What changes.
What it means for you.

Delaware signed SS1 for SB334 on September 8, 2026, with an effective date of January 1, 2028. Its uniform credentialing framework includes WC carriers and PBMs that require credentialing. The final text protects the existing WC provider-certification system: already certified providers cannot be required to obtain this additional credentialing to receive WC reimbursement.

Wisconsin DWD's Health Cost Dispute page covers treatment-necessity and fee-reasonableness disputes and says the division prepares pharmacy fee schedule disputes for resolution. It links separate forms and information for the dispute types.

California DWC proposes updating MTUS section 9792.23.6 to incorporate revised ACOEM Knee Disorders guidance. Its official rulemaking page schedules a virtual hearing for October 16, 2026, starting at 10 a.m., and requires written comments that day.

Texas DWC's fee-guideline FAQ distinguishes DME reimbursement from annual physician conversion-factor increases. It directs operators to Rule 134.203(d) and says Medicare DMEPOS fee-schedule updates are adopted as they occur. Network and approved out-of-network claim treatment must be checked separately.

Texas DWC says carriers, their agents, WC networks and government employers may not require injured employees to obtain pharmacy services from a particular pharmacy. Workers may use their chosen pharmacy if it accepts WC. This existing guidance is distinct from general commercial-health PBM reforms.

The Board of Physicians says dispensing generally requires a permit unless a listed exception applies. Its guidance distinguishes dispensing from prescribing or administering and describes permit, location and continuing-education requirements.

COMAR 10.34.37.04 requires a Maryland permit and a designated Maryland-licensed pharmacist for nonresident pharmacies. It also addresses home-state licensure, retrievable prescription records, patient telephone access and notices accompanying shipped drugs.

Alabama’s WC fee-schedule directory includes a 2026 Pharmaceutics Schedule alongside separate physician, facility and other schedules. Drug bills should be checked against the pharmaceutical document rather than a general medical rate table.

The 2026–2027 Pharmaceutical Fee Schedule expressly covers medications dispensed by healthcare providers and pharmacies, including online and mail-order pharmacies. The Commission lists May 1, 2026 through April 30, 2027 as the schedule period.

The Arkansas Workers’ Compensation Commission provides 2026 medical fee schedules in PDF and Excel formats, plus laboratory schedules and links to its rules and advisories. These are starting points for checking the current billing edition.

Connecticut’s Commission lists a practitioner fee schedule effective July 15, 2026 and benefit tables covering October 1, 2026 through September 30, 2027. The updates address different components of a claim; benefit rates are not pharmacy reimbursement rates.

The State Board of Workers’ Compensation identifies its April 1, 2026 Medical and Dental Fee Schedules as available for purchase from FAIR Health. Its page also links the electronic billing and payment companion guide.

Hawaii’s Disability Compensation Division publishes Exhibit A for the 2026 workers’ compensation medical fee schedule. The official schedule is a billing reference for covered medical services; it does not by itself establish an outpatient pharmacy rate or dispensing permit.

The Industrial Commission reports that proposed 2026 OPPS addenda were posted in error. Final Addenda B and D1 were posted April 8, 2026 and should be used for applicable provider reimbursement dates of service beginning January 1, 2026.

Indiana’s Workers’ Compensation Board explains the request-and-review process for formulary N drugs. Unless otherwise indicated, approval covers a single prescription order; another prescription requires another supported request. A denial must proceed to an appropriately certified reviewer.

Iowa’s Workers’ Compensation Division provides an injured-worker guide with the governing statutes, medical benefits and dispute framework. It also provides alternate-care forms and acts as the neutral tribunal for contested cases.

Kansas’s medical-services section oversees the WC fee schedule, which it says is updated every two years. Its fee lookup instructs users to select the edition applicable to the billing being prepared.

Kentucky’s Department of Workers’ Claims says WC carriers and self-insured programs must implement utilization-review and medical-bill-audit programs. Its medical-services page also explains managed-care provisions and links relevant regulations.

