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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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New York Bill Would Ensure Coverage During Disputes

Employers or insurers would be required to provide immediate medical treatment. If a claim is not compensable, they could seek reimbursement.
Read More →
April 21, 2025

CMS Publishes Update to NCCI Medically Unlikely Edits

The update includes a revised MUE value for certain HCPCS codes, retroactive to October 1, 2024.
Read More →
April 21, 2025

OSHA to Hold Public Hearing on Heat Injury and Illness Prevention

A June 16th virtual hearing will discuss proposed rules, and those interested in speaking must register by May 2nd.
Read More →
April 21, 2025

California P&T Committee to Meet on April 16th

The hybrid meeting will cover the pharmacy fee schedule, biosimilars, cannabis coverage, and payments for topical drugs.
Read More →
April 14, 2025

California Releases Report on Independent Medical Reviews

A total of 199,651 IMR applications were received in 2024, with pharmaceuticals making up 32.7%.
Read More →
April 14, 2025

Louisiana Proposes a Workers’ Comp Fee Schedule

The bill could require biennial updates, utilizing RVUs form the resource-based relative value scale (RBRVS).
Read More →
April 14, 2025

Nevada Now Considering Evidence-Based Formulary After Bill Hearing

Senate Bill 317 originally focused on provider panels, but a recent hearing amended the bill to include a workers’ comp formulary.
Read More →
April 14, 2025

Ohio Withdraws Outpatient Medication Reimbursement Rules

Filed in October 2024, the amendments aimed to adjust AWP discount rates and standardize dispensing fees.
Read More →
April 14, 2025

Wisconsin May Expand PTSD Presumption to Emergency Medical Workers and Others

The existing presumption only applies to firefighters and law enforcement officers, while this new bill would apply to other first responders.
Read More →
April 14, 2025
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 Further resources you may be interested in

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

The Real Promise of Artificial Intelligence in Healthcare and Workers’ Comp

Potential applications, benefits, pitfalls, questions, and the matter of regulation
Read More

Wacky Weather: How Climate Change Is Impacting Workers’ Comp

Weather-related disasters are on the rise. How do weather and climate change affect workers and workers’ comp?
Read More

Missouri Enacts PTSD Presumption for First Responders

The national trend continues, in this case with qualifying events and the inclusion of 911 dispatchers.
Read More

FDA Publishes Guidance on Clinical Trials for Psychedelic Drugs

These guidelines advise researchers on study design and other considerations as they develop medications that contain psychedelics.
Read More

Connecticut Passes PTSD Presumption for All Employees

Employees who experience a qualifying traumatic event on the job can receive PTSD coverage via workers’ comp.
Read More

Washington State Bans Pre-Employment Cannabis Screening

As other states come closer to recreational legalization, Washington State pushes the needle further.
Read More
1 … 15 16 17 18 19 … 46
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