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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.

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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.

Mental Health Presumptions

Minnesota Releases PTSD Report

At over 200 pages, this comprehensive report includes a review of PTSD claims in the workers’ comp system.

August 11, 2025

Pennsylvania Proposes Cannabis Reimbursement Bill

If enacted, insurers would be required to reimburse up to $250 per month for qualified medical use.

August 11, 2025

Senate Introduces Federal Heat Standard Bill

If enacted, OSHA would be required to adopt a federal standard for enforceable protections.

August 11, 2025

Cost Containment

South Dakota Approves Rulemaking for Physician Fee Schedule

The 2025 Optum RVPs for medical services and treatments will be adopted, but with current conversion factors.

August 11, 2025

Claim Costs Industry Data

NCCI Reports on Medical Inflation Highlights

While overall medical inflation remains low, certain tariffs are still pending, which could impact long-term costs.

August 4, 2025

Claim Costs Cost Containment Industry Data

California Publishes 2025 State of the System Report

Medical costs went up 8% in 2024, driven by increased utilization, fee schedule inflation, and growth in medical-legal services.

August 4, 2025

Advocacy Opportunity Cost Containment

California Sees Delay to Utilization Review Regulations

The Office of Administrative Law informed the DWC that seven areas of the proposed update required additional clarification or public notice.

August 4, 2025

NCCI Publishes Labor Market Insights

147,000 new jobs were reported in June, though half were driven by likely-seasonal education jobs.

July 28, 2025

NCCI Publishes Industry Trends Report

While claim severity decreased across all industries, construction saw the steepest decline since 2015.

July 28, 2025

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Further resources you may be interested in

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

Connecticut Passes PTSD Presumption for All Employees

Employees who experience a qualifying traumatic event on the job can receive PTSD coverage via workers’ comp.

Washington State Bans Pre-Employment Cannabis Screening

As other states come closer to recreational legalization, Washington State pushes the needle further.

Marijuana Reimbursement Initiatives See Signs of Life

Three states have introduced bills or seen court cases overturned in relation to this policy.

Fifth Annual Industry Insights Survey Reveals Evolving Needs in Workers’ Comp

Explore the top five major findings from this year’s Workers’ Comp Industry Insights Survey.

NCCI Publishes Research Brief on Firefighter Presumptions

Beyond PTSD, cancers, heart conditions, and communicable diseases are seeing legislative activity.

State of the States

A roundup of regulatory activity around the country

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Workers' Comp Property and Casualty PBM
Expires 01/01/2028