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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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Missouri Proposes Bill for Psilocybin Therapy

Medical use would be legalized, with legal protections for patients and physicians.
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December 16, 2024

California Publishes 2024 Geo Study

The new WCRIB study focuses on regional disparities in workers’ comp claim patterns from 2013-2022.
Read More →
December 16, 2024

Texas Seeks Input on Telemedicine Expansion for MMI Certifications

Stakeholders can email written comments to the DWC until January 13, 2025.
Read More →
December 9, 2024

CMS Publishes 2025 Q1 Updates to NCCI Edits

Changes will impact DME supplier services, facility outpatient hospital services, and practitioner services.
Read More →
December 9, 2024

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.
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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.
Read More →
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
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 Further resources you may be interested in

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

State of the States

A roundup of regulatory activity around the country
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IQVIA Reports on Healthcare Shifts in the COVID-19 Era

A new study explores patients’ use of health services, the impact on medicine use, research activity, and more.
Read More

California Executive Order Greatly Expands COVID-19 Presumption

Many states expanded workers’ comp for COVID-19, but California casts a wider net.
Read More

By the Numbers: Covid-19 Edition

A collection of facts and figures surrounding the COVID-19 pandemic
Read More

NCCI Publishes COVID-19 Resource Center

Lists of compiled information on telehealth, public notices, and more.
Read More

New York Postpones Formulary Deadlines

Providers receive more time in light of system disruptions due to COVID-19
Read More
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