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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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California Bill Would Require EORs to Include Contract Information

Provider EORs would require contract-specific info. Not providing a requested contract in 30 days allows bills to be reprocessed at full fee schedule rates.
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September 15, 2025

Delaware Approves 125% Medicare Reimbursement Rate for E&M Procedures

The adjustment aims to address longstanding underpayment for E&M services, as low reimbursement has contributed to provider shortages.
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September 15, 2025

Study Finds Long COVID Linked to Productivity Loss

Participants who reported ongoing long COVID symptoms were more than three times more likely to report work productivity loss than those without persistent symptoms.
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September 8, 2025

CMS Publishes 2025 Q4 NCCI Edit Updates

The changes are effective October 1, replacing the 2025 Q3 versions.
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September 8, 2025

Ohio BWC to Refile Outpatient Medication Rules

The BWC withdrew its proposed outpatient medication reimbursement rules for self-insured employer claims due to a technical error.
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September 8, 2025

NCCI Publishes New Research Brief on Medical Fee Schedules

The report reviews how changes to CMS reimbursement rules may impact medical costs in workers’ comp.
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September 1, 2025

CPWR Publishes Report on Heat Injuries and Illness Among Construction Workers

While construction workers make up only 7% of the workforce, they account for more than one-third of occupational heat-related deaths in the U.S.
Read More →
September 1, 2025

New Jersey Now Requires Counseling for First Responders After Traumatic Incidents

Effective immediately, workers’ comp programs are required to pay for up to 12 hours of counseling following critical incidents.
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September 1, 2025

California Proposes Updates to Medical Treatment Utilization Schedule

Public comments can be made on the proposed changes until September 26th, at which point a hearing will be held.
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September 1, 2025
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 Further resources you may be interested in

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

The Real Promise of Artificial Intelligence in Healthcare and Workers’ Comp

Potential applications, benefits, pitfalls, questions, and the matter of regulation.
Read More

California Enacts Skin Cancer Presumptions for First Responder and Other Occupations

This law also includes lifeguards, and certain employees in the Departments of Fish and Wildlife and Parks and Recreation.
Read More

Changing Minds? Unlocking the Potential of Psychedelics in Mental Health Therapy

Clinical research indicates the potential for strong mental health applications.
Read More

Connecticut Enacts Cancer Presumption for Firefighters

Enacted as part of the state’s budget bill, this new regulation comes with stipulations and exclusions.
Read More

The Real Promise of Artificial Intelligence in Healthcare and Workers’ Comp

Potential applications, benefits, pitfalls, questions, and the matter of regulation
Read More

Wacky Weather: How Climate Change Is Impacting Workers’ Comp

Weather-related disasters are on the rise. How do weather and climate change affect workers and workers’ comp?
Read More
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