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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 Proposes Updates to Mental Health Treatment Guidelines

Public comments will be accepted on proposed guideline updates until December 19, 2025.
Read More →
November 24, 2025

NCCI Reports on Trends in Home Health and Skilled Nursing Facilities

Claims exceeding $1 million in costs saw a projected home health share of medical costs reach 20.1%.
Read More →
November 24, 2025

Minnesota Reports on Prescription Drug Price Transparency

Drug classes with the most new, high-priced drugs were anti-cancer drugs, ADHD/anti-obesity drugs, and anti-inflammatory pain medications.
Read More →
November 24, 2025

New York Bill Could Remove References to CDC Guidelines

Existing laws and guidelines that refer to CDC guidelines would shift to “nationally recognized clinical practice guidelines.”
Read More →
November 17, 2025

Texas Issues Data Call

The call focuses on annual experience and workers’ comp deductible plans for the period of January 1, 2025, through December 31, 2025.
Read More →
November 17, 2025

Wisconsin Introduces Significant Reform Bill

Assembly Bill 651 could impact benefits levels, PTSD presumptions, penalties, and more
Read More →
November 17, 2025

New Mexico Revises Rules for Fee Schedule Changes

Effective January 1st, CARC and RARC codes will be permitted for use in EOBs, leveraging nationally recognized standards.
Read More →
November 17, 2025

Massachusetts Advisory Council Discusses Medical Fee Schedule

The fee schedule has not been updated since 2009, resulting in low reimbursement rates, which has impacted access to care.
Read More →
November 17, 2025

CMS Finalizes 2026 Medicare Physician Fee Schedule

States that base their workers’ comp fee schedules on the CMS Fee Schedule may adopt these adjustments, which go into effect January 1st.
Read More →
November 17, 2025
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 Further resources you may be interested in

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

White House Pardons Simple Possession Charges for Marijuana

A recent proclamation applies to simple federal possession charges on or before December 22, 2023.
Read More

PTSD Presumptions Could See More Action in 2024

As legislative sessions open, several states have continued to introduce PTSD bills.
Read More

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.
Read More

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.
Read More

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

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

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