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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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Minnesota Reports on Prescription Drug Price Transparency

Drug classes with the most new, high-priced drugs were anti-cancer drugs, ADHD/anti-obesity drugs, and anti-inflammatory pain medications.
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November 24, 2025

New York Bill Could Remove References to CDC Guidelines

Existing laws and guidelines that refer to CDC guidelines would shift to “nationally recognized clinical practice guidelines.”
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November 17, 2025

Texas Issues Data Call

The call focuses on annual experience and workers’ comp deductible plans for the period of January 1, 2025, through December 31, 2025.
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November 17, 2025

Wisconsin Introduces Significant Reform Bill

Assembly Bill 651 could impact benefits levels, PTSD presumptions, penalties, and more
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November 17, 2025

New Mexico Revises Rules for Fee Schedule Changes

Effective January 1st, CARC and RARC codes will be permitted for use in EOBs, leveraging nationally recognized standards.
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November 17, 2025

Massachusetts Advisory Council Discusses Medical Fee Schedule

The fee schedule has not been updated since 2009, resulting in low reimbursement rates, which has impacted access to care.
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November 17, 2025

CMS Finalizes 2026 Medicare Physician Fee Schedule

States that base their workers’ comp fee schedules on the CMS Fee Schedule may adopt these adjustments, which go into effect January 1st.
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November 17, 2025

White House Announces Deal to Expand Access to GLP-1 Medications

Qualifying CMS patients could face a co-pay of $50 a month for these highly popular drugs for obesity and diabetes.
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November 10, 2025

NCCI Reports on Medical Inflation Insights

Headline inflation rose 3% year over year in September, still above the Federal Reserve’s 2% target but well below 2022 levels.
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November 10, 2025
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 Further resources you may be interested in

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

Visit Healthesystems at RISKWORLD 2025

Drop by Booth #824 for a copy of the 15th Anniversary edition of RxInformer magazine, and to learn how we’re transforming healthcare.
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PTSD Presumptions Continue to See Activity

New York backpedaled on a PTSD presumption for all workers, while California considers a PTSD presumption for healthcare workers.
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Psilocybin and Ketamine Therapy Bills Introduced Across the Country

So far, seven psilocybin therapy bills have been introduced in 2025, with three ketamine therapy bills.
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Digital Therapeutics: The Promise of Better Health Outcomes for Injured Workers

Digital therapeutics products aim to improve patient health outcomes. What are their applications in workers’ comp?
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A Hot Topic: The Latest News on Workers and Extreme Heat

Extreme heat continues to be a serious risk for workers. What are the latest heat-related developments in workers’ comp?
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2025 Workers’ Comp Industry Insights Survey Report

The seventh annual survey report highlights the top challenges and priorities for 515 industry stakeholders.
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