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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Presumptions

Alaska Revises Cancer Presumption for Firefighters

While cancer coverage remains the same, timelines and qualifications for coverage have been adjusted.

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July 20, 2026

Advocacy Opportunity Treatment Guidelines

Texas Proposes Updates to Impairment Rating Guidelines

The Fourth Edition of the AMA Guidelines have been in use since 2000 and would be updated to the Six Edition, published 2025.

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July 20, 2026

Ancillary Services

CMS Proposes Updates to Expand Access to Home Healthcare

The proposed rule includes an estimated 2.4% increase in Medicare payments to home health agencies to support access to care.

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July 13, 2026

Billing & Payments Claims Procedures

Florida Extends Deadlines for Medical Reimbursement Disputes

Providers now have 60 days to petition the DWC when carriers adjust or disallow payment, while carriers have 45 days to respond to petitions.

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July 13, 2026

Worker Safety

Colorado Enacts Extreme Temperature Protections

Extreme heat and cold protections originally created for agricultural workers have now been extended to all employees.

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July 13, 2026

Worker Safety

New York City to Implement Heat Safety Standards

A mayoral executive order tasks the Department of Health and Mental Hygiene to develop and distribute heat safety guidelines as soon as possible.

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July 13, 2026

Claims Procedures

Hawaii Revises Requirements for Treatment Plans and FCE

A new timeline to object to treatment plans and new rules for who can authorize FCE.

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July 13, 2026

Claims Procedures

Indiana Limits IME Record Submission

When submitting records for IMEs, parties must limit documentation to 500 pages.

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July 13, 2026

Advocacy Opportunity Cost Containment Treatment Guidelines

Florida Sets Hearing for Physician Dispensing Rules

The hearing will take place on July 15th, allowing interested stakeholders to attend virtually.

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June 29, 2026

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Further resources you may be interested in

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

Expert Q&A: What Utah’s AI Prescription Renewal Pilot Signals About the Evolving Role of AI in Treatment Decisions

Utah’s prescription renewal pilot is a groundbreaking use case for AI in healthcare. What are the potential benefits and pitfalls?

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.

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.

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.