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

Texas: Key Updates from Quarterly Carrier Meeting

Findings from a gabapentin/pregabalin audit are expected in early 2026, the DWC addressed billing discrepancies, and more.

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October 27, 2025

Colorado Discusses Exclusions from Treating Provider List

Stakeholders provided feedback on the DWC’s proposed rules.

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October 27, 2025

Worker Safety

Educational Webinar: The Impact of California’s Heat Standard on Workers’ Comp

The 30-minute webinar will take place October 30th at 2:00 PM ET, highlighting findings from their recent report.

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October 20, 2025

Claim Costs Industry Data

WCRI Publishes 2025 Medical Benchmarks

Using data representing 60% of workers’ comp benefits nationwide, these reports examine trends in payments, prices, and utilization.

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October 20, 2025

Marijuana Psychedelics

California Enacts Bill to Expedite Research for Schedule I And Schedule II Drugs

Certain members of the Research Advisory Panel of California may conduct expedited reviews and approvals of research applications.

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October 20, 2025

Advocacy Opportunity Billing & Payments

Texas Accepting Public Comments on Proposed Billing and Processing Rule Repeals

Written comments will be accepted via email until November 10th.

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October 20, 2025

Advocacy Opportunity Cost Containment

Massachusetts Recap: Updates From the Fee Schedule Stakeholder Input Session

Fee schedule rates haven’t changed since 2009, and the low rates have discouraged provider participation.

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October 20, 2025

Access to Care Advocacy Opportunity Claims Procedures

Colorado Clarifies Provider List Sharing Rules For 2028 Reforms

While injured workers can choose any Level I or II provider from the DWC’s panel, employers and insurers may still share preferred or in-house lists.

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October 20, 2025

Advocacy Opportunity Treatment Guidelines

California Opens Public Comments on Proposed Updates to Traumatic Brain Injury Guidelines

Interested stakeholders must submit written comments by October 28th.

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October 20, 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.