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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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

Presumptions

Florida May Increase Cancer Benefits to Firefighters With $25,000 Payment

Additionally, benefits may be extended for up to 10 years post-employment.

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January 12, 2026

Mental Health Presumptions

Kentucky Could Make Psychological Injuries Compensable for First Responders

If enacted, House Bill 26 would apply to police officers, firefighters, emergency medical services personnel, and members of the National Guard.

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January 12, 2026

Presumptions

Virginia Considers Expanding Cancer Presumptions to Sheriffs

Exceptions to the presumption are made for certain cancers diagnosed prior to key dates.

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January 12, 2026

Access to Care

Washington State May Allow PTs and OTs to Qualify as Attending Providers

If enacted, physical therapists and occupational therapists could direct care for injured workers.

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January 12, 2026

Marijuana

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.

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December 22, 2025

Advocacy Opportunity Claim Data

Texas Seeks Feedback On 2026 Medical Audit Plan

Stakeholder input could determine if the audit focuses on either topical analgesics or utilization review compliance.

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December 22, 2025

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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.