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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.

Florida May Increase Cancer Benefits to Firefighters With $25,000 Payment

Additionally, benefits may be extended for up to 10 years post-employment.

January 12, 2026

Mental Health Presumptions

Kentucky Could Make Psychological Injuries Compensable for First Responders

If enacted, House Bill 26 would apply to police officers, firefighters, emergency medical services personnel, and members of the National Guard.

January 12, 2026

Virginia Considers Expanding Cancer Presumptions to Sheriffs

Exceptions to the presumption are made for certain cancers diagnosed prior to key dates.

January 12, 2026

Washington State May Allow PTs and OTs to Qualify as Attending Providers

If enacted, physical therapists and occupational therapists could direct care for injured workers.

January 12, 2026

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.

December 22, 2025

Advocacy Opportunity Claim Data

Texas Seeks Feedback On 2026 Medical Audit Plan

Stakeholder input could determine if the audit focuses on either topical analgesics or utilization review compliance.

December 22, 2025

States Consider Expanding Presumptions

Illinois, Pennsylvania, and Washington seek to expand current presumptions to additional occupations.

December 22, 2025

AI Oversight Bills

Florida, Pennsylvania, and New Hampshire are open to AI in claims management, but would require humans to have the final say.

December 22, 2025

OSHA Issues Seven Letters of Interpretation for Workplace Safety and Health Requirements

These letters provide official explanations of agency requirements and how they apply to workplace situations and hazardous conditions.

December 15, 2025

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Further resources you may be interested in

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

A Hot Topic: The Latest News on Workers and Extreme Heat

Recent data insights, state proposals, and updates on federal rulemaking procedures.

FDA Issues Draft Guidance for the Use of AI in the Creation of Drugs and Medical Devices

The guidelines provide recommendations on using AI to demonstrate drug safety and effectiveness, and recommendations for AI-enabled medical devices.

California Updates Pharmacy Fee Schedule

Among many changes, the state is replacing AWP with a new pricing model.

Missouri Proposes Bill for Psilocybin Therapy

Medical use would be legalized, with legal protections for patients and physicians.

New York Enacts Mental Injury Presumption for All Workers

All workers will now have the right to file a claim for mental injuries, based upon extraordinary work-related stress incurred on the job.

Texas Considers Making Infertility an Occupational Illness for First Responders

A proposed bill would apply to male and female reproductive systems for firefighters and EMTs.

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Workers' Comp Property and Casualty PBM
Expires 01/01/2028