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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Worker Classification

New York Considers Classifying App-Based Delivery Workers as Employees

If enacted, these workers would be entitled to certain benefits, including workers’ compensation.

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April 13, 2026

Access to Care

Oregon Extends Treatment Authority to Nurse Practitioners and Physician Associates

Under emergency declaration, the bill went into effect immediately.

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April 13, 2026

Presumptions

Maryland May Soon Expand Cardiovascular Presumption

Two bills passed both chambers with near unanimous support, but they now sit with the governor under a tight deadline.

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April 13, 2026

Presumptions

Alabama Enacts Parkinson’s Presumption for Firefighters

The presumption will go into effect October 1st.

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April 13, 2026

Advocacy Opportunity Treatment Guidelines

California P&T Committee to Address MTUS Updates and Ibuprofen Price Outliers

The April 15th hybrid meeting will take place from 12:30 PM to 2:30 PM PST, covering a wide variety of pharmacy topics.

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April 13, 2026

Billing & Payments

West Virginia PBM Bill Bans Spread Pricing

A new West Virginia PBM bill, effective immediately, prohibits spread pricing and requires PBM fees to be transparent and independent of drug cost.

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April 6, 2026

Mental Health Presumptions

Wisconsin Agreed Bill Expands PTSD Eligibility

On March 31, Wisconsin passed a bill expanding PTSD‑only workers’ compensation claim eligibility for certain first responders and adopting a broader package of agreed‑upon reforms.

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April 6, 2026

Access to Care Claim Costs Industry Data

WCRI Study Finds Provider Networks Improve Claim Outcomes

A new study from the Workers Compensation Research Institute found that injured workers treated in medical provider networks have lower medical and total claim costs, faster access to care, and improved disability outcomes.

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April 6, 2026

Industry Data Worker Safety

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

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Further resources you may be interested in

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

Eighth Annual Industry Insights Survey Reveals Focus on Injured Worker Engagement

Explore the top five major findings from this year’s Workers’ Comp Industry Insights Survey.

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?

The Cost of Exposure: How Occupational Cancer Impacts Workers’ Compensation

The risk and impact of occupational cancers vary significantly depending on the nature of the exposure and the affected workforce.

Utah Launches AI Prescription Renewal Pilot Program for Chronic Conditions

The pilot can approve a limited set of 192 medications and will be broken into three stages, each with different levels of review.

States Seek to Limit AI-Generated Care Decisions, Despite White House Order

Legislators continue to introduce bills to limit AI-generated healthcare decisions, even as the U.S. Attorney General has been instructed to oppose them.