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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.

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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New York Proposes Regulations Expanding Pay Without Prejudice Rules for Medical Payments

The New York Workers’ Compensation Board has proposed rules allowing carriers to temporarily pay for medical treatment while compensability is under review, without admitting liability.
Read More →
March 30, 2026

Colorado Will Host Fee Schedule Listening Session

The Colorado Division of Workers’ Compensation (DOWC) will host a listening session on April 9, 2026 at 4:00 p.m. MT to gather feedback from employers, insurers, providers, and other workers’ compensation stakeholders on Rule 18 (Medical Fee Schedule).
Read More →
March 30, 2026

Arizona Publishes 2026 Medical Fee Schedule

The updated schedule increases the maximum reimbursement for topical compounds and urges pharmacies to select the lowest-AWP medication when available, among other changes.
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March 30, 2026

Idaho Bill Would Expand the Definition of “First Responder” for PTSD Coverage

The new bill would add coroners, “medicolegal” death investigators, and qualifying coroner employees to the list of first responders eligible for workers’ compensation benefits for post-traumatic stress injuries.
Read More →
March 30, 2026

Florida Appeals Court Rules in Favor of Carriers and Employers on Physician-Dispensed Drugs

While injured workers have an absolute choice over their pharmacist, physicians are not considered pharmacists and therefore not entitled to reimbursement.
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March 2, 2026

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.
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March 23, 2026

New Jersey Proposes Medical Marijuana Reimbursements in Workers’ Comp

Two new companion bills carryover similar marijuana reimbursement proposals from 2024.
Read More →
March 23, 2026

Louisiana Reform Package Proposes Centralized Medical Authorization Database

Additionally, the bill would update the fee schedule and impact billing and utilization requirements.
Read More →
March 23, 2026

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.
Read More →
March 23, 2026
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 Further resources you may be interested in

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

The Cost of Exposure: How Occupational Cancer Impacts Workers’ Compensation

The risk and impact of occupational cancers vary significantly depending on the nature of the exposure and the affected workforce.
Read More

Utah Launches AI Prescription Renewal Pilot Program for Chronic Conditions

The pilot can approve a limited set of 192 medications and will be broken into three stages, each with different levels of review.
Read More

States Seek to Limit AI-Generated Care Decisions, Despite White House Order

Legislators continue to introduce bills to limit AI-generated healthcare decisions, even as the U.S. Attorney General has been instructed to oppose them.
Read More

White House Issues Executive Order to Reschedule Marijuana

Rescheduling marijuana to Schedule III will allow for greater clinical research, possible FDA-approved drugs, and more.
Read More

States Consider Expanding Presumptions

So far in 2026, eight states and counting are seeking to expand existing presumptions or create new presumptions.
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Could AI-Designed Drugs Impact Regulatory Frameworks?

While AI can be effective in some elements of drug design, AI models currently struggle to explain their decision making, a key component of drug review.
Read More
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