Florida
The Florida Division of Workers’ Compensation (DWC) is proposing to eliminate provisions on reimbursement and billing requirements for physician-dispensed medications. The proposed revisions update Rules 69L‑7.730 and 69L‑7.740 by removing language tied to reimbursement, authorization, and billing obligations for medications dispensed by practitioners. A public hearing on the proposal is scheduled for July 15, 2026. Stakeholders are invited to provide input as the DWC evaluates these changes.
Further information on the public hearing can be found here.
Separately, the DWC recommended a rule change for Rule 69L-7.750 governing insurer electronic medical report filing, which would move the Florida Medical EDI Implementation Guide (MEIG)—a manual that helps stakeholders submit medical data electronically—from Rule Chapter 69L-8 (which is being repealed) into Rule 69L-7.750 (Insurer Electronic Medical Report Filing to the Division). The update would also remove outdated “Revision F” testing timelines, since that testing process has already been completed.
More information on the proposed rule can be found here.
Louisiana
Louisiana Senate Bill 408, signed into law on June 3, introduces broad workers’ compensation reforms focused on modernizing medical billing, data reporting, and fee schedule development, with phased implementation extending through 2029. The bill requires the creation of a statewide medical bill database supported by mandatory payer reporting beginning January 1, 2027, and establishes electronic billing requirements to take effect on July 1, 2027, alongside updated timelines for bill payment, prior authorization, and dispute resolution. The law also directs the state’s Office of Workers’ Compensation Administration to implement a new medical fee schedule with rulemaking to start in 2029.
Further information can be found on the Louisiana State Legislature’s website here: SB408 HB819.
New York
The New York Legislature recently sent a bill to Governor Kathy Hochul regarding the use of telemedicine to treat mental health conditions in workers’ compensation. Assembly Bill 949 would permit telemedicine services for mental and behavioral health issues covered under a workers’ compensation claim and allow at least one in-person visit within twelve months unless the visit would cause a hardship on a claimant. The bill is currently awaiting action by the governor.
More information on AB 949 can be found here.
Pennsylvania
In a case involving 700 Pharmacy, the Bureau of Workers’ Compensation Fee Review Hearing Office, and the State Workers’ Compensation Insurance Fund, the Pennsylvania Supreme Court recently issued a ruling governing whether physicians can refer their patients to pharmacies they own or have a financial interest in.
The court found that the Workers’ Compensation Act’s anti-referral provision does not specifically prohibit these types of self-referrals. According to the court, the phrase “goods or services” is not a broad catch-all and does not include prescription drugs or pharmacy services.
As a result, employers must now pay for reasonable and necessary prescriptions written by physicians even when those prescriptions are filled at pharmacies in which the physician has a financial interest.
The ruling can be found here: 700-Pharmacy-Majority.pdf
Rhode Island
Rhode Island House Bill H 8579 requires PBMs to be licensed by the state Office of the Health Insurance Commissioner and authorizes that office to regulate PBMs and enforce penalties for non-compliance. Although the bill applies to PBM services provided in connection with health insurance coverage, it does not expressly include workers’ compensation PBM activities. The bill passed the Senate on June 11, 2026.
More information on the bill can be found here: H8579
South Carolina
South Carolina Governor Henry McMaster recently signed into law House Bill 3163, which expands compensable and occupational diseases for firefighters. The new law states that any impairment or injury to a firefighter caused by heart disease, stroke, or respiratory disease resulting in total or partial disability or death is presumed to have arisen in the course of employment, subject to certain requirements.
The law took effect on May 26 and can be viewed here.
Tennessee
In Tennessee, Governor Bill Lee signed SB 2040/HB 1959, which seeks to limit overlap between PBMs, insurers, and pharmacies by restricting certain ownership or control relationships when the interest exceeds 5%.
The law includes several exceptions for hospital and health system pharmacies, certain federal healthcare program pharmacy services, employer self-administered pharmacy benefit arrangements, and limited-distribution orphan or REMS drugs. Although most of the law is scheduled to take effect on July 1, several parties have already filed legal challenges seeking to block implementation.
More information on the bills can be found here.
Washington
The Washington State Department of Labor & Industries (L&I) has announced updates to its outpatient drug formulary effective July 1, adding four new drug classes that will either require prior authorization or move to non-covered status.
The formulary outlines medications and therapeutic classes eligible for consideration under the L&I’s workers’ compensation drug benefit, though inclusion does not guarantee coverage and remains subject to clinical appropriateness and program policies. Although Washington operates as a monopolistic workers’ compensation state, self-insured employers are permitted and are generally expected to align their treatment authorization practices with L&I formulary rules and requirements.
An updated version of the Outpatient Formulary can be found on the Department’s website here.