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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Claim Costs Claim Data

WCRI Publishes CompScope Benchmarks

Claim costs increased 6% per year from 2022-2025 in the median study state, with state-level variations.

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May 4, 2026

Mental Health Psychedelics

White House Issues Executive Order on Psychedelics

The order seeks to accelerate clinical trials, data sharing, drug approvals, and possibly rescheduling.

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April 27, 2026

Claim Costs Pharmacy Data

Minnesota Publishes Drug Price Transparency Report

Prescription drug list prices increased 23% in the last year, far outpacing inflation.

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April 27, 2026

Worker Classification

New York Could Exclude Unpaid Interns from Workers’ Comp

Such interns would not be considered employees, meaning they would not be entitled to various employee benefits.

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April 27, 2026

Marijuana Worker Safety

Oklahoma Employers Can Terminate Employees for Any Marijuana Use

Positive drug tests, even for medical use, can result in termination. The bill also updates rules around safety sensitive positions.

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April 27, 2026

Advocacy Opportunity Billing & Payments Cost Containment

Pennsylvania Advisory Council Signals Legislative Attention Needed on Topical Cap

Senate Bill 1215 was discussed, and it appears unlikely the proposed reimbursement caps will be passed.

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April 20, 2026

Advocacy Opportunity Treatment Guidelines

California P&T Committee Recommends Formulary Updates

The committee issued new recommendations related to 300 mg ibuprofen, gabapentin and pregabalin, cyclobenzaprine, and tizanidine.

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April 20, 2026

Advocacy Opportunity Billing & Payments Treatment Guidelines

Colorado Gathers Stakeholder Feedback on Medical Fee Schedule

Matters discussed included physician dispensing, missed appointment fees, passive therapy utilization, and interpreter bill denials.

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April 20, 2026

Advocacy Opportunity

Texas DWC Requests Legislative Recommendations

Stakeholders may send specific legislative recommendations to the DWC, if they are supported by data, and with relevant background or context.

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April 20, 2026

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Further resources you may be interested in

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

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.