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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.

WCRI Reports on Trends in Joint Replacement Surgery

Using data from 2 million claims across 32 states, the study found that the prevalence of these surgeries increased, driven by shoulder joint replacements.

February 9, 2026

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.

February 9, 2026

Cost Containment Treatment Guidelines

Hawaii Bills Target Pharmacy Management Rules

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

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.

February 2, 2026

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.

February 2, 2026

Arizona Could Cover Travel Injuries for Firefighters

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

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.

February 2, 2026

Maryland and Arizona Target Hypertension Presumptions for Firefighters

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

February 2, 2026

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.

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.

New York Enacts Mental Injury Presumption for All Workers

All workers will now have the right to file a claim for mental injuries, based upon extraordinary work-related stress incurred on the job.

Texas Considers Making Infertility an Occupational Illness for First Responders

A proposed bill would apply to male and female reproductive systems for firefighters and EMTs.

The Most Engaging RxInformer Articles from 2024

We checked the stats and reviewed our readers’ favorite articles from RxInformer magazine to bring you a list of our most engaging content from 2024.

Think Globally, Act Locally: Advocating for Administrative Simplification

Collaboration between national and regionally based stakeholders is one way to work towards improving the workers’ compensation system.

Minnesota Invites the Public to Complete a PTSD Survey

As part of a legislative-mandated study on work-related PTSD, the survey could influence regulator objectives for 2025.

Could Psychedelic Injections Help with Mental Illness While Avoiding Hallucinogenic Effects?

A recent study involving the compound DOI showed promising results in mice.

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Workers' Comp Property and Casualty PBM
Expires 01/01/2028