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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Presumptions

West Virginia Proposes Expansion to Firefighter Cancer Presumptions

If passed, House Bill 2197 would extend coverage to bladder cancer, mesothelioma, and testicular cancer.

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February 17, 2025

Opioids Presumptions

New York Considers Presumption for Opioid Overdose Deaths

The bill would require that deceased workers had received an opioid prescription for their workplace injury.

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February 17, 2025

Access to Care

New York Could Permit Massage Therapists to Act as Workers’ Comp Providers

If passed, massage therapists could provide care but would not be permitted to establish workplace injury causation or disability.

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February 17, 2025

Access to Care

Montana Considers Provider Choice Bill for Injured Workers

Provider choice would have to take into account practical matters, such as proximity and the ability to comply with workers’ comp care guidelines.

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February 17, 2025

Access to Care

Maryland Bills Could Expand Social Worker’s Authority

One bill would allow them to determine mental impairment, while another would let licensed clinical social workers to provide rehabilitation service.

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February 17, 2025

Mental Health Presumptions

Kentucky Proposes PTSD Presumption

If passed, the presumption would apply to police officers, fire fighters, EMTs, and “frontline staff” which includes other occupations.

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February 17, 2025

Mental Health Psychedelics

Illinois Introduces Psilocybin Therapy Bill

Along with the supervised therapeutic use, the bill would implement a sales tax, public education, and much more.

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February 17, 2025

Advocacy Opportunity Marijuana Treatment Guidelines

California Proposes Updates to Medical Treatment Utilization Schedule

The updates would incorporate evidence-based revisions to Chronic Pain Guidelines and Cannabis Guidelines from ACOEM.

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February 17, 2025

Claim Costs Industry Data

NCCI Publishes Mega Claims Report

Mega claims – with losses over $2 million – represent less than 0.1% of claims, but over 2% of total loss dollars.

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February 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.

Side Effects: COVID-19-Related Healthcare and Pharmacy Trends Impacting Workers’ Comp

The pandemic has disrupted access to care, but the industry has implemented reactive measures

Returning to Work in the COVID-19 Era

Considerations for infection prevention, unique population factors, and more

Moving Forward: How Should Opioid Guidance Continue to Evolve?

Opioid use has decreased, prompting calls for reform, but COVID-19 complicates opioid use

COVID-19 Infection Risks and Mental Health Impact Among Grocery Workers

Direct customer exposure is associated with a five-fold risk of infection, while less social distancing in the workplace is tied to depression and anxiety.