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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Mental Health Presumptions

PTSD Updates Across the Country

New Jersey could create a task force for pandemic-related PTSD, while Virginia and Connecticut could expand mental health presumptions.

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March 2, 2026

Worker Classification

West Virginia Proposes Using Federal Standards for Worker Classification

Senate Bill 1073 would eliminate state rules and replace them with federal IRS standards on the matter.

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March 2, 2026

Worker Safety

Colorado Proposes New Safety Requirements for Extreme Heat and Cold

In addition to creating a model temperature-related injury and illness prevention plan, the state would create measures to monitor these incidents.

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March 2, 2026

Access to Care Cost Containment Treatment Guidelines

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.

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March 2, 2026

Claim Costs Pharmacy Data

NCCI Reports on Interstate Variation in Pain Management Trends

While opioid utilization has decreased, overall spend on pain management has increased, in part due to the use of high-cost topical medications.

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March 2, 2026

Ancillary Services Cost Containment

CMS Publishes 2026 Q2 NCCI Edits

Changes were made to the Medically Unlikely Edits (MUEs) for Practitioner Services, DME Supplier Services and Outpatient Hospital Services.

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March 2, 2026

Cost Containment Treatment Guidelines

Hawaii Amends Bill to Target Physician Dispensing

Originally meant to address compound medications, the bill has been expanded to create limitations for physician dispensing.

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February 23, 2026

Access to Care Claims Procedures

Arizona Pharmacy Network Bill Fails to Pass

The bill did not pass out of its original committee before a crucial deadline, and failed to pass after a special hearing.

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February 23, 2026

Ancillary Services Billing & Payments Cost Containment

Alaska Updates Medical Fee Schedule

In a February 19th special meeting, the Board approved new rules and addressed confusion regarding resource materials

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February 23, 2026

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Further resources you may be interested in

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

Highlights from the NCCI Annual Insights Symposium 2025

In-depth reports cover topics ranging from an overview of the workers’ comp system to opioids, industry-specific trends, and more.

Congressional Budget Bill Could Place 10-Year Ban on State AI Regulations

If passed, the bill would prevent the enforcement of laws on AI models and automated decision systems.

Then and Now: 8 Reflections from 15 Years of RxInformer

In celebration of the 15 year anniversary of RxInformer, the editorial staff looked back at past issues to understand what has changed – and what hasn’t.

WCRI Reports on the Impact of Marijuana Laws on Workers’ Comp Benefits

While recreational marijuana laws may be tied to increases in claim frequency, medical payments and prescriptions decreased, including those for opioids.