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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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Wisconsin to Gather Stakeholder Input for Legislative Changes

A public hearing on December 10th will gather stakeholder input, with written comments accepted by January 10, 2025.
Read More →
December 9, 2024

Texas Publishes Biennial Report to the 89th Legislature

Among a wide array of data, pharmacy spend decreased 71% from 2012-2022, with average cost per pharmacy claim dropping 38%, from $908 to $563.
Read More →
December 9, 2024

New York Governor Vetoes Increase to Prior Authorization Thresholds

The proposed bill would have required prior authorization on treatments above $1,500, instead of $1,000.
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December 9, 2024

New Mexico Workers’ Compensation Administration Publishes Annual Report

Claim frequency has trended down since 2019, with medical-only claims fluctuating and average per-claim costs peaking at $8,817 in 2022.
Read More →
December 9, 2024

Illinois Proposes AI Regulations for Health Insurers

House Bill 5918 would prohibit using AI or predictive models as the sole basis for denying, reducing, or terminating coverage.
Read More →
December 9, 2024

NCCI Publishes Injury Characteristics and Insights Dashboard

The dashboard examines data on cause of injury, nature of injury, body part grouping, and injury severity rankings.
Read More →
December 3, 2024

Texas Bill Could Make Infertility an Occupational Illness for First Responders

Senate Bill 454 proposes an infertility presumption for firefighters and EMTs for male and female reproductive systems.
Read More →
December 3, 2024

Oklahoma Issues Bulletin on Ethical AI Use in Insurance

While the bulletin outlines ways carriers can demonstrate compliance with state laws, it does not mandate specific practices or documentation.
Read More →
December 3, 2024

New Jersey Proposes Heat Protection Bills

Two identical bills were introduced to the Assembly and Senate, which would define excessive heat as 85 degrees or higher, with provisions for working in excessive heat.
Read More →
December 3, 2024
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 Further resources you may be interested in

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

States Pass COVID-19 Liability Limitations

Arkansas and Louisiana enacted policies to protect businesses from civil liability stemming from COVID-19 exposure.
Read More

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

States Limit COVID-19 Liability

Could Arkansas and Louisiana start a trend?
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COVID-19: Hydroxychloroquine and Remdesivir Updates

The malaria drug loses an EUA for COVID-19, while the FDA warns of drug interactions that can reduce antiviral effectiveness.
Read More

Growing Pains: The Shift from Opioids to Other Pain Therapies

With opioid utilization decreasing, what concerns do other pain therapies pose?
Read More
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