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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Cost Containment

Massachusetts Clarifies Fee Schedule Recommendations to Legislature

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

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January 19, 2026

Mental Health Presumptions

Presumption Bills Continue to Trend

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

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January 19, 2026

Access to Care

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.

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January 19, 2026

Claim Data Pharmacy Data

WCRI Publishes Report on Injectable Therapies

The report classifies distinct subgroups of injectable by medication type and identifies those most common in workers’ comp.

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January 19, 2026

Access to Care

New Jersey Proposes Comp Exclusion for Intoxication

Intoxication as a material contributing factor to injury or death could disqualify individuals for benefits.

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January 19, 2026

Advocacy Opportunity Industry Data Pharmacy Data

Texas Publishes Audit Report for Gabapentin and Pregabalin Prescribing

The report includes recommendations for providers, and the findings could impact rules around prescribing, utilization review, and service delivery.

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January 12, 2026

Advocacy Opportunity Billing & Payments

New York Proposes Billing Guidelines for Residents and Fellows

After expanding access to care by allowing these providers to treat injured workers, billing guidelines for these providers are being developed.

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January 12, 2026

Advocacy Opportunity Ancillary Services

Ohio Proposes Rule Changes for Prosthetic Coverage

Under the proposal, the BWC would cover purchases through their surplus fund if the need stems from an allowed injury or occupational disease.

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January 12, 2026

Presumptions

Florida May Increase Cancer Benefits to Firefighters With $25,000 Payment

Additionally, benefits may be extended for up to 10 years post-employment.

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January 12, 2026

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Further resources you may be interested in

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

Sleep Woes: Fatigue in the Workplace

Sleep deprivation and fatigue have far-reaching consequences in the workplace, from poor productivity to injury or death.

Expert Q&A: Cybersecurity Tactics in Workers’ Compensation

RxInformer editors sat down with Healthesystems’ AVP of Information Security and resident cybersecurity expert, Tony Brown, to discuss how cyber threats affect workers’ comp organizations.

Drug Pricing Legislation and Its Impact on Workers' Comp

Lawmakers look to regulate the U.S. drug supply chain in ways that could impact workers’ comp pharmacy management.

High Prices, High Impact: Meet the Drugs Driving Up Claim Costs in Workers’ Comp

High-impact drugs, including topicals and compounds, represent proportionately low utilization compared to opioids or NSAIDs, but they can increase pharmacy spend exponentially on impacted claims.