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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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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.
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June 9, 2025

CMS Publishes 2025 Q3 Updates to NCCI Edits

Medically unlikely edits were updated across DME, outpatient hospital services, and more.
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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.
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June 2, 2025

Delaware Proposes 3% Fee Schedule Increase for E&M Services

Supporters of the bill believe it will alleviate a shortage of physicians willing to accept workers’ comp patients.
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June 2, 2025

Colorado Discusses Interpreter Reimbursement at Stakeholder Meeting

The cost of interpreter services now surpasses prescription drug expenses, which has sparked much concern across different stakeholders.
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June 2, 2025

Arizona Issues Executive Order for Workplace Heat Safety Task Force

The taskforce will have until December 31, 2025 to issue employer guidelines.
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June 2, 2025

WCRI Publishes Medical Price Index

The study compares prices paid for medical services across 36 states from 2008 to 2024, representing 88% of workers’ comp benefits in the U.S.
Read More →
May 27, 2025

Tennessee Medical Advisory Committee Meeting Highlights

Topics addressed included changes to the fee schedule, utilization review, spinal therapy guidelines, and more.
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May 27, 2025

Maryland Enacts AI Bill for Health Insurance Utilization

The law requires carriers, pharmacy benefit managers, and private review agents to ensure AI decisions are based on an individual's clinical information.
Read More →
May 27, 2025
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 Further resources you may be interested in

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

Wisconsin Announces Plan to Lower Prescription Drug Costs

State-led efforts to combat the drug price issue continue to emerge across the nation.
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COVID-19 Mutations Impact Testing

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

Worker Classification Debate Continues Across the Country

The Department of Labor issued a new rule while special interest groups push for regulatory change.
Read More

The Department of Justice Sues Walmart Over Role in Opioid Crisis

Alleged violations of the Controlled Substances Act could result in billions of dollars in penalties.
Read More

Top 10 Disruptors of 2020 for the Workers’ Comp Industry

Initial insights from Healthesystems’ annual industry survey.
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FDA Authorizes Two COVID-19 Vaccines, At-Home Test, More Treatments

Vaccine candidates from Pfizer-BioNTech and Moderna received EUAs, as did the first at-home test that delivers results in 30 minutes, and two treatments for the virus.
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