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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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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

California P&T Committee Reviews Drug List Changes

The July 16th meeting will review upcoming MTUS changes, which go into effect August 6th.
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July 14, 2025

Wisconsin WCAC Meeting Shares Key Regulatory Updates

Among other updates, Wisconsin will implement a hospital fee schedule by July 1, 2027.
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July 14, 2025

Alaska Considers Reimbursement Changes for Home Health, DME, And Ambulance Services

The proposed changes will be discussed further in the next meeting on July 18th.
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July 14, 2025

WCRI Publishes Overview of AI Promises and Challenges

The study is based on an exploration of literature and interviews with 34 leaders across workers’ comp.
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June 30, 2025

Oregon Publishes Biennial Premium Rate Comparison Study

The study focuses on Oregon’s 50 largest industry classes, comparing data to every other state in the country.
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June 30, 2025

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.
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June 30, 2025

Connecticut Adjusts Process to Update Fee Schedules

Effective July 1st, fee schedule adjustments can be made by the Workers’ Compensation Commission without revenue neutrality.
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June 30, 2025

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.
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June 30, 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.
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Growing Shifts in Child Labor Laws

Many states passed or proposed changes in 2023, with two states so far working on bills for 2024.
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White House Pardons Simple Possession Charges for Marijuana

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