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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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New York Bill Would Ensure Coverage During Disputes

Employers or insurers would be required to provide immediate medical treatment. If a claim is not compensable, they could seek reimbursement.
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April 21, 2025

Montana to Allow Physician Assistants and Physical Therapists to Treat Injured Workers

Physician assistants will be able to conduct impairment ratings, while physical therapists are now included in the definition of treating providers.
Read More →
April 21, 2025

California P&T Committee Meeting Recap

Healthe attended the April 16th meeting, capturing key updates regarding the pharmacy fee schedule and drug formulary.
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April 21, 2025

Wisconsin May Expand PTSD Presumption to Emergency Medical Workers and Others

The existing presumption only applies to firefighters and law enforcement officers, while this new bill would apply to other first responders.
Read More →
April 14, 2025

Ohio Withdraws Outpatient Medication Reimbursement Rules

Filed in October 2024, the amendments aimed to adjust AWP discount rates and standardize dispensing fees.
Read More →
April 14, 2025

Nevada Now Considering Evidence-Based Formulary After Bill Hearing

Senate Bill 317 originally focused on provider panels, but a recent hearing amended the bill to include a workers’ comp formulary.
Read More →
April 14, 2025

Louisiana Proposes a Workers’ Comp Fee Schedule

The bill could require biennial updates, utilizing RVUs form the resource-based relative value scale (RBRVS).
Read More →
April 14, 2025

California Releases Report on Independent Medical Reviews

A total of 199,651 IMR applications were received in 2024, with pharmaceuticals making up 32.7%.
Read More →
April 14, 2025

California P&T Committee to Meet on April 16th

The hybrid meeting will cover the pharmacy fee schedule, biosimilars, cannabis coverage, and payments for topical drugs.
Read More →
April 14, 2025
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 Further resources you may be interested in

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

Texas Division of Workers’ Compensation Publishes Biennial Report to Legislature

This report contains a high level report on the status of the Texas workers’ comp system.
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CDC Publishes Updated Opioid Guidelines

An update to the 2016 guidelines has been issued, promoting greater flexibility for individualized patient-centered care.
Read More

Midterm Marijuana Legalization

Maryland and Missouri voters pass recreational legalization.
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State of the States

A roundup of regulatory activity around the country
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Federal Bill Could Settle Worker Classification Debate for Gig Workers

If enacted, this bill would create an exemption where gig workers do not receive employee benefits.
Read More

There Is No “Set it and Forget It” Amid Prescription Drug Trends

As opioid prescribing continues to decline, more nuanced and population-specific drug trends emerge as cost drivers.
Read More
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