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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 Tracking

To track relevant regulatory trends across the nation, access our interactive map.
Go to Map

Regulatory Recap

A weekly e-newsletter informed by our Advocacy & Compliance team to help keep our clients and industry contacts in the know on the latest legislation and policy updates impacting workers' comp. Explore our complete article repository below.

California P&T Committee Meeting Recap

Healthe attended the April 16th meeting, capturing key updates regarding the pharmacy fee schedule and drug formulary.
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April 21, 2025

Montana to Allow Physician Assistants and Physical Therapists to Treat Injured Workers

Physician assistants will be able to conduct impairment ratings, while physical therapists are now included in the definition of treating providers.
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April 21, 2025

New York Bill Would Ensure Coverage During Disputes

Employers or insurers would be required to provide immediate medical treatment. If a claim is not compensable, they could seek reimbursement.
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April 21, 2025

CMS Publishes Update to NCCI Medically Unlikely Edits

The update includes a revised MUE value for certain HCPCS codes, retroactive to October 1, 2024.
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April 21, 2025

OSHA to Hold Public Hearing on Heat Injury and Illness Prevention

A June 16th virtual hearing will discuss proposed rules, and those interested in speaking must register by May 2nd.
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April 21, 2025

California P&T Committee to Meet on April 16th

The hybrid meeting will cover the pharmacy fee schedule, biosimilars, cannabis coverage, and payments for topical drugs.
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April 14, 2025

California Releases Report on Independent Medical Reviews

A total of 199,651 IMR applications were received in 2024, with pharmaceuticals making up 32.7%.
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April 14, 2025

Louisiana Proposes a Workers’ Comp Fee Schedule

The bill could require biennial updates, utilizing RVUs form the resource-based relative value scale (RBRVS).
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April 14, 2025

Nevada Now Considering Evidence-Based Formulary After Bill Hearing

Senate Bill 317 originally focused on provider panels, but a recent hearing amended the bill to include a workers’ comp formulary.
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April 14, 2025
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 Further resources you may be interested in

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

Drug Pricing Legislation and Its Impact on Workers' Comp

Lawmakers look to regulate the U.S. drug supply chain in ways that could impact workers’ comp pharmacy management.
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High Prices, High Impact: Meet the Drugs Driving Up Claim Costs in Workers’ Comp

High-impact drugs, including topicals and compounds, represent proportionately low utilization compared to opioids or NSAIDs, but they can increase pharmacy spend exponentially on impacted claims.
Read More

State of the Nation

A roundup of regulatory activity around the country
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Congress Urges USPS to Adopt Department of Labor’s Proposed Heat Protections

The push comes after a letter carrier died after working without air conditioning in 95° weather.
Read More

FDA Rejects MDMA for PTSD – Clinical Research to Continue for Psychedelics

The FDA requested additional trial data, with researchers eager to continue psychedelic trials.
Read More

In Person, In Print, and On Stage: Connect with Healthe at National Comp 2024!

Stop by our educational session or visit our booth for the latest issue of RxInformer magazine.
Read More
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 Interactive Map

To interact with this map, use the drop-downs to select a topic and type, then click the Display button. You can then roll over and click on individual states for more detailed information. This map represents legislation proposed during the most recent legislative cycle, typically spanning two years in most states. All current regulations are displayed up to present.
The content above is representative of topics Healthesystems proactively monitors and reports on. While not all topics are directly applicable to workers' compensation claims, some may have potential to impact workers' compensation in the future.
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