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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 Releases 2026 Performance Based Oversight Assessment Plan

The assessment will be based on five key metrics of medical data reported to the DWC from January 1st to June 30th of 2026.
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November 3, 2025

NCCI Reports on Remote Work and Workers’ Comp Frequency

According to the NCCI, remote work makes up 20–30% of the U.S. workforce, up from 4–7% pre-pandemic.
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November 3, 2025

Colorado Discusses Exclusions from Treating Provider List

Stakeholders provided feedback on the DWC’s proposed rules.
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October 27, 2025

Texas: Key Updates from Quarterly Carrier Meeting

Findings from a gabapentin/pregabalin audit are expected in early 2026, the DWC addressed billing discrepancies, and more.
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October 27, 2025

Maryland Provides Update on Prescription Fee Guide

The Medical Fee Guide Committee also discussed PPO practices, psychiatric IMEs, and more.
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October 27, 2025

Texas Proposes Rule Change for Death Investigator Claims

The DWC is accepting public comments on rules that expedite medical benefits and the dispute resolution process until November 24th.
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October 27, 2025

California Publishes 2026 Audit Standards for Claims Administrators

The audits will assess compliance with workers’ comp laws, focusing on timely and accurate payments and proper issuance of medical evaluation notices.
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October 27, 2025

California: New Standards for Third Party Settlements

Effective January 1, 2026, this new law applies to injured peace officers and firefighters.
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October 27, 2025

Maryland Urges Accommodations for Policyholders Affected by Government Shutdown

Proposed accommodations include deferring premium payments, extending grace periods, and waiving late fees and penalties.
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October 27, 2025
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 Further resources you may be interested in

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

Cybersecurity Strategies to Balance Innovation & Caution in the Age of AI

Healthesystems AVP of Information & Technology Security, Tony Brown, will speak about this topic at the 2025 IAIABC Convention.
Read More

Tracking Sub-Regulatory Changes in Workers’ Comp

Healthe’s VP of Industry and State Affairs, Sandy Shtab, shares her thoughts with Risk & Insurance magazine in a recent article.
Read More

FDA Orders Opioid Manufacturers to Update Prescribing Information for Long-Term Use

All opioid manufacturers must update their drug labeling to align with a list of notes provided by the FDA.
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Burden of Proof: Unpacking Presumptions in Workers’ Comp

Exploring the expansion of presumptions in PTSD, cancers, and more.
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FDA Takes Steps to Restrict Certain Kratom Products

The FDA recommended concentrated 7-OH kratom products to be rescheduled under the Controlled Substances Act.
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The Emerging Role of AI in Workers’ Comp – and the Regulations Surrounding It

An expert Q&A with Sandy Shtab, VP of Industry and State Affairs, on AI in workers’ comp and the regulations surrounding it.
Read More
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