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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Claim Data Pharmacy Data

California Publishes Independent Medical Review Report

Pharmaceutical requests represented 30.6% of all treatment requests submitted for IMR, a modest decline from 32.7% in 2024.

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May 25, 2026

Mental Health Psychedelics

Georgia Enacts Regulations for Psychedelic Clinics

The Georgia Composite Medical Board will issue rules and regulations for clinics administering psychedelic-assisted therapies by December 31, 2026.

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May 25, 2026

Presumptions

Colorado Could Expand Cancer Coverage for Firefighters

Senate Bill 184 passed both chambers and now sits with Governor Polis.

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May 25, 2026

Claim Costs Pharmacy Data

WCRI Publishes Interstate Variation and Trends Report on Drug Payments

Dermatological agents remained a significant cost driver, in part due to physician dispensing and delivery pharmacies, which accounted for a significant number of high-cost transactions.

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May 25, 2026

Advocacy Opportunity Ancillary Services Treatment Guidelines

Montana Proposes Updates to Formulary and Fee Schedule, Requesting Stakeholder Feedback

A remote hearing will be held on May 28th, with comments accepted through June 5th. If enacted, changes will take effect July 1st.

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May 18, 2026

Psychedelics

Oklahoma Enacts Law for Ibogaine Clinical Trials

Effective November 1st, the Department of Health can enter into contracts with drug developers to conduct ibogaine clinical trials.

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May 18, 2026

Psychedelics

Connecticut Could Soon Expand Psychedelic Pilot Program

Previously limited to veterans and other specific populations, the bill could apply to any adult that meets clinical eligibility criteria.

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May 18, 2026

Mental Health Opioids Psychedelics

Louisiana Considers Psychedelic-Assisted Therapy Program

Psilocybin and ibogaine clinical trials would target opioid use disorder and treatment-resistant mental health conditions.

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May 18, 2026

Mental Health Psychedelics

Minnesota Considers Psychedelics Therapy Program

A three-year pilot program would allow for 1,000 patients annually to receive treatment for PTSD, depression, chronic pain, and more.

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May 18, 2026

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Further resources you may be interested in

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

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.

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.

States Consider Expanding Presumptions

So far in 2026, eight states and counting are seeking to expand existing presumptions or create new presumptions.

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.