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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Ancillary Services Claim Data

WCRI Reports on Trends in Non-Price-Controlled Medical Services

The study focused on DME and professional services billed by nonhospital providers from January 1, 2010 through June 30, 2025.

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August 3, 2026

Advocacy Opportunity Treatment Guidelines

Pennsylvania Advisory Council Provides Pharmacy and Study Updates

The meeting discussed issues that could affect pharmacy reimbursement, statutory provider definitions, and medical accessibility reporting.

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July 27, 2026

Advocacy Opportunity Claims Procedures

Texas DWC Stakeholder Meeting

Topics covered include a new AI innovation office, a remote interpreters program, and updates for rulemaking and audits.

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July 27, 2026

Claim Costs Pharmacy Data

Generic Drug Tariffs Proposed for 2028

A 100% tariff is expected to take place August 1, 2028 for generic drugs imported into the U.S., followed by a 200% tariff in August 2029.

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July 27, 2026

Access to Care Claims Procedures

California Reports on the Impact of Reduced Utilization Requirements

Reforms from Senate Bill 1160 resulted in a modest overall effect, with some improvements in timely access to recommended care.

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July 27, 2026

Claim Data

California Reports on Cumulative Trauma Claims

California's rate of permanent partial disability claims reached approximately three times the national median.

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July 27, 2026

Advocacy Opportunity Cost Containment

IAIABC to Host PBM Legislation Webinar

The August 20th webinar will discuss the impact of PBM legislation on workers' compensation systems.

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July 27, 2026

Claim Data

NCCI Explores Workers’ Comp Trends by Industry and State

While most industries saw declines in claim frequency, healthcare, office, and private education defied larger trends.

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July 27, 2026

Advocacy Opportunity Psychedelics

FDA Seeks Input on Potential Therapeutic Use of Psychedelic Drugs

A public hearing will be held on September 14th. with written comments accepted until October 5th.

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July 20, 2026

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Further resources you may be interested in

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

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.

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?

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.