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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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Spotlight

Utah AI Prescription Renewal Pilot: Updates

The pilot can approve a limited set of 192 medications for chronic conditions and will be broken into three stages, the first including 250 patients.
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January 26, 2026
Spotlight

Texas Publishes Audit Report for Gabapentin and Pregabalin Prescribing

The report includes recommendations for providers, and the findings could impact rules around prescribing, utilization review, and service delivery.
Read More →
January 12, 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.
Read More →
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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January 26, 2026

California P&T Committee Outlines Pharmacy Topics for Review

The meeting discussed proton pump inhibitors and the need to review utilization, and future meetings will address GLP-1 drugs, migraine drugs, and more.
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January 26, 2026

Michigan Advisory Council Reviews Fee Schedule Ruleset Changes

Healthesystems played a significant role in reshaping policy surrounding reimbursement for physician dispensing.
Read More →
January 26, 2026

New York Publishes 2026 Regulatory Agenda

Initiatives for 2026 could affect medical billing, pharmacy programs, treatment guidelines, and administrative processes.
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January 26, 2026

Virginia Could Cover Pre-Existing PTSD Exacerbated by Workplace Incidents

While this bill could expand coverage of PTSD, it is still limited to first responders.
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January 26, 2026

Georgia Could Classify Gig-Worker Nurses as Independent Contractors

Healthcare workers utilizing apps like CareRev, Clipboard Health, and NurseDash would not be entitled to benefits such as workers’ comp.
Read More →
January 26, 2026
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 Further resources you may be interested in

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

White House Issues Executive Order to Reschedule Marijuana

Rescheduling marijuana to Schedule III will allow for greater clinical research, possible FDA-approved drugs, and more.
Read More

States Consider Expanding Presumptions

So far in 2026, eight states and counting are seeking to expand existing presumptions or create new presumptions.
Read More

Could AI-Designed Drugs Impact Regulatory Frameworks?

While AI can be effective in some elements of drug design, AI models currently struggle to explain their decision making, a key component of drug review.
Read More

Preliminary Findings from the 2026 Workers’ Comp Industry Insights Survey Report

Risk & Insurance® magazine published high-level findings from the eighth annual survey, in collaboration with Healthesystems.
Read More

Year in Review: What Made the Biggest Impacts in Workers’ Comp Claims Management in 2025?

From claims complexity to mental health, here’s what impacted workers’ comp claims management last year.
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New York Could Remove References to CDC Guidelines

After regional public health collaboratives formed in September, New York could be the first state to formally shift policies away from deferring to federal guidelines.
Read More
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