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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Advocacy Opportunity Cost Containment

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

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.

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March 23, 2026

Marijuana

New Jersey Proposes Medical Marijuana Reimbursements in Workers’ Comp

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

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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.

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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.

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March 23, 2026

Technology

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.

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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.

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March 16, 2026

Access to Care

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.

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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.

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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.

Preliminary Findings from the 2026 Workers’ Comp Industry Insights Survey Report

Risk & Insurance® magazine published high-level findings from the eighth annual survey, in collaboration with Healthesystems.

Year in Review: What Made the Biggest Impacts in Workers’ Comp Claims Management in 2025?

From claims complexity to mental health, here’s what impacted workers’ comp claims management last year.

New York Could Remove References to CDC Guidelines

After regional public health collaboratives formed in September, New York could be the first state to formally shift policies away from deferring to federal guidelines.

On the Front Lines: How Does Climate Change Continue to Impact Workers?

What are the latest developments in climate change, and how does it continue to impact front-line workers such as ocean workers and construction workers?

Expert Q&A: What Are the Impacts of the New Prescription Drug Tariff Policy?

With the Trump Administration’s new tariff on prescription medications, how are drug manufacturers reacting, and how might the workers’ compensation system be impacted?