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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Advocacy Opportunity Cost Containment

Alaska Schedules Public Hearing for Fee Schedule Changes

After public feedback is received at the February 19th meeting, the fee schedule is expected to take effect March 15, 2026.

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January 19, 2026

Cost Containment

Massachusetts Clarifies Fee Schedule Recommendations to Legislature

Reimbursement structures have remained unchanged for over a decade, prompting regulators to push for updates.

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January 19, 2026

Mental Health Presumptions

Presumption Bills Continue to Trend

Arizona proposes a PTSD presumption, while Maryland proposes a hypertension presumption.

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January 19, 2026

Access to Care

New Bills Propose Workers’ Comp Changes Related to Immigration Status

New bills in Florida and New Jersey could affect workers’ comp coverage for undocumented workers.

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January 19, 2026

Claim Data Pharmacy Data

WCRI Publishes Report on Injectable Therapies

The report classifies distinct subgroups of injectable by medication type and identifies those most common in workers’ comp.

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January 19, 2026

Access to Care

New Jersey Proposes Comp Exclusion for Intoxication

Intoxication as a material contributing factor to injury or death could disqualify individuals for benefits.

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January 19, 2026

Advocacy Opportunity Industry Data Pharmacy Data

Texas Publishes Audit Report for Gabapentin and Pregabalin Prescribing

The report includes recommendations for providers, and the findings could impact rules around prescribing, utilization review, and service delivery.

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January 12, 2026

Advocacy Opportunity Billing & Payments

New York Proposes Billing Guidelines for Residents and Fellows

After expanding access to care by allowing these providers to treat injured workers, billing guidelines for these providers are being developed.

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January 12, 2026

Advocacy Opportunity Ancillary Services

Ohio Proposes Rule Changes for Prosthetic Coverage

Under the proposal, the BWC would cover purchases through their surplus fund if the need stems from an allowed injury or occupational disease.

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January 12, 2026

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Further resources you may be interested in

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

State of the Nation with Sandy Shtab

Healthesystems VP of State & Industry Affairs comments on recent federal activity that creates potential impacts for workers’ comp.

Q&A with RxInformer Magazine Founder Jill Knight

Learn about the impetus for and history of our own RxInformer magazine from founder Jill Knight, VP of Marketing and Customer Experience.

By the Numbers: 15 RxInformer Stats for 15 Years

Now that RxInformer is officially 15, we looked back at past issues to gather interesting stats about the magazine and how it’s produced.

Burden of Proof: Unpacking Presumptions in Workers’ Comp

New presumptions in workers’ comp are making it easier for workers to qualify for benefits related to mental injury, including PTSD, as well as certain cancers and other conditions.