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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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

Worker Classification

New Jersey Receives $19.4 Million Payment from Lyft for Worker Misclassification

Over 100,000 drivers were misclassified as independent contractors, depriving those workers of various benefits – including workers’ comp.

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September 29, 2025

Advocacy Opportunity Cost Containment Treatment Guidelines

Arizona to Hold Public Stakeholder Meeting on Topical Medications Regulation

The meeting will take place October 2nd and presents an opportunity to influence how topicals are regulated in the state workers’ comp system.

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September 22, 2025

Advocacy Opportunity Billing & Payments Cost Containment

Oregon Seeks Stakeholder Recommendations for Medical Fee Schedule Rates

Public comments regarding fee and payment rules, medical services, and managed care organizations must be submitted by September 30th.

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September 22, 2025

Claim Costs Industry Data Treatment Guidelines

CWCI Study Reports on Functional Restoration Programs

Only 42.8% of injured workers on FRPs had a chronic pain diagnosis, even though clinical guidelines recommend FRPs only for these cases.

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September 22, 2025

Ancillary Services Industry Data Mental Health

WCRI Publishes Report on Psychosocial Impacts on Physical Therapy Outcomes

The presence of psychosocial risks causes functional scores to decrease 33% for workers’ comp patients with shoulder injuries.

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September 22, 2025

Billing & Payments Industry Data

Texas Plans 2026 Carrier and Healthcare Provider Audit

Random audits will review timely and accurate benefit delivery, medical reimbursement, and the reporting of electronic data to the DWC.

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September 22, 2025

Marijuana Mental Health Presumptions

NCCI Publishes 2025 Regulatory and Legislative Trends Report

NCCI tracked 950 bills impacting workers’ comp, highlighting key trends across the country.

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September 22, 2025

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Further resources you may be interested in

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

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.