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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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Louisiana Fee Schedule Bill Amended with Hopes of Compromise

In addition to bill amendments, the bill has been deferred for one week to allow for additional review and stakeholder input.
Read More →
April 28, 2025

California DWC Launches Test Pilot for New Pharmacy Fee Calculator

The pilot test will run from April 24 to May 8, 2025, allowing stakeholders to provide feedback to the DWC.
Read More →
April 28, 2025

OSHA to Hold Public Hearing on Heat Injury and Illness Prevention

A June 16th virtual hearing will discuss proposed rules, and those interested in speaking must register by May 2nd.
Read More →
April 21, 2025

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.
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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
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 Further resources you may be interested in

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

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

New York and New Hampshire Rule in Favor of Marijuana Reimbursement

Both State Supreme Courts ruled in favor of reimbursement.
Read More

FDA Approves Posimir for Post-Surgical Pain Relief

A novel bupivacaine formulation works as a 72-hour local anesthetic following shoulder surgery.
Read More

Wisconsin Announces Plan to Lower Prescription Drug Costs

State-led efforts to combat the drug price issue continue to emerge across the nation.
Read More

COVID-19 Mutations Impact Testing

False negatives may be reported due to genetic variations of the virus.
Read More
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