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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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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%.
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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.
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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.”
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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

White House Announces Deal to Expand Access to GLP-1 Medications

Qualifying CMS patients could face a co-pay of $50 a month for these highly popular drugs for obesity and diabetes.
Read More →
November 10, 2025
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 Further resources you may be interested in

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

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.
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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.
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The Cannabis Question: Marijuana and Workplace Safety?

With greater legalization and public approval, the question of safety grows more important.
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Rhode Island Legalizes Recreational Marijuana

A total of 19 states now allow for recreational marijuana in adults aged 21 and older.
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