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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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CMS to Reduce Medicare Physician Fee

The physician fee schedule will be reduced by 2.93%, while other changes are in store for primary care, telehealth, and more.
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November 11, 2024

Vermont Seeks Stakeholder Input on Medical Fee Schedule

Written comments from stakeholders who use the fee schedule will be accepted until December 15th.
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November 11, 2024

California to Hold Webinar on 2024 Geo Study

The December 4th webinar will cover regional differences in the California workers’ comp system.
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November 11, 2024

Department of Justice Reaches $21.5 Million Settlement Over Inflated AWP for Compound Ingredients

According to the DOJ, Medisca Inc. purchased resveratrol at $0.37 a gram, sold it for under $2.00 a gram, but reported an AWP of $777 per gram.
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November 11, 2024

Psychedelic Study Shows Improvements in Anxiety without Hallucinations

When injected into the hippocampus, the compound DOI reduced anxiety in mice without causing hallucinations.
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November 4, 2024

Texas Seeks Input On 2025 Medical Quality Review Audit Plan

Comments will be accepted until 5:00 PM PST on November 22, 2024, and the Medical Advisor may adjust the plan based on feedback received.
Read More →
November 4, 2024

Pennsylvania Publishes Prescription Drug Trends Report

This report reviews drug payments between 2012 and 2022, reviewing usage and cost, generics, opioids, and topicals.
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November 4, 2024

Nevada to Hold Four Workers’ Comp Training Webinars

The webinars will cover basic orientation, the C-4 process and using the coverage verification system, the D-35 form, and medical billing.
Read More →
November 4, 2024

Mississippi Requests Stakeholder Input for 2025 Fee Schedule

No deadline for feedback has been given, but the Commission will consider feedback for fee schedule changes for 2025.
Read More →
November 4, 2024
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 Further resources you may be interested in

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

Connecticut Enacts Major COVID-19 Presumption

Beyond first responders and healthcare workers, essential workers including grocery store workers are now covered by workers’ comp.
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Department of Labor Audit: COVID-19’s Impact on Comp

A new report on how federal workers’ comp claims have been impacted.
Read More

Virginia Adopts Workplace Safety Standards for COVID-19

Standards are in place for PPE, social distancing, testing procedures, and more.
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FDA Approves Hulio for Rheumatoid Arthritis and More

Subcutaneous injections of the new biologic, adalimumab-fkjp, were approved for seven indications.
Read More

States Pass COVID-19 Liability Limitations

Arkansas and Louisiana enacted policies to protect businesses from civil liability stemming from COVID-19 exposure.
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WCRI Reports on Interstate Variation Trends in Drug Payments

Data from 28 states years found that NSAIDs and dermatological agents are seeing growth in spending.
Read More
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