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.

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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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Worker Safety

New York Enacts Retail Worker Safety Law

Retailers with 500 or more employees must provide access to silent alarms by 2027.

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September 16, 2024

Advocacy Opportunity Cost Containment

Oregon to Hold Rulemaking Advisory Committee Meeting

A November 5th meeting will review fee schedule revisions and certain reimbursement rules.

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September 16, 2024

Treatment Guidelines

California UR Doctors May Require Board Licensing

Senate Bill 636 awaits the Governor's signature.

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September 9, 2024

Industry Data Worker Safety

Connecticut Publishes Occupational Disease Report

Among 8,418 cases of occupational disease in 2022, musculoskeletal disorders were the most common, followed by infectious disease.

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September 9, 2024

Cost Containment

Florida Proposes Prior Auth Requirements for Packs and Kits

Requiring prior authorization would likely reduce utilization, and by extension reduce spend.

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September 9, 2024

Advocacy Opportunity Cost Containment

Ohio Issues Draft Rules for Outpatient Drug Payments

The AWP discount could go from a fixed 15% to a variable rate set by the BWC, with an annual review.

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September 9, 2024

Worker Safety

California’s Indoor Heat Protections Go into Effect

When temperatures reach 87°F, employers must implement work-rest schedules and provide personal heat protective equipment, where feasible.

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July 29, 2024

Industry Data Mental Health

WCRI Publishes Behavioral Health Report for New York State

About 3% of claims had services for behavioral health, representing 8% of total medical payments

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August 5, 2024

Industry Data

California WCRIB Releases State of the System Report

Pharmaceutical costs decreased 88% since 2012, but medical costs are increasing due to longer claim durations and inflationary updates to fee schedules.

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August 5, 2024

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Further resources you may be interested in

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

How Off-Label Prescribing Drives a Claim Off Course

Off-label prescribing, or the prescribing of drug therapies outside their approved use, occurs commonly with certain medications in workers’ comp

Bridging the Gap Between Opioid Policy and Prescribing

State and federal governments have taken legislative action to reduce the harm caused by the opioid epidemic

Polypharmacy: How Many Drugs is Too Many?

A claims professional noted that a patient’s drug regimen included 11 medications, raising serious concerns.

Myth Busters: Private-Label Topicals Edition

Private-label topical (PLT) analgesics are independently manufactured lotions and creams that are increasingly being prescribed to patients for the temporary relief of minor pain associated with injury.