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.

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WCRI Publishes Report on Psychosocial Impacts on Physical Therapy Outcomes

The presence of psychosocial risks causes functional scores to decrease 33% for workers’ comp patients with shoulder injuries.

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September 22, 2025

Claim Costs Industry Data Treatment Guidelines

CWCI Study Reports on Functional Restoration Programs

Only 42.8% of injured workers on FRPs had a chronic pain diagnosis, even though clinical guidelines recommend FRPs only for these cases.

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September 22, 2025

Advocacy Opportunity Billing & Payments Cost Containment

Oregon Seeks Stakeholder Recommendations for Medical Fee Schedule Rates

Public comments regarding fee and payment rules, medical services, and managed care organizations must be submitted by September 30th.

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September 22, 2025

Advocacy Opportunity Cost Containment Treatment Guidelines

Arizona to Hold Public Stakeholder Meeting on Topical Medications Regulation

The meeting will take place October 2nd and presents an opportunity to influence how topicals are regulated in the state workers’ comp system.

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September 22, 2025

Industry Data

NCCI Publishes Labor Market Insight Report

Job growth slowed to 22,000 in August, with declines in construction and manufacturing.

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September 15, 2025

Worker Safety

Pennsylvania Proposes Workplace Heat Protection Bill

The bill would require mandatory training on heat-related risks, emergency response planning, paid rest breaks and access to shade, and more.

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September 15, 2025

Training Opportunity

Nevada Offers Training Webinar for ODG Formulary

The webinar will take place on November 5th at 11:00 AM PST.

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September 15, 2025

Billing & Payments Cost Containment

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

Access to Care Ancillary Services

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

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Further resources you may be interested in

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

Changing Workforce, Claims Automation and Tech Connectivity Among Top Priorities in 2022 Industry Survey

The priorities and challenges revealed in our 2022 Workers’ Compensation Industry Insights Survey Report reflect an industry focused on moving forward.