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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.

Mental Health Presumptions

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.

January 26, 2026

Worker Classification

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.

January 26, 2026

Utah Proposes Reduced Benefits for Positive Marijuana Tests

If enacted, this bill would go into effect May 6, 2026.

January 26, 2026

Bureau of Labor Statistics Publishes Workplace Injury Report

2.5 million nonfatal workplace injuries and illnesses were reported in 2024, a drop of 3.1% from 2023.

January 26, 2026

Access to Care Technology

Utah Will Allow AI Prescription Renewal for Chronic Conditions

High volumes of prescription renewals are cited as a driver in medication lapses and preventable health outcomes.

January 19, 2026

Advocacy Opportunity Cost Containment

Alaska Schedules Public Hearing for Fee Schedule Changes

After public feedback is received at the February 19th meeting, the fee schedule is expected to take effect March 15, 2026.

January 19, 2026

Cost Containment

Massachusetts Clarifies Fee Schedule Recommendations to Legislature

Reimbursement structures have remained unchanged for over a decade, prompting regulators to push for updates.

January 19, 2026

Mental Health Presumptions

Presumption Bills Continue to Trend

Arizona proposes a PTSD presumption, while Maryland proposes a hypertension presumption.

January 19, 2026

New Bills Propose Workers’ Comp Changes Related to Immigration Status

New bills in Florida and New Jersey could affect workers’ comp coverage for undocumented workers.

January 19, 2026

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Further resources you may be interested in

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

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.

The Most Engaging RxInformer Articles from 2024

We checked the stats and reviewed our readers’ favorite articles from RxInformer magazine to bring you a list of our most engaging content from 2024.

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