In every legislative session in all 50 states, bills are considered that affect the daily tasks of workers’ compensation professionals across the nation — and the injured workers they serve.   

While the challenge of tracking and managing the intricacies and eccentricities of each state’s regulatory processes may seem insurmountable, some forward thinkers have developed a cascading set of solutions to ensure compliance even in the most daunting of rule making circumstances. However, these gains are heavily dependent on the rise of online resources, team capabilities and coordination and government transparency.  

For regulatory affairs experts, workers’ compensation regulations fall into a couple of categories, but not all are captured in the typical legislative process, which presents those tasked with managing interstate compliance on a national level with the challenge akin to detective work.  

“In my experience, the changes that are most difficult to track are those that are slipped in without advance notice or a public comment period, or at least with short notice,” said Adam Fowler, director of regulatory affairs at MyMatrixx.   

Fowler explained that the “sub-regulatory documents” are an additional compliance hurdle.  

Typically, this category of rule is decreed outside of the regulatory process and takes the form of a guidance document or PDF on the state’s website. The changes can be wide ranging like limitations and explanations of new PTSD coverages, or simple like a change in the Medicare multiplier for medical equipment reimbursement.   

However, the unpredictability regarding when and how these sub-regulatory documents are issued makes them easy to overlook. “Unfortunately, in workers’ comp, [release of sub-regulatory documents] happens quite often for certain states because they’re not necessarily required to go through a formal rulemaking process. These ‘pop up’ changes can be difficult to prepare for and then deal with once they are adopted or published,” Fowler said.  

Adam Fowler, director of regulatory affairs, MyMatrixx

For the majority of workers’ comp regulation though, the problem is one of volume and team size and expertise. “If you do business like we do business in all 50 states, you’ve got to be on your toes,” explained Kevin Tribout, VP of public policy and regulatory affairs at Optum.  

“If you’re a key department in the organization you need to have people that understand regulation and regulatory processes. You need multiple people as well, you’d be going crazy with just one. Most of the states follow the administrative procedures act, and everything is pretty similar in most states, but there are some states that do things quicker or more quietly.”  

For those quiet states, much of the simple monitoring can be outsourced to a number of solutions that aggregate data (often tied to legal services or consulting companies) in a relatively easily digestible format like a heat map for regulatory compliance and government affairs staff keyed to states or issues of interest. From there, regulatory teams can review the magnitude of the tracked regulations and their status. This is especially handy during the legislative session, where bills of concern can wither on the vine in a single committee hearing. 

However, tracking is only part of the battle.  

“Regulatory awareness isn’t just about watching policy—it’s about shaping it,” said Sandy Shtab, VP of industry and state affairs, Healthesystems.  

“We don’t simply monitor changes; we actively engage with regulators and clients to improve outcomes for injured workers and enhance system effectiveness. It’s about turning experience, expertise and data into meaningful system changes.”  

 To ensure that the system does indeed consider unintended consequences, knock on effects, and similar issues inherent to lawmaking, experts agreed that public comment is a primary vehicle. Most large workers’ comp organizations have subject matter experts that can provide both factual expertise and cache to those comments, and the best compliance officers know how to garner that feedback efficiently and ensure it reaches the right people at the right time. Similarly, the less formal but equally important role that personal relationships and rapport have in the governance process was frequently cited as an advantage. 

“We work in concert with the states and our contacts at the states. Our job is to monitor things and make sure we alert. We participate in hearings as well. I like to work in our organization with the people that are actually doing the job. When the policy is in flight and we’re thinking about submitting comments we ask our internal SMEs to submit comments to us,” said Tribout. 

This focus on stakeholder input is one of the key components of dynamic regulatory compliance. This applies to the entire system and requires government transparency throughout the process.  

Tribout, whose career in regulatory compliance has spanned decades, explained this as a major boon to his work.   

“After I left legislative staff and started with PMSI in 2001, things in state legislative tracking was very piecemeal,” he said.   

“Some states were well organized and had a lot of tools and keys you could use to log into their legislative website and track various bills and some states were not as organized. But even then, a lot of it was done on an individual state level and you had to just keep on top of what the state was doing through trade associations and other organizations. There were quite a few companies back then, mostly out of DC, that you could contract with to provide you tracking information in a weekly report because they had staff who bundled these reports from the various state web sites. These reports were often emailed to a person like myself and you would manually track them internally. Then states began to feel the pressure to be more open and transparent and make the legislative process open to anyone who could simply operate a website, and search by a bill number.”  

This manual tracking effort is still a relevant part of the daily work of compliance teams, even when software is used to streamline the effort.  

“We also put in the work just by monitoring the websites of several states,” Fowler explained.   

“This helps us keep track of those states that adopt fee schedules for providers without a public comment period or with little to no advanced notice, and also the states that typically adopt their medical fee schedule once a year. It’s a little old fashioned, a little manual, but we have a small team, and that’s our job to monitor this information so we can inform our clients and stay compliant.”   

