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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Presumptions

States Consider Expanding Presumptions

Illinois, Pennsylvania, and Washington seek to expand current presumptions to additional occupations.

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December 22, 2025

Technology

AI Oversight Bills

Florida, Pennsylvania, and New Hampshire are open to AI in claims management, but would require humans to have the final say.

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December 22, 2025

Worker Safety

OSHA Issues Seven Letters of Interpretation for Workplace Safety and Health Requirements

These letters provide official explanations of agency requirements and how they apply to workplace situations and hazardous conditions.

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December 15, 2025

Industry Data

NCCI Economic Outlook for Q4 2025

This new report focuses on the economic impacts of the recent 43-day government shutdown.

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December 15, 2025

Claim Data Industry Data

NCCI Reports on Interstate Regional Cost Differences

The report provides a collection of actuarial metrics across three of the NCCI’s largest jurisdictions by population – Florida, Illinois, and Texas.

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December 15, 2025

Access to Care Claims Procedures

Indiana and Washington Introduce Provider Choice Bills

If enacted, Indiana House Bill 1069 would go into effect July 1, 2026, while Washington Senate Bill 5847 would go into effect June 30, 2027.

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December 15, 2025

Access to Care Claims Procedures

New York Pharmacy Network Bill Vetoed by Governor

The bill would have duplicated existing protections for filling certain prescription out-of-network.

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December 8, 2025

Access to Care

Expanding Access to Care Across the Country

Delaware reported success with a recent bill, while Washington State is undergoing rulemaking and the U.S. Senate introduced a new bill.

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December 8, 2025

Billing & Payments Cost Containment

Pennsylvania Supreme Court Reviews Drug Pricing Case

The case will examine the Bureau of Workers’ Compensation’s use of RED BOOK for calculating AWP.

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December 8, 2025

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Further resources you may be interested in

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

INFOGRAPHIC: Current State of Complex Claims in Workers’ Comp

Statistics from recent studies across the industry shed light on complex claims in workers' compensation.

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.