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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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

Claim Data

California Reports That COVID-19 Drove Recent Increases in Injury and Illness

Using data from the Bureau of Labor Statistics, the CWCI found that COVID-19 drove recent increases in injury and illness, with rates decreasing lately.

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February 23, 2026

Access to Care Ancillary Services

Oregon Extends Sign Language Interpreter Licensing Pause

Prolonged licensure pauses risk reducing interpreter availability and disrupting access to care.

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February 23, 2026

Advocacy Opportunity Treatment Guidelines

Tennessee Medical Advisory Committee Meeting Recap

The meeting covered potential updates to treatment guidelines, specifically for physical therapy, as well as other topics.

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February 16, 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 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.

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.