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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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Healthesystems at the IAIABC 111th Annual Convention 

A recap of conference highlights and key presentations.
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October 13, 2025

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

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

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

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

Wisconsin Proposes Increased Penalties for Worker Misclassification

If passed, the bill would increase fees, and in some cases remove fee limits, for employers that continue to misclassify workers to avoid providing benefits.
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October 6, 2025

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

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

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
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 Further resources you may be interested in

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

Nevada Enacts Workers’ Comp Formulary

The state will adopt the ODG Drug Formulary by July 1, 2027, with coverage of non-formulary drugs allowed through January 1, 2028.
Read More

CWCI Publishes Report on Long-COVID

Long COVID cases made up 4.7% of COVID claims, totaling 6,000 claims, yet their medical payments totaled $105 million.
Read More

WCRI Publishes New Report on Medical Fee Schedule Design

The study compares workers’ comp fee schedules for professional services to Medicare rates within 44 states, accounting for 41% of medical costs.
Read More

Healthesystems at WCI 2025

Visit Healthe at Booth #921 to learn about our solutions and how we reduce burdens for claims professionals.
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Expert Q&A with Sandy Shtab: The Emerging Role of AI in Workers’ Comp Healthcare – and the Regulations Surrounding It

AI is increasingly being used in healthcare delivery. What are its applications in workers’ comp? What are the benefits and risks?
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WCRI Publishes Medical Price Index

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