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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Tennessee Medical Advisory Committee Meeting Highlights

Topics addressed included changes to the fee schedule, utilization review, spinal therapy guidelines, and more.

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May 27, 2025

Claim Costs Industry Data

WCRI Publishes Medical Price Index

The study compares prices paid for medical services across 36 states from 2008 to 2024, representing 88% of workers’ comp benefits in the U.S.

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May 27, 2025

Cyber Risk Technology

Congressional Budget Bill Would Place a 10-Year Ban on State AI Regulations

If passed with this recent amendment, the bill would prevent the enforcement of laws on AI models and automated decision systems.

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May 19, 2025

Marijuana Training Opportunity

ACOEM Webinar to Cover Cannabis Guidelines

The May 21st webinar will examine medical literature on cannabis for acute, chronic, and postoperative pain.

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May 19, 2025

Presumptions

Connecticut Updates Cancer Coverage for Firefighters

In addition to now covering skin cancer, the state will handle cancer cases differently and adjust the five-year service requirement.

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May 19, 2025

Worker Classification

Oklahoma Employers Can Now Exclude Unpaid Temp Workers from Workers’ Comp

Unpaid temp workers who are working for experience will no longer be considered employees entitled to workers’ comp coverage.

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May 19, 2025

Access to Care

New York Expands Provider Access with Residency and Fellowship Programs

Effective immediately, 20,000 residents and fellowship physicians in ACGME programs can now treat injured workers, under faculty supervision.

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May 19, 2025

Advocacy Opportunity Cost Containment

New York PBM Bill Enacted with Exemption for Workers’ Comp

The exemption reduces unnecessary burden and grows recognition that workers’ comp PBMs operate differently from traditional PBMs.

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May 19, 2025

Industry Data

Recapping the NCCI Annual Insights Symposium

Healthesystems attended the event, summarizing major highlights from the symposium.

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May 19, 2025

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Further resources you may be interested in

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

DEA to Reschedule Marijuana

While bureaucratic wheels may take time, marijuana will become a Schedule III drug soon.

Triple Threat: Healthcare Fraud, Waste and Abuse in Workers' Comp

A current look at fraud, waste and abuse in workers’ comp pharmacy and medical services with strategies for management, including next-generation strategies involving AI.

Child Labor Laws Are Changing: How Could This Impact Workers’ Comp?

An increase in the teen workforce could impact workplace injury and claims management

Extreme Weather: How Climate Change Impacts Workers and Workers’ Compensation

While everyone is affected by climate change, it’s often those on the front lines who feel it the most – those who work outdoors, in hot indoor environments, or in emergency response.