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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.

FDA Approves New Acetaminophen Injection Dose

A new 500mg injection will soon be available.
Read More

2021 Workers’ Comp Industry Insights Survey Report

Over 600 stakeholders shared their thoughts on top industry challenges.
Read More

New York and New Hampshire Rule in Favor of Marijuana Reimbursement

Both State Supreme Courts ruled in favor of reimbursement.
Read More

FDA Approves Posimir for Post-Surgical Pain Relief

A novel bupivacaine formulation works as a 72-hour local anesthetic following shoulder surgery.
Read More

Wisconsin Announces Plan to Lower Prescription Drug Costs

State-led efforts to combat the drug price issue continue to emerge across the nation.
Read More

COVID-19 Mutations Impact Testing

False negatives may be reported due to genetic variations of the virus.
Read More
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