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A significant part of the Healthesystems vision is to create a more integrated experience for our customers

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.

Cost Containment Treatment Guidelines

Hawaii May Require Compounds to Be Created by Licensed, In-State Pharmacists

The state’s definition of “compounded prescription drug” would be updated to fall in line with federal standards.

March 23, 2026

New Jersey Proposes Medical Marijuana Reimbursements in Workers’ Comp

Two new companion bills carryover similar marijuana reimbursement proposals from 2024.

March 23, 2026

Billing & Payments Claims Procedures Cost Containment

Louisiana Reform Package Proposes Centralized Medical Authorization Database

Additionally, the bill would update the fee schedule and impact billing and utilization requirements.

March 23, 2026

Billing & Payments Cost Containment

South Carolina Approves 2026 Fee Schedule and Targets IMEs

The updated fee schedule will go into effect April 1st, while a new IME subcommittee will evaluate cost and practice concerns.

March 23, 2026

American Medical Association Reports on Increased Physician AI Use

Over 80% of physician respondents currently use AI in a professional context – double the share reported in 2023.

March 23, 2026

Advocacy Opportunity Cost Containment

Massachusetts Announces Draft Fee Schedule Rules

At a March 11th meeting, the Workers’ Compensation Advisory Council announced a draft expected in fall of 2026 for public comments.

March 16, 2026

New York Considers Update to Pharmacy Rules

The bill would allow injured workers to obtain medication from out-of-network pharmacies when specific conditions occur.

March 16, 2026

Access to Care Claims Procedures

WCRI Panel Flags Key Challenges

An employer panel discussed issues such as access to care, early intervention practices, and claims culture and communication.

March 16, 2026

Alabama Considers Covering Parkinson’s Disease for Firefighters

The bill includes standards for demonstrating that the disease is occupational in origin, and if enacted it would go into effect October 1st.

March 16, 2026

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Further resources you may be interested in

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

State of the Nation

A roundup of regulatory activity around the country

Congress Urges USPS to Adopt Department of Labor’s Proposed Heat Protections

The push comes after a letter carrier died after working without air conditioning in 95° weather.

FDA Rejects MDMA for PTSD – Clinical Research to Continue for Psychedelics

The FDA requested additional trial data, with researchers eager to continue psychedelic trials.

In Person, In Print, and On Stage: Connect with Healthe at National Comp 2024!

Stop by our educational session or visit our booth for the latest issue of RxInformer magazine.

Worker Heat Protections Continue to Make Waves

The U.S. Department of Labor proposed new rules, while other states introduce legislation.

WCRI Reports on Drug Payment Trends

Dermatologicals made up the largest share of drug payments, with NSAIDs coming in second.

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