Federal
The Department of Justice (DOJ) has reclassified FDA‑approved, state‑regulated medical marijuana products to Schedule III while maintaining marijuana’s overall illegality under federal law. Effective immediately, the move implements a December 2025 White House directive and launches expedited rulemaking on broader rescheduling, including an administrative hearing scheduled for June 29, 2026.
Although the change does not directly alter workers’ compensation coverage, it may shape future policy discussions as clinical research and regulated product development expand.
A press release from the DOJ on the rescheduling can be viewed here.
Separately, the White House issued an executive order directing agencies to accelerate evaluation of – and access to – novel treatments for serious, treatment‑resistant mental illnesses, focusing on investigational psychedelic therapies. The order creates regulatory fast‑track mechanisms, expands federal funding and state partnerships, and increases FDA and VA involvement in clinical trials. It also outlines a pathway to potentially reschedule specific products following Phase 3 trials.
The executive order can be read here.
Alabama
The Alabama Department of Labor has completed annual fee schedule adjustments for all medical services. Changes to the state’s pharmaceutical fee schedule updated dispensing fees for brand drugs to $11.71 and generics to $15.22. Although all fee schedules became effective March 1, 2026, the revised fee schedule was not posted on state website until April 13, 2026.
The updated fee schedule can be reviewed here.
Arizona
The Industrial Commission of Arizona (ICA) has updated its physicians' fee schedule for 2026, effective May 1, 2026, to April 30, 2027. Changes to two specific areas of the pharmacy fee schedule are:
- Raising the maximum reimbursement rate (30 days or prorated by day-supply) for topical compounded medications from $200 to $240
- Imposing a limit on the days-supply for OTC medications dispensed by pharmacies “not accessible to the general public”, such as those in physicians’ practices
- The OTC medication must be dispensed by a healthcare provider or pharmacy within seven days from DOI.
- The OTC medication is limited to no more than a one-time, ten day-supply.
The fee schedule can be viewed here.
California
The California’s Division of Workers’ Compensation (DWC) has revised its Medical Treatment Utilization Schedule (MTUS), with the changes applying to care delivered beginning April 1, 2026. As part of this update, the DWC has incorporated newly issued clinical guidance from the American College of Occupational and Environmental Medicine (ACOEM), including its October 1, 2025 publications addressing workplace mental health, post‑traumatic stress disorder, and acute stress disorder.
The guidelines can be viewed here.
On June 26, the DWC will hold a public hearing on its proposed modifications to the Ankle and Foot MTUS Guidelines as well as the Hip and Groin MTUS Guidelines. Stakeholders are encouraged to participate in the hearing and submit public comments until 5:00 pm PDT on June 5th.
More information about the proposed regulations and the hearing can be found here: DWC - Proposed Regulations
Hawaii
The Hawaii Legislature has passed and sent House Bill 1514 to the Governor. HB 1514 addresses the selection of vocational rehabilitation providers and clarifies the process for selecting a certified provider. It also requires providers to automatically approve vocational rehabilitation services that may be necessary for the injured employee to qualify for suitable employment if the initial evaluation determines that the employee can participate. Lastly, the bill requires providers to submit an employee’s vocational rehabilitation plan within 120 days of the initial evaluation report.
More information on the bill can be found here.
Louisiana
The Louisiana House recently passed House Bill 357, which would require the Office of Workers’ Compensation Administration to implement a new fee schedule by January 1, 2027.
The bill directs the new fee schedule to be more reasonable than the current fee schedule and reflect characteristics similar to those used in surrounding states. The state Senate is currently considering the bill. More information on the bill can be found here.
New York
The Workers’ Compensation Board (WCB) has resolved several technical issues affecting the Request for Further Action by Insurer/Employer (RFA-2) eForm and a new version of the form is ready for use. The WCB is not accepting paper RFA-2 forms postmarked after April 7 of this year. More guidance on using the RFA-2 eForm can be found at the RFA-2 webpage.
Tennessee
Updates to the Tennessee Department of Labor and Workforce Development’s annual Workers’ Compensation Medical Fee Schedule Handbook took effect on April 1. The Handbook’s Pharmacy section now designates the Medi‑Span Price Alert as the primary source for determining Average Wholesale Price (AWP) and Red Book as the secondary source.
There are no substantive changes to the Durable Medical Equipment (DME) section. Maximum Allowable Reimbursement (MAR) calculations for general medicine, therapy, chiropractic services, evaluation & management, and home health have been adjusted for inflation. Additionally, the OP modifier for physician professional services has been replaced by the CP modifier.
The Handbook can be viewed here.
Texas
The Texas Division of Workers’ Compensation (DWC) has adopted its 2026 Medical Quality Review Annual Audit Plan. In the 2026 plan, topical analgesics are the subject of a plan‑based audit based on stakeholder input received late last year. The agency will collaborate with system participants to define audit parameters, including scope, sampling, and review periods. As utilization of these products continues to grow, audit results could inform future reimbursement or prescribing oversight changes. The DWC also noted it may separately review utilization review peer reports for compliance with clinical guidelines and reviewer standards, subject to available resources.
The Medical Quality Review Annual Audit Plan can be read here.
West Virginia
West Virginia House Bill 5430 was signed into law on April 1, 2026. This new law substantially expands PBM regulation, establishing provisions that directly impact workers’ compensation pharmacy benefit administration.
Because HB 5430 took effect retroactively on March 13, 2026, implementation runway has been considerably diminished. As a result, industry trade associations have raised concerns with the Office of the Insurance Commissioner regarding enforcement timing, operational feasibility, and ambiguities in the pricing provisions – particularly where PBMs are restricted to billing payors at or below NADAC even when pharmacy reimbursement exceeds that amount.
The full text of the bill can be found here.