Louisiana’s WC resources identify LW-WC 1009 as the form filed with the Medical Services Director for a disputed claim for medical treatment. The resources distinguish treatment disputes from other WC filings.

Maine’s Workers’ Compensation Board lists a medical fee schedule effective October 1, 2026 alongside its January edition and correction history. Use the dated edition and applicable appendix rather than assuming every medical or pharmacy provision changed.

The Department of Industrial Accidents’ medical-rates page links Advisory Bulletin 24-14 addressing out-of-state prescription-drug providers under 114.3 CMR 40.00. This is an existing reference particularly relevant to pharmacies shipping into Massachusetts.

Michigan’s Workers’ Disability Compensation Agency maintains its Health Care Services rules, manuals and fee materials. The official collection is the starting point for verifying current billing requirements and the applicable reimbursement edition.

Minnesota DLI publishes a WC RBRVS table for October 1, 2026 through September 30, 2027. The page separates professional services and associated conversion-factor instructions from other reimbursement systems.

Missouri’s Division of Workers’ Compensation explains that authorized care includes prescriptions and medical devices, without a deductible. It also distinguishes employer-selected care from a worker choosing treatment at their own expense.

Montana DLI maintains its WC formulary with preferred Y and nonpreferred N classifications and links to treatment guidelines. The page says drug lists are maintained monthly or as needed and prior versions are archived.

Nebraska’s Workers’ Compensation Court lists a medical-services fee schedule effective January 1, 2026. The access page uses Google forms and PDF downloads, and also contains an availability note; confirm successful access before relying on a cached edition.

New Hampshire’s Labor Department says the carrier reimburses prescriptions relating to the work injury and describes a 30-day period after receipt of the request. Its public FAQs address prescription and medical-bill questions.

New Jersey’s Division of Workers’ Compensation describes medical treatment, wage replacement and permanent disability benefits, and links its claims and injured-worker resources. A medical benefit entitlement does not establish a universal pharmacy fee.

New Mexico’s official Director’s order adopts the 2026 Health Care Provider Fee Schedule and Billing Instructions, effective January 1, 2026. Its Medical Cost Containment Bureau also provides billing-dispute and utilization-review resources.

The Industrial Commission publishes professional, DME and laboratory fee tables for dates of service on or after January 1, 2026. Its Medical Fees Section also helps review bills and resolve fee disputes.

WSI’s pharmacy guidance says providers and pharmacies must submit covered medication charges through its PBM rather than seek direct WSI reimbursement. Clinic dispensing uses the current NCPDP pharmacy transaction standard. The plan lists supply limits and formulary restrictions.

Oklahoma’s Workers’ Compensation Commission medical page provides fee-schedule materials, instructions for disputing reduced medical payments, Schedule II drug guidelines and medical-plan resources. Verify the posted edition before applying a rate.

Oregon’s Workers’ Compensation Division provides fee-schedule calculators, payment tables and forms. Its payment-table page points to appendices of OAR 436-009; pharmacy provisions should be checked in the governing rules.

DLT’s December 31, 2025 information letter announces a revised WC medical fee schedule for services on or after February 1, 2026, regardless of injury date. Hospital services use a separate rate framework.

The WC Commission’s April 2 notice identifies April 1, 2026 as the effective date of its 2026 Medical Services Provider Manual. The manual sets billing and payment policy for authorized providers.

South Dakota’s Labor Department provides a guide explaining its WC medical and disability benefits and the roles of insurers and self-insured employers. Its coverage framework makes identifying the responsible payer especially important.

Tennessee’s Bureau uses the ODG Drug Formulary. Its guidance describes prior approval for N-status medications and explains that Y-status or unlisted drugs may still face later review affecting future refills.

Texas DWC’s September 23, 2026 notice says the topical analgesic plan-based audit was approved with edits after stakeholder comments. The plan sets medical-quality-review priorities and focuses on prescribing and documentation.

