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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 Tracking

To track relevant regulatory trends across the nation, access our interactive map.
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Regulatory Recap

A weekly e-newsletter informed by our Advocacy & Compliance team to help keep our clients and industry contacts in the know on the latest legislation and policy updates impacting workers' comp. Explore our complete article repository below.

New York Clarifies When Injured Workers Can Use Out of Network Pharmacies

Effective July 11th, the updated rules apply to controverted claims and other dispute conditions.
Read More →
June 16, 2025

Nevada Enacts Formulary and Changes for Provider Panels

The DIR must adopt the ODG formulary by July 1, 2027.
Read More →
June 16, 2025

Arizona Commission Discusses Trends and Solutions for Topical Prescriptions

Fee schedule clarity and defined reimbursement caps were discussed as ways to reduce ambiguity and prevent payment disputes.
Read More →
June 16, 2025

CMS Publishes 2025 Q3 Updates to NCCI Edits

Medically unlikely edits were updated across DME, outpatient hospital services, and more.
Read More →
June 9, 2025

Arizona Seeks Stakeholder Input on Prescription Topicals

The meeting will take place on June 12th, aiming to explore current trends, challenges, and proposed solutions related to these drugs.
Read More →
June 9, 2025

CWCI Publishes Report on Long-COVID

Long COVID cases made up 4.7% of COVID claims, totaling 6,000 claims, yet medical payments for long COVID claims was $105 million.
Read More →
June 9, 2025

Colorado Injured Workers Can Now Choose Any Treating Provider

Injured workers may now choose any Level I or II accredited physician licensed under the Colorado Medical Practice Act.
Read More →
June 9, 2025

Connecticut, Nebraska, Nevada, and Texas Introduce AI Regulation Bills

These different bills would prevent AI from denying, delaying, modifying, or making clinical decisions in healthcare.
Read More →
June 9, 2025

Texas Publishes 2024 Health Care Cost and Utilization Report

Pharmacy service costs fell 40% - or $28 million dollars – from 2018 through 2023.
Read More →
June 9, 2025
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 Further resources you may be interested in

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

Sleep Woes: Fatigue in the Workplace

Sleep deprivation and fatigue have far-reaching consequences in the workplace, from poor productivity to injury or death.
Read More

Expert Q&A: Cybersecurity Tactics in Workers’ Compensation

RxInformer editors sat down with Healthesystems’ AVP of Information Security and resident cybersecurity expert, Tony Brown, to discuss how cyber threats affect workers’ comp organizations.
Read More

Drug Pricing Legislation and Its Impact on Workers' Comp

Lawmakers look to regulate the U.S. drug supply chain in ways that could impact workers’ comp pharmacy management.
Read More

High Prices, High Impact: Meet the Drugs Driving Up Claim Costs in Workers’ Comp

High-impact drugs, including topicals and compounds, represent proportionately low utilization compared to opioids or NSAIDs, but they can increase pharmacy spend exponentially on impacted claims.
Read More

State of the Nation

A roundup of regulatory activity around the country
Read More

Congress Urges USPS to Adopt Department of Labor’s Proposed Heat Protections

The push comes after a letter carrier died after working without air conditioning in 95° weather.
Read More
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 Interactive Map

To interact with this map, use the drop-downs to select a topic and type, then click the Display button. You can then roll over and click on individual states for more detailed information. This map represents legislation proposed during the most recent legislative cycle, typically spanning two years in most states. All current regulations are displayed up to present.
The content above is representative of topics Healthesystems proactively monitors and reports on. While not all topics are directly applicable to workers' compensation claims, some may have potential to impact workers' compensation in the future.
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