In Conversation: Enlyte’s Legal and Regulatory Experts on Top Trends to Watch in 2024

From shifts in drug costs to state-based workers’ comp system restructuring efforts, these are the trends workers’ comp professionals need to make sure they’re paying attention to. 
By: | December 1, 2023

Workers’ comp professionals know the importance of staying abreast of legal and regulatory trends. Federal and state laws and regulations are constantly shifting, which means that industry professionals are often implementing new rules, sometimes in multiple jurisdictions.

Even if a law isn’t directly part of workers’ comp legislation, it can have ripple effects.

One big federal issue that’s trickling down to the industry this year is drug costs. Centers for Medicare & Medicaid Services (CMS) is in the process of negotiating prices for a variety of different medications with pharmaceutical companies. These federal negotiations could lead pharmacies to cost-shift — charging commercial and workers’ comp clients more — or it could lead to reduced prices across the board.

Providers are billing above fee schedules for various medications, and they’re pushing back against CMS’s desire to roll back temporary pandemic-related price increases. States like Florida are raising their fee schedules, leading to higher costs for some drugs.

Risk & Insurance writer Courtney DuChene delved into this and other key legal and regulatory workers’ comp trends with a team of professionals from Enlyte: Lisa Anne Bickford, director of government relations, Coventry; Brian Allen, vice president of government affairs, Mitchell Pharmacy Solutions; and Michele Hibbert, senior vice president of regulatory compliance management, Mitchell.

Their conversation touched on everything from national issues such as inflationary pressures on medical spend to state-by-state affairs, including provider network litigation issues in Florida and California’s efforts to restructure its workers’ comp system.

The R&I Editorial Team can be reached at [email protected].

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