Utah’s Labor Commission provides its 2026 Medical Fee Standard and resources for injury reporting and medical disputes. Prescription and administered-drug charges should be matched to the applicable provisions instead of a general procedure rate.

Vermont’s Labor Department says a final proposed Rule 40 update was filed September 24, 2026. Its page provides proposed text, rate tables and responses to comments. Final proposed text should not be treated as an in-effect replacement without adoption verification.

Virginia’s Workers’ Compensation Commission provides 2026 medical fee-schedule materials and its official fee calculator. These resources address applicable medical services; confirm prescription-specific authority separately.

The Insurance Commissioner’s WC legislation and rules directory links Title 85 rules for Medical Management and Managed Health Care Plans, alongside the WC statute and informational letters. Rule indexes should be checked against controlling text and effective dates.

Wyoming’s official provider-bulletin directory includes compound medications and creams, off-label medication use, payment processing and frequent denials, and January 2026 fee-schedule updates. Each bulletin has its own scope and date.

NCCI's October report describes weaker September job growth and slowing hourly wage growth, alongside rising labor-force participation and low worker mobility. Its monthly indicators offer context for WC exposure and business planning rather than a pharmacy coverage or reimbursement change.

California DWC announced an order adopting fourth-quarter Medicare updates to the WC durable medical equipment, prosthetics, orthotics and supplies fee schedule for services rendered on or after October 1, 2026.

California DWC's practitioner-services order incorporates the fourth-quarter Medicare relative-value file, procedure-to-procedure edits and medically unlikely edits for services rendered on or after October 1, 2026.

Washington L&I’s outpatient formulary dated October 1, 2026 marks Hepatitis D Treatment Agents and Aldosterone Synthase Inhibitor as new classes requiring prior authorization. Formulary listing does not guarantee coverage for an individual WC condition.

Healthesystems reports that Colorado DWC is exploring consolidation of nine Medical Treatment Guidelines into one document, targeting September 2027. Initial stakeholder feedback is requested by October 22. This is an early proposal, not a replacement guideline in effect.

September industry commentary describes an acquisition-cost WC pharmacy schedule as overdue. The official 2025 SB 306 record retrieved for this review still shows a House hearing, not enactment. Its fiscal note describes a proposal limited to pharmacy-permit holders. We have not verified a final pharmacy reimbursement schedule.

Enlyte’s analysis of its 2025 transactions reports that out-of-network topicals accounted for 41.1% of topical prescription volume and 65% of topical spend. Florida, Pennsylvania and Illinois led out-of-network topical billed amounts in its dataset. The research includes retail, mail-order and medical-bill channels; it is not a census of the entire WC market.

Nevada’s Workers’ Compensation Section will hold a workshop October 12 at 2 p.m. to discuss streamlining existing WC regulations. Written comments are encouraged by October 11. The notice states that no action will be taken at the meeting; it does not announce a pharmacy-rule change.

Assembly Bill A11714 proposes additional interest and civil penalties for unpaid WC medical-care or supply bills. Its text includes 3% monthly interest for an award unpaid after 15 days, with separate provisions for patterns of nonpayment. The official bill page shows the measure in Assembly committee, not enacted.

California DWC announced an October 21 public meeting of its Pharmacy and Therapeutics Committee, from 12:30 to 2:30 p.m. The committee advises on the MTUS Drug Formulary. Meeting materials and comment details are available from DWC. A committee discussion is not an adopted formulary change.

Following the February Publix decision, Florida amended Rules 69L-7.730 and 69L-7.740. The changes remove protections against denying reimbursement solely because a medication was practitioner-dispensed. The final rules took effect September 2. This changes authorization and payment protections; it is not a general prohibition on physician dispensing.

