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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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Nevada Schedules Workshop to Review Reform Rule Changes

This workshop will cover rules around panel provider lists, delegating follow-up care to physician assistants, and other clerical matters.
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December 8, 2025

Texas Finalizes Designated Doctor Plan-Based Audit

The audit will evaluate the medical necessity and reasonableness of referrals and diagnostic testing ordered by designated doctors.
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November 24, 2025

Florida May Permit Older Physical to Help Establish First Responder Presumptions

Exams from previous employers could be used to demonstrate that workers had no signs of occupational illnesses prior to employment.
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November 24, 2025

California Publishes 2025 Geo Study

The study explores regional differences in claims patterns and cost drivers across the state.
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November 24, 2025

Congressional Bill Proposes Safety Standards for Wildland Firefighters

The bill would require federal agencies to determine appropriate protective equipment and under what conditions such equipment would be required.
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November 24, 2025

California Proposes Updates to Mental Health Treatment Guidelines

Public comments will be accepted on proposed guideline updates until December 19, 2025.
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November 24, 2025

NCCI Reports on Trends in Home Health and Skilled Nursing Facilities

Claims exceeding $1 million in costs saw a projected home health share of medical costs reach 20.1%.
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November 24, 2025

Minnesota Reports on Prescription Drug Price Transparency

Drug classes with the most new, high-priced drugs were anti-cancer drugs, ADHD/anti-obesity drugs, and anti-inflammatory pain medications.
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November 24, 2025

New York Bill Could Remove References to CDC Guidelines

Existing laws and guidelines that refer to CDC guidelines would shift to “nationally recognized clinical practice guidelines.”
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November 17, 2025
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 Further resources you may be interested in

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

The Emerging Role of AI in Workers’ Comp – and the Regulations Surrounding It

An expert Q&A with Sandy Shtab, VP of Industry and State Affairs, on AI in workers’ comp and the regulations surrounding it.
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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.
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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.
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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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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?
Read More
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