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.

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Advocacy Opportunity Cost Containment

Arizona Study Prompts Stakeholder Feedback for High-Cost Prescription Topicals

A small group of prescribers and out-of-network pharmacies are driving utilization of costly drugs with affordable alternatives.

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October 6, 2025

Advocacy Opportunity Billing & Payments

Ohio Resubmits Outpatient Medication Rules: Comments Accepted Until October 9th

BWC resubmits outpatient medication rules with unchanged compound provisions, sets February 2026 start date, and reopens public comments.

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October 6, 2025

Access to Care Advocacy Opportunity Claims Procedures

Oregon Considers Stakeholder Feedback for Improving Access to Care

Stakeholders discussed inefficiencies in claim procedures, and regulators will continue to review feedback prior to finalizing recommendations.

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October 6, 2025

Worker Safety

WCRI Report: California’s Heat Safety Standards Reduced Workplace Injuries

Work-related injuries on hot days decreased 15-17% for construction workers, 24-27% in agricultural workers, and 19-25% for transportation workers.

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October 6, 2025

Worker Classification

Wisconsin Proposes Increased Penalties for Worker Misclassification

If passed, the bill would increase fees, and in some cases remove fee limits, for employers that continue to misclassify workers to avoid providing benefits.

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October 6, 2025

Access to Care Advocacy Opportunity Training Opportunity

Colorado Seeks Stakeholder Feedback for 2028 Comp Reform

Three listening sessions will give stakeholders the chance to comment on how to implement major workers’ comp reforms.

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September 29, 2025

Advocacy Opportunity Cost Containment

Tennessee: Formulary and UR Updates from the Medical Advisory Committee Meeting

Advocacy efforts by Healthesystems helped create a prior authorization for 300mg ibuprofen, as other cost-effective doses are readily available.

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September 29, 2025

Claim Costs Industry Data

Florida Workers’ Comp Trends Highlighted in WCRI Webinar

The webinar covered topics ranging from claims costs to drug payments, heat-related injuries, and more.

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September 29, 2025

Claims Procedures

Nevada CARDS Portal Down: State Issues Guidance Bulletin

There is no timeline for when the system will be back online, requiring various go-arounds for certain claims procedures.

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September 29, 2025

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Further resources you may be interested in

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

WCRI Reports on the Impact of Marijuana Laws on Workers’ Comp Benefits

While recreational marijuana laws may be tied to increases in claim frequency, medical payments and prescriptions decreased, including those for opioids.

State of the Nation with Sandy Shtab

Healthesystems VP of State & Industry Affairs comments on recent federal activity that creates potential impacts for workers’ comp.

Q&A with RxInformer Magazine Founder Jill Knight

Learn about the impetus for and history of our own RxInformer magazine from founder Jill Knight, VP of Marketing and Customer Experience.

By the Numbers: 15 RxInformer Stats for 15 Years

Now that RxInformer is officially 15, we looked back at past issues to gather interesting stats about the magazine and how it’s produced.

Burden of Proof: Unpacking Presumptions in Workers’ Comp

New presumptions in workers’ comp are making it easier for workers to qualify for benefits related to mental injury, including PTSD, as well as certain cancers and other conditions.