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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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Texas Proposes Rule Change for Death Investigator Claims

The DWC is accepting public comments on rules that expedite medical benefits and the dispute resolution process until November 24th.
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October 27, 2025

Maryland Provides Update on Prescription Fee Guide

The Medical Fee Guide Committee also discussed PPO practices, psychiatric IMEs, and more.
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October 27, 2025

Texas: Key Updates from Quarterly Carrier Meeting

Findings from a gabapentin/pregabalin audit are expected in early 2026, the DWC addressed billing discrepancies, and more.
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October 27, 2025

Colorado Discusses Exclusions from Treating Provider List

Stakeholders provided feedback on the DWC’s proposed rules.
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October 27, 2025

Educational Webinar: The Impact of California’s Heat Standard on Workers’ Comp

The 30-minute webinar will take place October 30th at 2:00 PM ET, highlighting findings from their recent report.
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October 20, 2025

WCRI Publishes 2025 Medical Benchmarks

Using data representing 60% of workers’ comp benefits nationwide, these reports examine trends in payments, prices, and utilization.
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October 20, 2025

California Enacts Bill to Expedite Research for Schedule I And Schedule II Drugs

Certain members of the Research Advisory Panel of California may conduct expedited reviews and approvals of research applications.
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October 20, 2025

Texas Accepting Public Comments on Proposed Billing and Processing Rule Repeals

Written comments will be accepted via email until November 10th.
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October 20, 2025

Massachusetts Recap: Updates From the Fee Schedule Stakeholder Input Session

Fee schedule rates haven’t changed since 2009, and the low rates have discouraged provider participation.
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October 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.

Healthesystems at WCI 2025

Visit Healthe at Booth #921 to learn about our solutions and how we reduce burdens for claims professionals.
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Expert Q&A with Sandy Shtab: The Emerging Role of AI in Workers’ Comp Healthcare – and the Regulations Surrounding It

AI is increasingly being used in healthcare delivery. What are its applications in workers’ comp? What are the benefits and risks?
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WCRI Publishes Medical Price Index

The study compares prices for medical services across 36 states from 2008 to 2024, representing 88% of workers’ comp benefits in the U.S.
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Highlights from the NCCI Annual Insights Symposium 2025

In-depth reports cover topics ranging from an overview of the workers’ comp system to opioids, industry-specific trends, and more.
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Congressional Budget Bill Could Place 10-Year Ban on State AI Regulations

If passed, the bill would prevent the enforcement of laws on AI models and automated decision systems.
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Then and Now: 8 Reflections from 15 Years of RxInformer

In celebration of the 15 year anniversary of RxInformer, the editorial staff looked back at past issues to understand what has changed – and what hasn’t.
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