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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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Texas DWC Quarterly Insurance Carrier Meeting Highlights

The meeting covered 2024 healthcare costs and utilization, along with incoming regulatory changes.
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July 21, 2025

Michigan Advisory Council Discusses 2026 Ruleset

The meeting covered fee schedule policies impacting physician-dispensed medication, electronic delivery for EOBs, and more.
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July 21, 2025

California P&T Committee Reviews Topical Analgesics 

The next meeting in October will deliver an expanded formulary list, with a review of the top five to ten exempt drugs based on utilization.
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July 21, 2025

WCRI Reports on High-Cost Claims with Rotator Cuff Disorders

In rotator cuff claims exceeding $65,000 in costs within 36 months of injury, surgery was present 85% of the time.
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July 14, 2025

WCRI Publishes Report on Post-Inflation Trends in Medical Payments

From 2021 to 2024, medical payments per claim increased by about 5% per year in most states, rebounding from earlier pandemic-related declines.
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July 14, 2025

New Jersey May Require Counseling for First Responders After Traumatic Incidents

Up to 12 hours of counseling must be provided by workers’ comp – with up to 24 hours more if a mental health professional finds it necessary.
Read More →
July 14, 2025

Maine Indefinitely Extends PTSD Presumption for First Responders

Set to expire on October 30th, the state’s PTSD presumption no longer faces an expiration date.
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July 14, 2025

California Proposes Multiple New Presumptions for Hospital Workers

Senate Bill 632 would grant these workers presumptions for musculoskeletal injuries, COVID-19, respiratory disease, cancer, and PTSD.
Read More →
July 14, 2025

California Reports on Independent Medical Reviews (IMRs)

The report reviews 1.57 million IMR decision letters from 2015 through March 2025.
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July 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.

Department of Health and Human Services Reveals Cannabis Rescheduling Findings

With many federal agencies in alignment, the ultimate decision rests with the DEA.
Read More

Growing Shifts in Child Labor Laws

Many states passed or proposed changes in 2023, with two states so far working on bills for 2024.
Read More

White House Pardons Simple Possession Charges for Marijuana

A recent proclamation applies to simple federal possession charges on or before December 22, 2023.
Read More

PTSD Presumptions Could See More Action in 2024

As legislative sessions open, several states have continued to introduce PTSD bills.
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This Year’s Top Insights in Workers’ Compensation Medical Management

As we enter 2024, let’s look at the top insights for workers’ comp managed care programs in 2023.
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White House Issues Executive Order on Artificial Intelligence

The order seeks increased transparency from AI companies regarding model operations, safety and privacy standards, and consumer/worker protections.
Read More
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