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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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NCCI Highlights 2026 Legislative and Regulatory Trends

NCCI’s 2026 Emerging Legislative and Regulatory Issues report identifies heat exposure, workplace violence, and broader workers’ compensation system changes as key areas impacting workers’ compensation programs.
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April 6, 2026

Louisiana Bill Would Modify Key Parts of State’s Workers’ Compensation System

On March 31, Louisiana introduced a bill that would change how Medical Maximum Improvement (MMI) is defined and how wage-loss benefits are paid.
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April 6, 2026

Oklahoma Bills Would Create Conflicts for Workers’ Compensation Pharmacy

Two Oklahoma bills heading for House consideration would establish a NADAC based reimbursement floor, minimum dispensing fees, and a shortened 30 day payment timeframe.
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March 30, 2026

DME Vendors Are Not “Providers” Under Pennsylvania Workers’ Comp Law

A Pennsylvania appellate court ruled that a distributor of Durable Medical Equipment (DME) does not qualify as a “healthcare provider” under the Workers’ Compensation Act and therefore cannot use the state’s medical fee review process to dispute reimbursement.
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March 30, 2026

New York Proposes Regulations Expanding Pay Without Prejudice Rules for Medical Payments

The New York Workers’ Compensation Board has proposed rules allowing carriers to temporarily pay for medical treatment while compensability is under review, without admitting liability.
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March 30, 2026

Colorado Will Host Fee Schedule Listening Session

The Colorado Division of Workers’ Compensation (DOWC) will host a listening session on April 9, 2026 at 4:00 p.m. MT to gather feedback from employers, insurers, providers, and other workers’ compensation stakeholders on Rule 18 (Medical Fee Schedule).
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March 30, 2026

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
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 Further resources you may be interested in

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

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.
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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.
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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.
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Psilocybin and Ketamine Therapy Bills Introduced Across the Country

So far, seven psilocybin therapy bills have been introduced in 2025, with three ketamine therapy bills.
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Digital Therapeutics: The Promise of Better Health Outcomes for Injured Workers

Digital therapeutics products aim to improve patient health outcomes. What are their applications in workers’ comp?
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A Hot Topic: The Latest News on Workers and Extreme Heat

Extreme heat continues to be a serious risk for workers. What are the latest heat-related developments in workers’ comp?
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