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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Access to Care

Nevada Provider Panel Bill Fails

Assembly Bill 469 missed a committee deadline, removing it from consideration this legislative session.

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April 28, 2025

Worker Safety

Nevada Heat Safety Rules to Take Effect April 29th

Employers with over 10 employees working outdoors, or indoors without climate control, must adhere to the new rules.

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April 28, 2025

Cost Containment

Louisiana Fee Schedule Bill Amended with Hopes of Compromise

In addition to bill amendments, the bill has been deferred for one week to allow for additional review and stakeholder input.

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April 28, 2025

Advocacy Opportunity Cost Containment

California DWC Launches Test Pilot for New Pharmacy Fee Calculator

The pilot test will run from April 24 to May 8, 2025, allowing stakeholders to provide feedback to the DWC.

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April 28, 2025

Advocacy Opportunity Worker Safety

OSHA to Hold Public Hearing on Heat Injury and Illness Prevention

A June 16th virtual hearing will discuss proposed rules, and those interested in speaking must register by May 2nd.

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April 21, 2025

Ancillary Services Billing & Payments

CMS Publishes Update to NCCI Medically Unlikely Edits

The update includes a revised MUE value for certain HCPCS codes, retroactive to October 1, 2024.

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April 21, 2025

Billing & Payments

New York Bill Would Ensure Coverage During Disputes

Employers or insurers would be required to provide immediate medical treatment. If a claim is not compensable, they could seek reimbursement.

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April 21, 2025

Access to Care

Montana to Allow Physician Assistants and Physical Therapists to Treat Injured Workers

Physician assistants will be able to conduct impairment ratings, while physical therapists are now included in the definition of treating providers.

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April 21, 2025

Cost Containment Treatment Guidelines

California P&T Committee Meeting Recap

Healthe attended the April 16th meeting, capturing key updates regarding the pharmacy fee schedule and drug formulary.

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April 21, 2025

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Further resources you may be interested in

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

Rebuilding the Recovery Model: Balancing the Patient and the Big Picture

A message from the Chief Executive Officer

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.