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A significant part of the Healthesystems vision is to create a more integrated experience for our customers

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.

Bureau of Labor Statistics Publishes Workplace Injury Report

2.5 million nonfatal workplace injuries and illnesses were reported in 2024, a drop of 3.1% from 2023.

January 26, 2026

Access to Care Technology

Utah Will Allow AI Prescription Renewal for Chronic Conditions

High volumes of prescription renewals are cited as a driver in medication lapses and preventable health outcomes.

January 19, 2026

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.

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.

January 19, 2026

Mental Health Presumptions

Presumption Bills Continue to Trend

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

January 19, 2026

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.

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.

January 19, 2026

New Jersey Proposes Comp Exclusion for Intoxication

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

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.

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

A perspective penned by our VP of Industry and State Affairs

Digital Therapeutics: The Promise of Better Health Outcomes for Injured Workers

What they are, the benefits, how they’re currently covered by insurers, and future outlooks.

Massachusetts Considers Reimbursement, California Could Reject Medical Recommendation

A bill in Massachusetts could require insurers to pay for marijuana, while ACOEM recommends against marijuana for chronic pain guidelines.

Visit Healthesystems at RISKWORLD 2025

Drop by Booth #824 for a copy of the 15th Anniversary edition of RxInformer magazine, and to learn how we’re transforming healthcare.

PTSD Presumptions Continue to See Activity

New York backpedaled on a PTSD presumption for all workers, while California considers a PTSD presumption for healthcare workers.

Psilocybin and Ketamine Therapy Bills Introduced Across the Country

So far, seven psilocybin therapy bills have been introduced in 2025, with three ketamine therapy bills.

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Workers' Comp Property and Casualty PBM
Expires 01/01/2028