Data presented at PAINWeek 2026 indicates that the novel, non-opioid pain medication may be shaking up prescribing patterns for acute pain.
Data presented at PAINWeek 2026 indicates that the novel, non-opioid pain medication may be shaking up prescribing patterns for acute pain.
Rising GLP-1 use is slowly creeping into claims, requiring a review of clinical considerations.
Frequency for mental health claims was higher among longer-tenure workers, higher-wage earners, women, and those in clerical and professional occupations.
Trending topics include worker classification, portable benefits, mental injuries, single-payer insurance, marijuana, and psychedelics.
In addition to recapping roundtable discussions, the event saw Sandy Shtab, Healthesystems VP of Industry and State Relations, receive the IAIABC President’s Award.
A study from PLOS One examined trends in drug approvals before and after implementation of new federal regulations for evidentiary standards.
Shortages can increase costs, delay or alter treatment, increase complexity, and impact claims outcomes.
Impacted drugs include physician-dispensed and repackaged drugs, topicals, compounds, and OTC medications.
States are encouraged to plan now for the implications of potential psychedelic therapies, including Medicaid coverage obligations.
Business Insurance recaps an educational presentation held at WCI 2026, featuring Healthesystems VP of Clinical Services, Silvia Sacalis, PharmD, BS.
A 100% tariff will take effect August 1, 2028 for generic drugs imported into the U.S., followed by a 200% tariff in August 2029.
Effective pharmacy workflows pair greater efficiency with better health outcomes, reducing burden for claims professionals while increasing impact.
The study focused on DME and professional services billed by nonhospital providers from January 1, 2019 through June 30, 2025.
Effective January 1, 2027, payers may voluntarily cover medical treatment for up to one year while compensability determination is under review.
A public hearing will be held on September 14th, with written comments accepted until October 5th.
Visit Healthe at Booth #415 to chat and pick up a copy of RxInformer magazine, or sit in on our panel discussion.
This approval marks the third OTC naloxone medication available for the treatment of opioid overdose.
These diseases are infrequent, but they can incur significant costs as they can be present for life, requiring ongoing monitoring, treatment, and medication.
Florida, Pennsylvania, and Michigan have recently made waves regarding physician dispensing.
While migraine drugs make up less than 1% of prescriptions, they now make up 7.5% of drug spend, primarily driven by CGRP drugs.
Patients taking DT120 for major depressive disorder experienced significant drops in depression symptoms.
Visit Healthe at Booth #921, and don’t forget to check out two educational sessions featuring Healthe leaders!
While experts agree more research is needed, several studies have noted patients on these drugs showed reduced rates of certain types of cancer.
Demand for DME is rising, as are costs. What’s driving this growth, and how can the workers’ compensation industry contain costs?
Several states continue to update presumptions for cancer, PTSD, and other conditions.
Dermatological agents remained a significant cost driver, in part due to physician dispensing and delivery pharmacies, which accounted for a significant number of high-cost transactions.
Connecticut, Georgia, and Oklahoma enacted laws to enable certain programs, while a Louisiana bill awaits gubernatorial decisions.
The rescheduling of marijuana may introduce significant implications for clinical research, drug development, and downstream utilization.
Claim costs increased 6% per year from 2022-2025 in the median study state, with state-level variations.
The order seeks to accelerate clinical trials, data sharing, drug approvals, and possibly rescheduling.
After soliciting stakeholder feedback on possible audit topics, the DWC prioritized a study of topical analgesics by the Medical Quality Review Panel.
Workplace assaults have increased at a rate of 5.3% per year from 2011-2022, primarily impacting health care and social assistance workers.
The once-daily tablet starts at an 0.8 mg dosage, which is then steadily increased at 30-day intervals, based on treatment response and tolerability.
While severe cases are less common, they greatly impact costs, recovery, and return to work.
The bill would create a $400, 30-day supply cap for compound drugs.
Companion bills S3984 and A1023 would require health insurance coverage for the medical use of cannabis under certain circumstances.
From a poll of 1,692 physicians, over 80% used AI in some context – twice the percent noted in 2023.
Mike Theis, AVP of Product and Analytics, joins other industry experts featured in Risk and Insurance’s latest article on how AI can reduce clutter to allow for a more human touch.
With the workforce growing older, degenerative conditions may have a growing impact on claims.
While injured workers have an absolute choice over their pharmacist, physicians are not considered pharmacists and therefore not entitled to reimbursement.
While the report addresses multiple topics, a significant focus was given to the expanding role of pharmacists as a healthcare provider.
Utah’s prescription renewal pilot is a groundbreaking use case for AI in healthcare. What are the potential benefits and pitfalls?
While opioid utilization has decreased, overall spending on pain management has increased, in part due to the use of high-cost topical medications.
Healthe’s VP of Industry and State Affairs, Sandy Shtab, joins a panel presentation at the Pennsylvania/Delawaare 2026 Workers’ Compensation Symposium.
The risk and impact of occupational cancers vary significantly depending on the nature of the exposure and the affected workforce.
The pilot can approve a limited set of 192 medications and will be broken into three stages, each with different levels of review.
The medical device supplier is charged with fraudulently submitting millions of dollars in billing for devices that were not necessary, covered, or agreed to by patients.
Legislators continue to introduce bills to limit AI-generated healthcare decisions, even as the U.S. Attorney General has been instructed to oppose them.
Approximately 11 million adults used psilocybin in the last year, with an estimated 10 million adults microdosing with a psychedelic.
Using data from 2 million claims across 32 states, the study found that the prevalence of these surgeries increased, driven by shoulder joint replacements.
This approval marks the arrival of the first oral GLP-1 semaglutide drug.
A small percentage of claims drive the majority of costs in workers’ comp. How can mega claims be mitigated?
Rescheduling marijuana to Schedule III will allow for greater clinical research, possible FDA-approved drugs, and more.
So far in 2026, eight states and counting are seeking to expand existing presumptions or create new presumptions.
While AI can be effective in some elements of drug design, AI models currently struggle to explain their decision making, a key component of drug review.
Risk & Insurance® magazine published high-level findings from the eighth annual survey, in collaboration with Healthesystems.
The 2025 negotiations covered drugs for obesity, cancer, diabetes, COPD, asthma, and more.
Engaging directly with injured workers is one important way to improve pharmacy network utilization in workers’ comp.
The review examines the efficacy of cannabis therapy for various indications, including chronic pain and psychiatric conditions.
Drug classes with the most new, high-priced drugs were anti-cancer drugs, ADHD/anti-obesity drugs, and anti-inflammatory pain medications.
