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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California Publishes Report on Medical Service Cost Trends

Cost growth of services not subject to fee schedule caps has accelerated in recent years, driven largely by higher utilization.

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September 15, 2026

Ancillary Services Claim Data

WCRI Webinar Recap: Non-Price Controlled Services

Ambiguity for the billing of DME has led to significant increases in workers’ comp spend.

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September 15, 2026

Claim Costs Claim Data Pharmacy Data

WCRI Publishes 2026 CompScope Benchmarks

Many states experienced higher medical payments, driven by higher prices for professional services and evolving trends in prescription drug utilization.

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September 15, 2026

Industry Data

NCCI Publishes September Labor Market Insights

Leisure and hospitality had the largest growth of 62,000 jobs in August, bouncing back from declines in June and July.

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September 15, 2026

Advocacy Opportunity

Texas Proposes 2027 Workers’ Comp Research Agenda

Stakeholders can submit feedback on the research agenda through September 28th.

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August 31, 2026

Mental Health Psychedelics

SAMHSA Recommends States Plan for Legal Implications of FDA-Approved Psychedelics

States are encouraged to plan now for the implications of potential psychedelic therapies, including Medicaid coverage obligations.

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August 31, 2026

Advocacy Opportunity Cost Containment

New York Proposes Fee Schedule Updates

The proposed changes will have a 45-day public comment period for stakeholders to provide feedback.

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August 31, 2026

Claim Data

Minnesota Publishes Workers’ Compensation System Report

The report overviewed data from 2004 to the present, focused on claims, benefits, costs, vocational rehab, disputes, and dispute resolution.

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August 31, 2026

Access to Care

California Backtracks on Naturopathic Doctors Treating Injured Workers

Negative feedback from employers, insurers, and medical organizations resulted in the removal of this proposed clause.

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August 31, 2026

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Further resources you may be interested in

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

Rescheduling Questions: How the Marijuana Landscape Could Soon Change

The rescheduling of marijuana may introduced significant implications for clinical research, drug development, and downstream utilization.

State of the Nation: Summer 2026

Healthesystems’ Sandy Shtab examines key workers’ comp policy trends, from PBM regulation and AI oversight to marijuana rescheduling and injured worker engagement.

Pennsylvania Proposes Reimbursement Caps for Compounds and Topicals

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

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.

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.