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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Worker Safety

Congressional Bill Proposes Safety Standards for Wildland Firefighters

The bill would require federal agencies to determine appropriate protective equipment and under what conditions such equipment would be required.

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November 24, 2025

California Proposes Updates to Mental Health Treatment Guidelines

Public comments will be accepted on proposed guideline updates until December 19, 2025.

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November 24, 2025

Ancillary Services Claim Costs Cost Containment

NCCI Reports on Trends in Home Health and Skilled Nursing Facilities

Claims exceeding $1 million in costs saw a projected home health share of medical costs reach 20.1%.

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November 24, 2025

Cost Containment Pharmacy Data

Minnesota Reports on Prescription Drug Price Transparency

Drug classes with the most new, high-priced drugs were anti-cancer drugs, ADHD/anti-obesity drugs, and anti-inflammatory pain medications.

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November 24, 2025

Treatment Guidelines

New York Bill Could Remove References to CDC Guidelines

Existing laws and guidelines that refer to CDC guidelines would shift to “nationally recognized clinical practice guidelines.”

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November 17, 2025

Industry Data

Texas Issues Data Call

The call focuses on annual experience and workers’ comp deductible plans for the period of January 1, 2025, through December 31, 2025.

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November 17, 2025

Claims Procedures Presumptions

Wisconsin Introduces Significant Reform Bill

Assembly Bill 651 could impact benefits levels, PTSD presumptions, penalties, and more

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November 17, 2025

Billing & Payments Claims Procedures Cost Containment

New Mexico Revises Rules for Fee Schedule Changes

Effective January 1st, CARC and RARC codes will be permitted for use in EOBs, leveraging nationally recognized standards.

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November 17, 2025

Access to Care Advocacy Opportunity Cost Containment

Massachusetts Advisory Council Discusses Medical Fee Schedule

The fee schedule has not been updated since 2009, resulting in low reimbursement rates, which has impacted access to care.

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November 17, 2025

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Further resources you may be interested in

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

State of the Nation

Sandy Shtab, VP of Industry and State Affairs, shares policy perspectives.

Cannabis Drug Beats Opioids in Phase 3 Low Back Pain Trial

VER-01, a cannabis extract, outperformed both placebo and opioids in two late-stage clinical trials.

NCCI Publishes 2025 Regulatory and Legislative Trends Report

NCCI tracked 950 bills impacting workers’ comp, highlighting key trends across the country, such as PTSD and cancer presumptions, worker classification, and psychedelics.