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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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Department of Justice Reaches $21.5 Million Settlement Over Inflated AWP for Compound Ingredients

According to the DOJ, Medisca Inc. purchased resveratrol at $0.37 a gram, sold it for under $2.00 a gram, but reported an AWP of $777 per gram.
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November 11, 2024

Psychedelic Study Shows Improvements in Anxiety without Hallucinations

When injected into the hippocampus, the compound DOI reduced anxiety in mice without causing hallucinations.
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November 4, 2024

Texas Seeks Input On 2025 Medical Quality Review Audit Plan

Comments will be accepted until 5:00 PM PST on November 22, 2024, and the Medical Advisor may adjust the plan based on feedback received.
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November 4, 2024

Pennsylvania Publishes Prescription Drug Trends Report

This report reviews drug payments between 2012 and 2022, reviewing usage and cost, generics, opioids, and topicals.
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November 4, 2024

Nevada to Hold Four Workers’ Comp Training Webinars

The webinars will cover basic orientation, the C-4 process and using the coverage verification system, the D-35 form, and medical billing.
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November 4, 2024

Mississippi Requests Stakeholder Input for 2025 Fee Schedule

No deadline for feedback has been given, but the Commission will consider feedback for fee schedule changes for 2025.
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November 4, 2024

Arizona Offers Medical Resource Training Opportunities for Workers’ Comp Stakeholders

A four-part series of 30-minute training webinars are available for adjusters, payers, healthcare providers, and TPAs.
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November 4, 2024

NCCI Reports on Adverse Weather and Workers’ Comp Claims

Using data from 35 states from 2001-2022, the report noted up to 10% higher claim frequency in both significantly hotter and colder temperatures.
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October 28, 2024

NCCI Reports on Medical Inflation

After starting the year with 3.5% growth, the inflation moderated to around 2.5% in Q3, consistent with trends from 2022-2023.
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October 28, 2024
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 Further resources you may be interested in

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

New Drug Developments Impacting Comp

A biosimilar to Humira is approved, the FDA Fast Tracks a PTSD drug, and more.
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Questioning Costs: A Field Guide to Fee Schedules

Understand how prices are set for medical equipment and services, and how to scrutinize those costs.
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How Declining Opioid Use Impacts Claims and Outcomes

According to the CWCI, reduced opioid utilization from 2010-2017 saved $6.5 billion in California comp costs.
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Minnesota Proposes PTSD Treatment Guidelines

Beyond compensability, Minnesota considers rules for evaluation, treatment planning, acceptable psychotherapies, and more.
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Healthe in the Media

Workers’ comp publications cover Healthesystems content surrounding aging physicians, successful return-to-work programs, and more.
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By the Numbers

A collection of workers’ compensation facts and figures
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