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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Spotlight

California Reports Meloxicam as Highest NSAID Cost Driver

A small number of high-cost meloxicam capsule prescriptions sharply increased the drug’s average payment from $9 in 2020 to $92 in 2025.

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November 9, 2026

Spotlight

Claim Data Industry Data

Texas Publishes Compliance and Investigation Audit Plan

Audits will review the payment, reporting, and accuracy of lifetime income benefits and death benefits, and initial temporary income benefits.

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November 2, 2026

Spotlight

Industry Data

NCCI Reports on Medical Inflation

Workers’ comp increased 1.2%, with annual price growth expected to reach 2-2.5% over the next several quarters.

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November 2, 2026

Claim Data Cost Containment

California Introduces New Measure for Medical Service Utilization

RVUs will be utilized to account for differences in resource intensity, instead of tracking just the number of medical transactions.

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November 9, 2026

Access to Care

WCRI Examines How Loss of Medicaid Impacts Workers’ Comp Benefits

Congress expects 11 million people to lose Medicaid coverage by 2034, which is expected to cause ripples across healthcare – including workers’ comp.

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November 9, 2026

Mental Health Presumptions

Pennsylvania Recognizes 911 Telecommunicators as Emergency Responders

These operators will now receive similar mental health presumptions that other first responders in the state are eligible for.

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November 2, 2026

Access to Care Advocacy Opportunity Pharmacy Data

Pennsylvania Advisory Council Discusses Physician Dispensing and Medical Accessibility

Drugs remained approximately 10% of medical costs, with physician-dispensed drugs accounting for 5% of total drug payments.

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October 26, 2026

Advocacy Opportunity Cost Containment Treatment Guidelines

Idaho Subcommittee Reviews Physician Dispensing Concerns

Spending remains high despite limits passed in 2025, with patterns of duplicate therapy, lack of medical necessity, and changes in drug strength.

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October 26, 2026

Claims Procedures Treatment Guidelines

California Proposes Changes to Medical Provider Network Rules

A stakeholder meeting will take place on December 11th to review the proposed rule revisions.

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October 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.

NCCI Publishes Legislative and Regulatory Trends Report

Trending topics include worker classification, portable benefits, mental injuries, single-payer insurance, marijuana, and psychedelics.

Updates from the IAIABC’s 112th Convention

In addition to recapping roundtable discussions, the event saw Sandy Shtab, Healthesystems VP of Industry and State Relations, receive the IAIABC President’s Award.