Third-Party Institutions Can Help  

Trusted sources in the space are also a wellspring of useful information during and between legislative sessions, especially for trending focus areas, like medical marijuana and presumptions, or workplace mental injuries. The National Council on Compensation Insurance’s (NCCI’s) annual legislative trends report is one frequently cited example. And the sheer volume of bills of interest is enough to give frontline staff pause.  

According to the 2024 report, NCCI tracked 911 state and federal bills that could impact workers’ compensation stakeholders, including 470 bills in states where NCCI provides ratemaking services. As of the publication of the 2024 report, 108 of those bills were enacted across all jurisdictions. NCCI also monitored 267 proposed worker’s compensation-related regulations and by the end of July last year, 103 of those proposed regulations were adopted.   

This is a significant increase from the previous year in which NCCI tracked nearly 100 fewer bills (809), but 143 bills were enacted, indicating a greater appetite for legislation in the sector. As they do every year, NCCI also monitored regulations, with 236 proposed workers compensation-related regulations on the docket for 2023. Eighty-three of those proposed regulations were adopted.  

For interested parties, NCCI provides an interactive dashboard that allows for state by state, per issue, and by year search functions of enacted legislation. Each entry is summarized and links to the actual legislation.  

Meanwhile, the Workers’ Compensation Research Institute (WCRI)’s reports dig into the trending topics themselves, adding color to the narrative of a particular legislative priority. Their website contains numerous studies of post legislative effects of everything from specific medical procedures to settlement behavior.  

While the onus is on all stakeholders in the system to participate and ensure a balanced, fair workers’ compensation framework in every state, once a new law is passed, or becomes very likely to pass, compliance teams kick into high gear, and their internal management techniques are a mixture of the familiar and the sophisticated.  

“Internally, we provide a monthly slide deck for the big changes. Then we have calls internally with account management, our compliance team, IT, and then with leadership to walk through the changes that are taking place and what’s actually been adopted and the effective date,” explained Tribout. “We also provide this to select clients that we know are especially into the regulatory side and we present what they need to do to stay in compliance.”  

As a value-added service, some updates are made publicly available creating an information network for everyone partnering to keep the system streamlined and navigable.  

“We report on legislation internally and externally,” said Fowler. “Internally, we keep our leadership and other interested parties abreast of things as we see legislation coming and moving through the legislative process. Once legislation is enacted into law, we’ll have a combination of internal meetings, as well as presentations, and we do formal notices anytime there’s a final policy development, whether it be enacted legislation or adopted regulations.” 

 However, sometimes it’s the basics that matter the most. “It’s all about keeping it simple,” Shtab explained.   

“Legal language can be tough to navigate, so we translate complex regulatory updates into clear, actionable guidance for our internal teams and customers—ensuring everyone understands what’s changing, when, and why it matters. Whether we’re publishing website updates or social media posts, we make sure our partners are not just informed, but empowered to engage in the regulatory process. We want our clients to be part of the conversation—not just recipients of change, but contributors to it. Because informed customers are powerful allies in shaping policy.”  

In the effort to shape policy in this way, Shtab cited the resources mentioned above, and other neutral observers, as well as bespoke data. “We leverage our own analytics alongside trusted sources like WCRI, NCCI, and CWCI to advocate for balanced, evidence-based public policy. While workers’ comp is a 50 state system, good public policy transcends state boundaries,” said Shtab.   

“Despite the differences, there’s room for greater consistency. Regulators want to hear from experts who know what works in other states — and what doesn’t.” Often it’s what doesn’t that can make all the difference.  

During the legislative session to keep frontline staff informed and empowered, regulatory experts lead meetings to demystify the new law and ensure that as enactment dates come closer, their colleagues are aware of how internal policy will change. 

 “We host in-flight policy calls where we have subject matter experts from across the organization to explain policy changes coming up. Sometimes we get commentary from them which we submit to the states as well,” Tribout said. “And whenever there’s an adopted policy we draft an internal memo to go to all of the frontline staff. We also make ourselves completely available to talk to me and our team, since the end game is everyone in compliance all the time.”  

Tribout offered Nevada’s implementation of ODG by 2027 and Colorado’s e-billing initiatives as current examples of high level changes that require frequent updates and reporting.  

Just as regulations and laws evolve with the times, workers’ compensation professionals are always seeking the best new solutions to stay in compliance and employing a mixture of methods to wrangle a complicated 50 state system, plus any relevant federal legislation. While it’s easy to lose the forest for the trees, all participants in the system share the same goal, returning injured workers to their baseline health and to gainful employment.   

At this year’s National Comp conference November 11-12 in Nashville, several sessions will address legislative trends and forecasting, to help attendees prepare for the new landscape in 2026. Legislation is available on the National Comp conference website. &