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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Billing & Payments Claims Procedures

Washington Increases Penalties for Violations of Workers’ Comp Laws

Effective July 1st, certain violations of workers’ comp law will see a 12.11% increase in penalties.

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May 18, 2026

Billing & Payments

Department of Labor Expands Pharmacy Models Across Programs

This development signals a shift toward a standardized OWCP pharmacy model that could impact Longshore and Black Lung claimants.

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May 11, 2026

Worker Classification

New York Could Cover 9/11 Claims for National Guard Responders

If enacted, the bill would categorize organized militia members as state employees, entitling them to workers’ comp benefits.

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May 11, 2026

Worker Classification

Ohio Bill Could Entitle Rideshare Drivers to Workers’ Comp

If enacted, rideshare companies would have to report drive-time data quarterly that would determine workers’ comp premiums.

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May 11, 2026

Access to Care

WCRI Reports on Impact of Hospital Closures on Access to Care and Claims Outcomes

While patients in rural areas had to travel further for care, there were no meaningful increases to claim costs or disability duration.

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May 11, 2026

Advocacy Opportunity Cost Containment

Texas Announces Audit for Topical Analgesics

The DWC will work with system participants to develop the audit plan, including timeframe, size, and case selection.

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May 4, 2026

Presumptions

Maryland Eases Requirements for Cardiovascular Presumption

Two separate bills would respectively change certain rules for firefighters and specific correctional officers.

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May 4, 2026

Presumptions

Arizona Considers Expanding Cancer Presumption for First Responders

The bill would add five years of retroactive effect, allowing certain individuals who were denied claims to file once more.

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May 4, 2026

Billing & Payments Cost Containment Treatment Guidelines

Louisiana Bills to Watch

Three in-progress bills impact medical reimbursement and fee schedules, prescription drug authorizations, and medical necessity evaluations.

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May 4, 2026

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Further resources you may be interested in

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

New Jersey Proposes Marijuana Reimbursement in Workers’ Comp and Group Health

Companion bills S3984 and A1023 would require health insurance coverage for the medical use of cannabis under certain circumstances.

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.

WCRI Publishes National Repository on Prescription Drug Regulations

While the report addresses multiple topics, a significant focus was given to the expanding role of pharmacists as a healthcare provider.

Expert Q&A: What Utah’s AI Prescription Renewal Pilot Signals About the Evolving Role of AI in Treatment Decisions

Utah’s prescription renewal pilot is a groundbreaking use case for AI in healthcare. What are the potential benefits and pitfalls?

Inside Medical Experience: Signals, Trends, and System Impact

Healthe’s VP of Industry and State Affairs, Sandy Shtab, joins a panel presentation at the Pennsylvania/Delawaare 2026 Workers’ Compensation Symposium.