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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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South Dakota Reports on Fee Schedule and Medical Trends

2025 relative values for physicians will be incorporated, while NCCI medical data was reviewed to compare state trends to national trends.
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November 3, 2025

Nevada Clarifies Provider Choice Requirements for First Responders

Since October 1st, first responders have been able to select their own physician for heart and lung claims under certain conditions.
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November 3, 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

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

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

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

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: 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

Colorado Discusses Exclusions from Treating Provider List

Stakeholders provided feedback on the DWC’s proposed rules.
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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.

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.
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California Bans Pre-Employment Marijuana Screening

Similar to a Washington law passed earlier this year, employees are not permitted to possess, to be impaired by, or to use cannabis on the job.
Read More
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