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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.

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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.

Access to Care Ancillary Services

Oregon Expands Waiver Enforcement for Sign Language Interpreters

The extension will allow sign language interpreters with temporary licenses to continue providing services through June 30, 2026.

June 30, 2025

Access to Care Cost Containment

Connecticut Adjusts Process to Update Fee Schedules

Effective July 1st, fee schedule adjustments can be made by the Workers’ Compensation Commission without revenue neutrality.

June 30, 2025

Cost Containment

WCRI Publishes New Report on Medical Fee Schedule Design

The study compares workers’ comp fee schedules for professional services to Medicare rates within 44 states, accounting for 41% of medical costs.

June 30, 2025

Advocacy Opportunity Industry Data

Washington Advisory Committee Meeting Highlights

The meeting focused on long-term disability claims, going into IMEs and PTSD claims.

June 30, 2025

Advocacy Opportunity Cost Containment Treatment Guidelines

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.

June 16, 2025

Cost Containment Treatment Guidelines

Nevada Enacts Formulary and Changes for Provider Panels

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

June 16, 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.

June 16, 2025

Claim Costs Industry Data Pharmacy Data

Texas Publishes 2024 Health Care Cost and Utilization Report

Pharmacy service costs fell 40% - or $28 million dollars – from 2018 through 2023.

June 9, 2025

Technology Treatment Guidelines

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.

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.

More States Consider Cancer Presumptions for Firefighters

Different types of cancers are being added to pre-existing presumptions.

Visit Healthesystems at RISKWORLD 2024

Pick up a copy of the new Summer 2024 edition of RxInformer magazine, and learn how Healthe is transforming healthcare.

AI Utilization Review Bills Appear Across the Country

California, Georgia, New York, Oklahoma, and Pennsylvania could start a national trend.

Three More States Introduce Psychedelics Bills, While FDA Sets MDMA Decision Date

Connecticut, Missouri, and New Hampshire join 10 other states considering psychedelics bills.

2024 Workers’ Comp Industry Insights Survey Report

This sixth annual survey report highlights the top challenges and priorities of 500 industry professionals.

U.S. Department of Labor Issues Final Rule on Worker Classification

The rule clarifies differences between employees and contractors, establishing who is entitled to benefits – including workers’ comp.

« Previous 1 … 13 14 15 16 17 … 47 Next »

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Workers' Comp Property and Casualty PBM
Expires 01/01/2028