Alaska
At its October 15-16 meeting, the Alaska Workers’ Compensation Board advanced the proposed 2027 Fee Schedule toward adoption and approved additional amendments to strengthen the language governing topical compounds. Pending final approval, the fee schedule is expected to take effect on January 1, 2027.
Proposed changes to the schedule include updates to reimbursement, medical necessity, and billing requirements for physician-dispensed, repackaged, compounded, topical, and over-the-counter medications (including use of original manufacturer NDC for physician-dispensed and repackaged drugs).
In addition, reimbursements for topical medications would be capped at:
- $30 per 30-day supply for creams, gels, ointments, lotions, and similar non-patch formulations
- $70 per 30-day supply for patches
- $240 per 30-day supply for topical compounds
These caps would be prorated based on the exact days’ supply and would include applicable dispensing or compounding fees. Topical and non-topical compounded prescriptions would be eligible for only one compounding fee of $10 for three or fewer ingredients or $20 for more than three ingredients.
The full draft Fee Schedule can be reviewed here.
Arizona
Industrial Commission considers $300 cap for topical medications
The Arizona Industrial Commission has proposed language for the 2027 fee schedule that would cap reimbursement for topicals at $300 for a 30-day supply. The Commission is currently accepting comments.
More information can be found on the Commission’s website.
Colorado
Fee Schedule proposal targets combination topicals and compounded drugs
The Workers’ Compensation Division has adopted revisions to its medical fee schedule and utilization review rules that would require prior authorization for combination topical agents/patches as well as the use of lower cost alternatives for all topical agents. These proposed updates are scheduled to take effect on January 1, 2027.
Under the proposal, combination topical agents and patches would be limited to the lowest-cost, therapeutically equivalent option unless prior authorization is obtained. In addition, “Prescription-Strength Topical Compounds” would be replaced by “Non-Sterile Compounded Drugs.” These products would be reimbursable only when medically indicated and when no FDA-approved drug is available.
The full proposed revisions can be viewed here.
California
Public hearing scheduled on MTUS knee guideline update
The Division of Workers’ Compensation will hold a public hearing on October 16th to consider a proposed MTUS update that would incorporate the July 2026 ACOEM Knee Disorders Guideline.
Written comments are also due on October 16th. More information can be found on the Division’s website here.
P&T Committee to review GLP-1 drugs, biologics, and other formulary topics
The Division’s Pharmacy and Therapeutics (P&T) Committee will meet on October 21st to discuss drug utilization and potential formulary updates, including GLP-1 drugs, acid-reducing medications, biologics, and other formulary-related topics.
More information can be found on the Division’s website here.
Oregon
Oregon finalizes workers’ compensation rule updates
The Oregon Workers’ Compensation Division has adopted permanent amendments to its Medical Fee, Medical Services, Managed Care, Claim Closure, Disability Rating, and Claims Administration rules, effective October 1, 2026. The amendments primarily make permanent temporary rules that took effect April 8, 2026, which expanded the authority of nurse practitioners and physician associates within Oregon’s workers’ compensation system.
The new and existing rules can be reviewed on the Division’s website at Oregon Workers' Compensation Division : New rules : Laws and rules : State of Oregon
Texas
Texas DWC adopts updated return-to-work rules
The Texas Division of Workers’ Compensation (DWC) has adopted rule changes concerning return-to-work guidelines. The changes direct insurance carriers, health care providers, and employers to use the disability duration values in the current edition of the ODG by MCG, published by MCG Health as the guideline for evaluating expected or average return-to-work timeframes, replacing references to MDGuidelines (formerly known as the Medical Disability Advisor).
The amendments also update the DWC website address referenced in the rule to ensure it remains current and accurate. The rule was published on September 25, 2026, and became effective on September 29, 2026. Additional information can be found here.
Vermont
Fee schedule revisions target pharmacy reimbursement and DME controls
Although a final rule filed on September 24th is awaiting final approval, an effective date has not yet been published. Changes include:
- An increase in the pharmacy dispensing fee increased from $3.15 to $5.00 per prescription,
- Adoption of NCCI PTP and MUE coding edits
- A requirement that reimbursement for automatically shipped DME/supplies be subject to approval by either the carrier or the prescribing provider
The full final version can be reviewed here: Vermont Rule 40 – Medical Fee Schedule.