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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Advocacy Opportunity Treatment Guidelines

California Proposes Updates to Medical Treatment Utilization Schedule

Public comments can be made on the proposed changes until September 26th, at which point a hearing will be held.

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September 1, 2025

Advocacy Opportunity Cost Containment

Tennessee Medical Payments Committee Meeting Highlights

Discussions centered around the proposed medical fee schedule, particularly the Medicare negotiated pricing for pharmaceuticals.

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September 1, 2025

Cyber Risk Technology

Wisedocs Publishes Survey Report on AI In Claims

Over 65 claims professionals were surveyed on their thoughts surrounding AI in the insurance industry.

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August 25, 2025

Opioids

FDA Orders Opioid Manufacturers to Update Prescribing Information for Long-Term Use

Labeling changes must address safety considerations including the limited use of extended-release formulations, safe discontinuation, and more.

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August 25, 2025

Access to Care Advocacy Opportunity

Oregon’s MLAC Discusses Access to Care

Two recent committee meetings addressed access to care, exclusive remedy, and more.

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August 25, 2025

Advocacy Opportunity Cost Containment Treatment Guidelines

California Shares Key Updates at CHWSC Meeting

Topics covered included recent MTUS updates, the pharmacy fee schedule update, UR and IMR updates, and more.

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August 18, 2025

Advocacy Opportunity

Texas Requests Feedback for 2026 Research Agenda

Stakeholders can submit feedback on the research agenda by September 15th.

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August 18, 2025

Advocacy Opportunity Cost Containment

Oklahoma Solicits Public Feedback on Medical Fee Schedule

Public comments will be accepted on the current fee schedule until September 7th.

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August 18, 2025

Presumptions

Michigan Proposes Cancer Presumption for Medical Examiners

The presumption would cover a wide variety of cancers for medical examiners with 60 months of active duty, or exposure to certain hazardous incidents.

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August 18, 2025

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Further resources you may be interested in

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

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.

Positive Marijuana Screenings Increase – What More to Expect with Rescheduling?

New data from Quest Diagnostics 2024 Drug Testing Index, and industry leaders discuss how rescheduling will impact workers’ comp.

Physician Dispensing Concerns in Workers’ Compensation

Physician dispensing represents an ongoing challenge for today’s workers’ comp payers – not only from a cost perspective, but from clinical and safety perspectives.