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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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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

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

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.
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June 16, 2025

Nevada Enacts Formulary and Changes for Provider Panels

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

CMS Publishes 2025 Q3 Updates to NCCI Edits

Medically unlikely edits were updated across DME, outpatient hospital services, and more.
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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.
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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.
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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.
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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.

California Proposes Psychedelics Pilot Program

Five treatment centers would offer psychedelic therapy for veterans and former first responders.
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Healthesystems at WCI 2024

Adjusters Assemble! Visit Healthe at Booth #921 to learn how we reduce day-to-day burdens for claims professionals.
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Child Labor Laws are Changing: How Could This Impact Workers’ Comp?

An increase in the teen workforce could impact workplace injury and claims management.
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New Jersey Proposes Worker Heat Protections, Continuing Recent Trend

As another state considers protections, WCRI publishes new data on heat’s impact on workplace accidents.
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More States Continue with PTSD Legislation

Oklahoma and Rhode Island enact new presumptions, with Georgia adding extra coverage.
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Maryland and Arizona Enact New Psychedelic Laws

A Maryland taskforce will plan regulation, while Arizona will tentatively cover MDMA treatment for first responders with PTSD.
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