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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Billing & Payments Claims Procedures

Oklahoma Proposes Contested PBM Bills

One bill conflicts with existing statutes on the timeline to pay pharmacy bills, while another could be preempted by TRICARE law.

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January 26, 2026

California P&T Committee Outlines Pharmacy Topics for Review

The meeting discussed proton pump inhibitors and the need to review utilization, and future meetings will address GLP-1 drugs, migraine drugs, and more.

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January 26, 2026

Advocacy Opportunity Billing & Payments Cost Containment

Michigan Advisory Council Reviews Fee Schedule Ruleset Changes

Healthesystems played a significant role in reshaping policy surrounding reimbursement for physician dispensing.

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January 26, 2026

Billing & Payments Cost Containment

New York Publishes 2026 Regulatory Agenda

Initiatives for 2026 could affect medical billing, pharmacy programs, treatment guidelines, and administrative processes.

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January 26, 2026

Mental Health Presumptions

Virginia Could Cover Pre-Existing PTSD Exacerbated by Workplace Incidents

While this bill could expand coverage of PTSD, it is still limited to first responders.

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January 26, 2026

Worker Classification

Georgia Could Classify Gig-Worker Nurses as Independent Contractors

Healthcare workers utilizing apps like CareRev, Clipboard Health, and NurseDash would not be entitled to benefits such as workers’ comp.

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January 26, 2026

Marijuana

Utah Proposes Reduced Benefits for Positive Marijuana Tests

If enacted, this bill would go into effect May 6, 2026.

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January 26, 2026

Industry Data

Bureau of Labor Statistics Publishes Workplace Injury Report

2.5 million nonfatal workplace injuries and illnesses were reported in 2024, a drop of 3.1% from 2023.

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January 26, 2026

Access to Care Technology

Utah Will Allow AI Prescription Renewal for Chronic Conditions

High volumes of prescription renewals are cited as a driver in medication lapses and preventable health outcomes.

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January 19, 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.