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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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Arizona Publishes 2026 Medical Fee Schedule

The updated schedule increases the maximum reimbursement for topical compounds and urges pharmacies to select the lowest-AWP medication when available, among other changes.
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March 30, 2026

Idaho Bill Would Expand the Definition of “First Responder” for PTSD Coverage

The new bill would add coroners, “medicolegal” death investigators, and qualifying coroner employees to the list of first responders eligible for workers’ compensation benefits for post-traumatic stress injuries.
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March 30, 2026

Pennsylvania Proposes Price Caps on Compound and Topical Drugs

Senate Bill 1215 proposes a $400, 30-day supply cap for compound drugs and a $240, 30-day supply cap for non-compound topicals.
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March 23, 2026

Florida Appeals Court Rules in Favor of Carriers and Employers on Physician-Dispensed Drugs

While injured workers have an absolute choice over their pharmacist, physicians are not considered pharmacists and therefore not entitled to reimbursement.
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March 2, 2026

Hawaii May Require Compounds to Be Created by Licensed, In-State Pharmacists

The state’s definition of “compounded prescription drug” would be updated to fall in line with federal standards.
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March 23, 2026

New Jersey Proposes Medical Marijuana Reimbursements in Workers’ Comp

Two new companion bills carryover similar marijuana reimbursement proposals from 2024.
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March 23, 2026

Louisiana Reform Package Proposes Centralized Medical Authorization Database

Additionally, the bill would update the fee schedule and impact billing and utilization requirements.
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March 23, 2026

South Carolina Approves 2026 Fee Schedule and Targets IMEs

The updated fee schedule will go into effect April 1st, while a new IME subcommittee will evaluate cost and practice concerns.
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March 23, 2026

American Medical Association Reports on Increased Physician AI Use

Over 80% of physician respondents currently use AI in a professional context – double the share reported in 2023.
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March 23, 2026
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 Further resources you may be interested in

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

Pain Points: Chronic Pain and the Injured Worker

Chronic pain affects millions and has direct consequences for injured workers and in the workplace, from absenteeism to higher healthcare costs.
Read More

State of the Nation

A perspective penned by our VP of Industry and State Affairs
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Digital Therapeutics: The Promise of Better Health Outcomes for Injured Workers

What they are, the benefits, how they’re currently covered by insurers, and future outlooks.
Read More

Massachusetts Considers Reimbursement, California Could Reject Medical Recommendation

A bill in Massachusetts could require insurers to pay for marijuana, while ACOEM recommends against marijuana for chronic pain guidelines.
Read More

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.
Read More

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.
Read More
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