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

NCCI Publishes Report on Fast-and-Slow Emerging Claims

Both claims reach costs of $1 million or more, but at different points in time after injury.

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February 9, 2026

Cost Containment Treatment Guidelines

Hawaii Bills Target Pharmacy Management Rules

New bills would address compounds, deadlines for authorization decisions, and more.

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February 2, 2026

Cost Containment

Missouri Proposes Fee Schedule

The bill would require a formal fee schedule for all services provided under workers’ comp, taking effect August 28, 2026.

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February 2, 2026

Technology

Multiple States Seek to Limit AI-Generated Care Decisions

Alabama, Hawaii, Kentucky, Oklahoma, Pennsylvania, and Virginia have all introduced bills to limit AI-generated care decisions.

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February 2, 2026

Presumptions

Arizona Could Cover Travel Injuries for Firefighters

Injuries occurring when traveling to and from work would be covered, assuming no criminal activity was undertaken.

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February 2, 2026

Mental Health Presumptions

Florida and Vermont Could Extend PTSD Coverage to 911 Dispatchers

Pre-existing PTSD presumptions for first responders could be extended to 911 dispatchers.

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February 2, 2026

Presumptions

Maryland and Arizona Target Hypertension Presumptions for Firefighters

Maryland would create a hypertension presumption, while Arizona would strengthen theirs by increasing rebuttal requirements.

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February 2, 2026

Presumptions

Vermont and Virginia Consider Covering Additional Cancers for Firefighters

Vermont could soon cover larynx, pharynx, and trachea cancers, while Virginia could cover lung cancer and non-Hodgkin’s lymphoma.

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February 2, 2026

Presumptions

Virginia Proposes Spousal Wage Reimbursement for At-Home Caretaking

The bill applies to the spouse of law-enforcement officers who require at-home care following a line-of-duty injury.

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February 2, 2026

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Further resources you may be interested in

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

Cannabis Drug Beats Opioids in Phase 3 Low Back Pain Trial

VER-01, a cannabis extract, outperformed both placebo and opioids in two late-stage clinical trials.

NCCI Publishes 2025 Regulatory and Legislative Trends Report

NCCI tracked 950 bills impacting workers’ comp, highlighting key trends across the country, such as PTSD and cancer presumptions, worker classification, and psychedelics.