuana Legalization Blazes On

In two months, three states legalized recreational marijuana, and more could soon follow.
Read More

Developing and Advancing Meaningful Connection in a Virtual Work Environment

Join Healthe’s Heather Stempien and Sandy Shtab for a panel presentation with IAIABC on April 28th!
Read More

FDA Approves New Acetaminophen Injection Dose

A new 500mg injection will soon be available.
Read More

2021 Workers’ Comp Industry Insights Survey Report

Over 600 stakeholders shared their thoughts on top industry challenges.
Read More
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