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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Access to Care Claims Procedures

Arizona Bill Could Expand Worker Choice in Medical Care

Senate Bill 1404 could grant workers greater choice over their provider, pharmacy, certain ancillary services, and more.

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February 9, 2026

Worker Safety

States Introduce Bills to Protect Workers from Extreme Temperatures

So far, Arizona, Georgia, and Virginia have introduced bills that would require workplace safety standards for heat protection.

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February 9, 2026

Presumptions

Hawaii Could Expand Firefighter Cancer Presumption

A proposed bill could add additional types of cancer to the pre-existing presumption for firefighters.

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February 9, 2026

Billing & Payments Claim Data Industry Data

California Publishes Independent Billing Review Report

About 6% of medical bills challenged through the dispute process were initially paid correctly.

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February 9, 2026

Claim Data

WCRI Reports on Trends in Joint Replacement Surgery

Using data from 2 million claims across 32 states, the study found that the prevalence of these surgeries increased, driven by shoulder joint replacements.

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February 9, 2026

Claim Costs Claim Data

NCCI Publishes Report on Fast-and-Slow Emerging Claims

Both claims reach costs of $1 million or more, but at different points in time after injury.

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February 9, 2026

Cost Containment Treatment Guidelines

Hawaii Bills Target Pharmacy Management Rules

New bills would address compounds, deadlines for authorization decisions, and more.

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February 2, 2026

Cost Containment

Missouri Proposes Fee Schedule

The bill would require a formal fee schedule for all services provided under workers’ comp, taking effect August 28, 2026.

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February 2, 2026

Technology

Multiple States Seek to Limit AI-Generated Care Decisions

Alabama, Hawaii, Kentucky, Oklahoma, Pennsylvania, and Virginia have all introduced bills to limit AI-generated care decisions.

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February 2, 2026

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Further resources you may be interested in

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

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.