Alaska solicits input on workers’ compensation regulatory revisions
The Alaska Division of Workers’ Compensation is soliciting input on revisions to regulations. Public meetings will be held on October 20 and 23, November 6 and 18, and December 16. Details on these meetings and instruction on how to submit oral or written comments can be found here.
Arizona stakeholder meeting on prescription topicals
The Industrial Commission (IC) of Arizona held a stakeholder meeting on October 2 to solicit feedback on high-cost topical prescriptions following publication of a white paper commissioned by the IC’s Medical Resource Office. A recording of the meeting can be viewed here. A copy of the white paper can be accessed on the Commission’s website.
California presumption bills approved by governor
Governor Gavin Newsom signed Assembly Bill 1125 and Senate Bill 230 into law, expanding workers compensation presumptions for cancer, PTSD, and cardiovascular conditions across different professions.
Bill 1125 modifies existing law, which provides a presumption for heart trouble and other cardiac conditions for certain peace officers and administrative officers to now include officers and employees of the Department of Corrections. The bill can be viewed here.
Bill 230 modifies existing law, which provides for presumptions for various injuries and illnesses frequently associated with employment as a firefighter to now cover firefighters employed at commercial airports. The bill can be viewed here.
California updates hospital outpatient and ACS fee schedule
The California Division of Workers’ Compensation has updated sections of its official medical fee schedule directing hospital departments and ambulatory surgical centers to conform to changes made by Medicare. The updates apply to services provided on or after October 1, 2025 and can be found on the Division’s website here.
Maine adopts bi-annual fee schedule update
The Maine Workers’ Compensation Board has issued a bi-annual update of its medical fee schedule. The updates impact coding and reimbursement for inpatient and outpatient facilities as well as for DMEPOS. The order was issued and took effect on October 1, 2025. The new fee schedule can be viewed here.
Massachusetts hosts listening session on fee schedule
The Massachusetts Executive Office of Health and Human Services and Department of Industrial Accidents (DIA) hosted a listening session on October 14 to gather public input on current workers’ compensation medical payment rates and methodologies which have not been updated since 2009. Numerous stakeholders have provided feedback to the DIA on various medical, ancillary, and pharmacy fee schedules. A previous listening session held in 2018 resulted in no changes and it is uncertain if the DIA will hold future sessions.
New Mexico proposes 2026 healthcare provider fee schedule & billing instructions
The New Mexico Workers’ Compensation Administration (WCA) is accepting public comment on its proposed 2026 Health Care Provider Fee Schedule and Billing Instructions. Written public comment will be accepted until close of business on October 31, 2025 and an in-person meeting will be held in Albuquerque on October 23, 2025. The proposed 2026 fee schedule can be viewed here. Public comments can be submitted here.
New York makes changes to C-8.1B form
The New York State Workers’ Compensation Board (NYS WCB) recently updated its “Notice of Objection to a Payment of a Bill for Treatment Provided” Form (C-8.1B) requiring payers to provide a detailed explanation of their objections to bills for medical treatment. The form’s certification statement has also been amended to indicate that copies of the form were sent to all parties as required by law. The changes apply to both the paper form and the electronic format. The new form will be required for utilization on or after January 5, 2026 and should be published on the WCB website.
Oregon revises formatting and guidance for MCO quarterly reports
The Oregon Workers’ Compensation Division revised Bulletin No. 247 describing the format for certified managed care organizations (MCOs) to submit quarterly reports to the state Department of Consumer and Business Services replacing earlier guidance in place since March 2015. This will impact the three currently certified MCOs in Oregon (Kaiser On-The-Job, Majoris Health Systems Oregon, and Providence MCO). The bulletin can be accessed here.
Pennsylvania Supreme Court schedules oral arguments regarding AWP dispute
The Pennsylvania Supreme Court will hear oral arguments in the case of Federated Ins. Co. v. Summit Pharmacy (WC) on November 19, 2025. The case involves a dispute over correct pharmacy reimbursement as well as the sourcing and definition of Average Wholesale Pricing (AWP). An appeals court in 2024 had rejected the use of Redbook by the Pennsylvania Bureau of Workers compensation to determine AWP in disputes. The hearing may be available on the Court’s broadcast channel here: SupremeCtofPAOfficial - YouTube.