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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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Nevada Enacts Formulary and Changes for Provider Panels

The DIR must adopt the ODG formulary by July 1, 2027.
Read More →
June 16, 2025

New York Clarifies When Injured Workers Can Use Out of Network Pharmacies

Effective July 11th, the updated rules apply to controverted claims and other dispute conditions.
Read More →
June 16, 2025

Texas Publishes 2024 Health Care Cost and Utilization Report

Pharmacy service costs fell 40% - or $28 million dollars – from 2018 through 2023.
Read More →
June 9, 2025

Connecticut, Nebraska, Nevada, and Texas Introduce AI Regulation Bills

These different bills would prevent AI from denying, delaying, modifying, or making clinical decisions in healthcare.
Read More →
June 9, 2025

Colorado Injured Workers Can Now Choose Any Treating Provider

Injured workers may now choose any Level I or II accredited physician licensed under the Colorado Medical Practice Act.
Read More →
June 9, 2025

CWCI Publishes Report on Long-COVID

Long COVID cases made up 4.7% of COVID claims, totaling 6,000 claims, yet medical payments for long COVID claims was $105 million.
Read More →
June 9, 2025

Arizona Seeks Stakeholder Input on Prescription Topicals

The meeting will take place on June 12th, aiming to explore current trends, challenges, and proposed solutions related to these drugs.
Read More →
June 9, 2025

CMS Publishes 2025 Q3 Updates to NCCI Edits

Medically unlikely edits were updated across DME, outpatient hospital services, and more.
Read More →
June 9, 2025

Tennessee Expands PTSD Benefits for First Responders

Law enforcement officers and emergency medical responders will receive the same benefits previously granted to fire fighters.
Read More →
June 2, 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 Issues Vaccine Mandate

All federal employees are impacted, as are companies with 100 or more employees.
Read More

Stepping Up to Take on Pandemic Ripple Effects

A message from the Chief Executive Officer
Read More

Classification Complications: Will Gig Workers Enter the Workers’ Comp Market?

Legislation could reclassify gig workers as employees, which could entitle them to benefits
Read More

The Long Haul: Chronic Health Complications of COVID-19

Those previously infected by coronavirus may face long-term health complications, potentially complicating workers' comp claims
Read More

How Opioid Policy Impacts Opioid Utilization and Disability

A new WCRI report explores the impact recent opioid legislation has had on injured worker care.
Read More

The Early Impact of COVID-19 on Workers’ Comp Claims

Another WCRI report looks at non-COVID-19 claims with injuries in the first two quarters of 2019 and 2020.
Read More
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