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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.

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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.

Marijuana Bills in Massachusetts, Nebraska, and South Dakota

Massachusetts is considering reimbursement, Nebraska works on medical use, and South Dakota considers revoking medical use.

February 3, 2025

NCCI Publishes Labor Market Insight Report

The report covers trend in employment growth, wages, and sectors most impacted.

January 27, 2025

WCRI Explores the Lifecycle of Claims in New York

The study examines overall claim cost, timing of key indemnity payments, and other system performance indicators.

January 27, 2025

Mental Health Presumptions

New York, Oklahoma, Oregon, and Washington Propose Updates to PTSD Presumptions

The updates vary across each state and for different occupations, but the trend of more PTSD presumptions around the country continues.

January 27, 2025

Cost Containment

Hawaii Bill Could Cap Nonprescription Drugs Reimbursement

The bill would cap nonprescription, over the counter, and non-legend drug reimbursements at the drug’s cost plus 40%.

January 27, 2025

Four States Consider Expanding Cancer Presumptions

Connecticut, Hawaii, Mississippi & Nebraska each introduced bills that would create or expand cancer presumptions.

January 27, 2025

Access to Care Cost Containment

Arizona Proposes Employer Pharmacy Network Bill

If passed, employees would be required to use network pharmacies effective December 31, 2025.

January 27, 2025

Virginia Considers Making Repetitive Trauma an Occupational Illness

The bill would apply when repetitive and sustained physical stress have occurred over a period of time.

January 20, 2025

Cost Containment

Illinois Bill Aims to Limit Custom Compound Reimbursements

If passed, the bill would limit reimbursements to a one-time, seven-day supply if no commercial equivalent exists.

January 20, 2025

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Further resources you may be interested in

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

2020 Workers’ Comp Industry Insights Survey & Infographic

Results, insights, and various stakeholder perspectives on important industry issues

FDA Approves Elyxyb Oral Solution for Migraines

Elyxyb (celecoxib) is an NSAID for the acute treatment of migraine with or without aura.

Live Better, Heal Better: Employee Wellness in Workers' Comp

How comorbidities, fatigue, and mental health impact claims management.

Texas Reminds Providers Certain Exams Must Be Done in Person

Maximum medical improvement (MME) and impairment rating (IR) evaluations cannot be done remotely.

Remdesivir a Potential Treatment for COVID-19?

The FDA allows emergency use in response to positive trials, but more research is needed.

State of the States

A roundup of regulatory activity around the country

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Workers' Comp Property and Casualty PBM
Expires 01/01/2028