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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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Colorado Study Evaluates Cannabis Reimbursement in Workers’ Comp

Among many aspects, the program involved a specialized medical cannabis physician who managed dosing, titration, and cannabinoid ratios.
Read More →
August 10, 2026

CMS Proposes 2027 Medicare Physician Fee Schedule Updates

Proposed changes would impact reimbursement for telehealth, evaluation and management, and more.
Read More →
August 10, 2026

Arizona Proposes $300 Topical Prescription Cap

The cap is for a 30-day supply. If actual acquisition cost exceeds $300, reimbursement would be limited to 120% of documented AAC.
Read More →
August 10, 2026

California Publishes Study on Cumulative Trauma Claims

CT claims nearly doubled from 9.1% of claims to 16.5% from 2018-2025, with these claims increasing across all regions, demographics, and tenures.
Read More →
August 10, 2026

Colorado Gathers Stakeholder Feedback for Rulemaking Updates

Impacted items would include pharmacy and topical reimbursement, home health, prior authorization, and more.
Read More →
August 10, 2026

New York Broadens Pay Without Prejudice Rules

Effective January 1, 2027, payers may voluntarily cover medical treatment for up to one year while compensability determination is under review.
Read More →
August 3, 2026

Texas Seeks Input on Draft for Topical Analgesic Audit

Stakeholder feedback for the audit plan will be accepted until 5:00 PM CST on August 6th.
Read More →
August 3, 2026

CHSWC Releases 2025 Annual Report

Recommendations from the California report touched on pharmacy topics and access to care.
Read More →
August 3, 2026

Congressional Bill to Remove Federal Heat Standards Advances

If enacted, OSHA would be prevented from adopting heat protection standards proposed in 2024, or any substantially similar rule.
Read More →
August 3, 2026
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 Further resources you may be interested in

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

Pennsylvania Proposes Reimbursement Caps for Compounds and Topicals

The bill would create a $400, 30-day supply cap for compound drugs.
Read More

New Jersey Proposes Marijuana Reimbursement in Workers’ Comp and Group Health

Companion bills S3984 and A1023 would require health insurance coverage for the medical use of cannabis under certain circumstances.
Read More

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.
Read More

WCRI Publishes National Repository on Prescription Drug Regulations

While the report addresses multiple topics, a significant focus was given to the expanding role of pharmacists as a healthcare provider.
Read More

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?
Read More

Inside Medical Experience: Signals, Trends, and System Impact

Healthe’s VP of Industry and State Affairs, Sandy Shtab, joins a panel presentation at the Pennsylvania/Delawaare 2026 Workers’ Compensation Symposium.
Read More
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