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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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New York Governor Vetoes Increase to Prior Authorization Thresholds

The proposed bill would have required prior authorization on treatments above $1,500, instead of $1,000.
Read More →
December 9, 2024

New Mexico Workers’ Compensation Administration Publishes Annual Report

Claim frequency has trended down since 2019, with medical-only claims fluctuating and average per-claim costs peaking at $8,817 in 2022.
Read More →
December 9, 2024

Illinois Proposes AI Regulations for Health Insurers

House Bill 5918 would prohibit using AI or predictive models as the sole basis for denying, reducing, or terminating coverage.
Read More →
December 9, 2024

NCCI Publishes Injury Characteristics and Insights Dashboard

The dashboard examines data on cause of injury, nature of injury, body part grouping, and injury severity rankings.
Read More →
December 3, 2024

Texas Bill Could Make Infertility an Occupational Illness for First Responders

Senate Bill 454 proposes an infertility presumption for firefighters and EMTs for male and female reproductive systems.
Read More →
December 3, 2024

Oklahoma Issues Bulletin on Ethical AI Use in Insurance

While the bulletin outlines ways carriers can demonstrate compliance with state laws, it does not mandate specific practices or documentation.
Read More →
December 3, 2024

New Jersey Proposes Heat Protection Bills

Two identical bills were introduced to the Assembly and Senate, which would define excessive heat as 85 degrees or higher, with provisions for working in excessive heat.
Read More →
December 3, 2024

Nevada Enacts Worker Heat Protections

Businesses with more than 10 employees will be required to follow these regulations, 90 days after the filing date of November 15th.
Read More →
December 3, 2024

California Reports on Inflation’s Impact on State Fee Schedule

The CWCI notes that cumulative percent increases to the Official Medical Fee Schedule have been lower than economy-wide inflation.
Read More →
December 3, 2024
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 Further resources you may be interested in

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

By the Numbers

A collection of workers’ compensation facts and figures
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FDA Requires Boxed Warning Update for Benzodiazepines

Even at recommended doses, benzodiazepine use can lead to misuse, abuse, and addiction.
Read More

Purdue, OxyContin Manufacturer, Loses Federal Case and Will Shut Down

The drug manufacturer is pleading guilty and paying out billions.
Read More

California COVID-19 Report

COVID-19 claim data through October 5th has been captured and broken down by industry, age, region, and more.
Read More

FDA Approves Two New Opioids

Olinvyk injections and Qdolo oral solution are approved for the management of acute pain.
Read More

Side Effects: COVID-19-Related Healthcare and Pharmacy Trends

With the pandemic disrupting the healthcare system, how has workers’ comp been impacted?
Read More
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