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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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Massachusetts Clarifies Fee Schedule Recommendations to Legislature

Reimbursement structures have remained unchanged for over a decade, prompting regulators to push for updates.
Read More →
January 19, 2026

Presumption Bills Continue to Trend

Arizona proposes a PTSD presumption, while Maryland proposes a hypertension presumption.
Read More →
January 19, 2026

New Bills Propose Workers’ Comp Changes Related to Immigration Status

New bills in Florida and New Jersey could affect workers’ comp coverage for undocumented workers.
Read More →
January 19, 2026

WCRI Publishes Report on Injectable Therapies

The report classifies distinct subgroups of injectable by medication type and identifies those most common in workers’ comp.
Read More →
January 19, 2026

New Jersey Proposes Comp Exclusion for Intoxication

Intoxication as a material contributing factor to injury or death could disqualify individuals for benefits.
Read More →
January 19, 2026

Texas Publishes Audit Report for Gabapentin and Pregabalin Prescribing

The report includes recommendations for providers, and the findings could impact rules around prescribing, utilization review, and service delivery.
Read More →
January 12, 2026

New York Proposes Billing Guidelines for Residents and Fellows

After expanding access to care by allowing these providers to treat injured workers, billing guidelines for these providers are being developed.
Read More →
January 12, 2026

Ohio Proposes Rule Changes for Prosthetic Coverage

Under the proposal, the BWC would cover purchases through their surplus fund if the need stems from an allowed injury or occupational disease.
Read More →
January 12, 2026

Florida May Increase Cancer Benefits to Firefighters With $25,000 Payment

Additionally, benefits may be extended for up to 10 years post-employment.
Read More →
January 12, 2026
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 Further resources you may be interested in

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

Burden of Proof: Unpacking Presumptions in Workers’ Comp

Exploring the expansion of presumptions in PTSD, cancers, and more.
Read More

FDA Takes Steps to Restrict Certain Kratom Products

The FDA recommended concentrated 7-OH kratom products to be rescheduled under the Controlled Substances Act.
Read More

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.
Read More

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
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