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A significant part of the Healthesystems vision is to create a more integrated experience for our customers

Regulatory Tag: Claims Procedures

February 6, 2026
Georgia Introduces Prescription Drug Reform Bill

The bill would allow payers to direct prescriptions to pharmacy networks and create limits for physician dispensing and compounds.

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February 6, 2026
Arizona Bill Could Expand Worker Choice in Medical Care

Senate Bill 1404 could grant workers greater choice over their provider, pharmacy, certain ancillary services, and more.

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January 26, 2026
Arizona Could Allow Payers to Direct Injured Workers to Pharmacy Networks

Employees could be informed of network pharmacies, while out-of-network pharmacies could be denied reimbursement.

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January 26, 2026
Oklahoma Proposes Contested PBM Bills

One bill conflicts with existing statutes on the timeline to pay pharmacy bills, while another could be preempted by TRICARE law.

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December 12, 2025
Indiana and Washington Introduce Provider Choice Bills

If enacted, Indiana House Bill 1069 would go into effect July 1, 2026, while Washington Senate Bill 5847 would go into effect June 30, 2027.

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December 8, 2025
New York Pharmacy Network Bill Vetoed by Governor

The bill would have duplicated existing protections for filling certain prescription out-of-network.

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December 8, 2025
Nevada Schedules Workshop to Review Reform Rule Changes

This workshop will cover rules around panel provider lists, delegating follow-up care to physician assistants, and other clerical matters.

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November 21, 2025
Florida May Permit Older Physical to Help Establish First Responder Presumptions

Exams from previous employers could be used to demonstrate that workers had no signs of occupational illnesses prior to employment.

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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 7, 2025
Nevada Publishes FAQ for Upcoming Procedural Reforms

Among many things, the FAQ discusses processes for formulary changes, administrative fines, and provider lists.

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November 7, 2025
California Considers Rule Change for Greater E-Filing in Workers’ Comp

Proposed updates also allow for electronic filing and service of all WCAB case related documents in EAMS rather than requiring service by mail.

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November 7, 2025
Michigan Introduces Bill to Strengthen Injured Worker Protections

The bill impacts required medical services, provider choice, preauthorization requests, and more.

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November 3, 2025
Nevada Clarifies Provider Choice Requirements for First Responders

Since October 1st, first responders have been able to select their own physician for heart and lung claims under certain conditions.

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October 27, 2025
Maryland Urges Accommodations for Policyholders Affected by Government Shutdown

Proposed accommodations include deferring premium payments, extending grace periods, and waiving late fees and penalties.

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