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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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California Reports on Independent Medical Reviews (IMRs)

The report reviews 1.57 million IMR decision letters from 2015 through March 2025.
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July 14, 2025

California P&T Committee Reviews Drug List Changes

The July 16th meeting will review upcoming MTUS changes, which go into effect August 6th.
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July 14, 2025

Wisconsin WCAC Meeting Shares Key Regulatory Updates

Among other updates, Wisconsin will implement a hospital fee schedule by July 1, 2027.
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July 14, 2025

Alaska Considers Reimbursement Changes for Home Health, DME, And Ambulance Services

The proposed changes will be discussed further in the next meeting on July 18th.
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July 14, 2025

WCRI Publishes Overview of AI Promises and Challenges

The study is based on an exploration of literature and interviews with 34 leaders across workers’ comp.
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June 30, 2025

Oregon Publishes Biennial Premium Rate Comparison Study

The study focuses on Oregon’s 50 largest industry classes, comparing data to every other state in the country.
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June 30, 2025

Oregon Expands Waiver Enforcement for Sign Language Interpreters

The extension will allow sign language interpreters with temporary licenses to continue providing services through June 30, 2026.
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June 30, 2025

Connecticut Adjusts Process to Update Fee Schedules

Effective July 1st, fee schedule adjustments can be made by the Workers’ Compensation Commission without revenue neutrality.
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June 30, 2025

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.
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June 30, 2025
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 Further resources you may be interested in

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

New York Prepares to Launch New Claim Portal

Stakeholders will soon experience a streamlined digital process for managing claims.
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FDA Approves Veklury for COVID-19, Issues EUA for Bamlanivimab

Veklury is approved for hospitalized patients, while bamlanivimab is being investigated in mild-to-moderate cases of COVID-19.
Read More

Side Effects: COVID-19-Related Healthcare and Pharmacy Trends Impacting Workers’ Comp

The pandemic has disrupted access to care, but the industry has implemented reactive measures
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Returning to Work in the COVID-19 Era

Considerations for infection prevention, unique population factors, and more
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Moving Forward: How Should Opioid Guidance Continue to Evolve?

Opioid use has decreased, prompting calls for reform, but COVID-19 complicates opioid use
Read More
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