Alaska is considering its 2027 WC medical fee schedule at an October 15–16 Board meeting. The proposal includes physician dispensing, repackaged drugs, topical and compounded products, OTC medications and generic-equivalent pricing. Written comments are due October 9; January 1, 2027 is the conditional effective date if adopted.

Washington L&I lists an October 1 change from Provider Hotline to Claim Manager prior authorization for E0764, E0783, E0786, E0304, E0302, E0652, E0782 and E0784. Its September 1 update also announces revised vision-services guidance effective October 1.

The official Mississippi WC medical fee schedule, amended September 1, 2026, includes a reimbursement ceiling for manufactured topical medications other than patches: the billed charge capped at $30 for a 30-day supply, prorated for a smaller supply. Separate provisions cover compounded topicals and patches.

Public Act 104-0792 took effect August 7, 2026. Official bill information describes a formal appeal process for non-certifications and a three-month treatment-certification period, with treatment-length provisions. Industry reporting also identifies reviewer-licensure requirements and a 90-day deadline for certain examinations used instead of utilization review.

NCCI's 2026 Medicare fee-schedule study reports that DMEPOS accounts for 4% to 13% of WC medical costs across states and describes a 2.0% CMS DMEPOS update factor. The WC effect depends on state adoption, covered categories and the mix of services.

California DWC’s final rulemaking page confirms an August 1, 2026 effective date for MTUS sections 9792.23.7 and 9792.23.10. The update incorporates revised Ankle and Foot Disorders and Hip and Groin Disorders guidelines; the page links the final text, director’s order and approval notice.

Ohio's current Rule 4123-6-21.3 is effective August 1, 2026. It links BWC reimbursement to allowed claim conditions and dispensing by an enrolled outpatient pharmacy. The formulary includes drug-specific restrictions and documented medical-necessity exceptions, including certain new drugs requiring prior authorization.

Enlyte’s 2026 analysis combines 2025 in-network and out-of-network activity, including retail, mail-order and medical-bill prescriptions. The report describes differences by therapeutic category, channel and state. Its findings offer a vendor-data benchmark, not a forecast for an individual practice.

Connecticut WCC confirms its 2026 Practitioner Fee Schedule applies from July 15. Healthesystems reports drug reimbursement of brand AWP minus 20% plus $5 and generic AWP minus 80% plus $8. The public WCC memo verifies the schedule date, but does not publish those drug formulas.

Effective July 1, nonresident pharmacies must identify a California-licensed pharmacist employed and working at the pharmacy as the proposed Pharmacist-in-Charge for California operations. The Board also specifies notice within 90 days of designation, required PIC training and notification of subsequent changes.

Healthesystems reports a proposed reimbursement limit to the first 42 days of care for physician-dispensed medication. Michigan's official 2026-9 LE record lists filing and effectiveness as pending and includes an August 4 final-language package. The July 24 hearing has passed; a final package is not proof of an in-effect restriction.

In 700 Pharmacy, the Pennsylvania Supreme Court held that the WC Act’s anti-referral prohibition is limited to its enumerated services. Prescription drugs and professional pharmaceutical services are not on that list. The Court reversed the Commonwealth Court’s interpretation in the consolidated appeals.

California DWC adopted MTUS Drug List v.14 effective April 30, with changes based on updated ACOEM traumatic brain injury guidance. The official formulary page hosts the list and order. Check for later adoption orders before treating this dated announcement as the current operational list.

Ohio’s February 18 guidance says revised compounding references took effect February 28, 2026, while enforcement of new USP 795/797 versions is delayed until February 28, 2027. It also addresses an Ohio-licensed responsible person for nonresident pharmacies shipping compounded drugs into Ohio.

Nevada's official announcement separates formal ODG Drug Formulary adoption on September 9, 2025 from full implementation on July 1, 2027. It describes non-emergency outpatient application, insurer approval of non-formulary drugs and appeals through the Hearings Division. This is implementation guidance, not a new October rule.

New York WCB's DME schedule lists maximum purchase and weekly rental amounts and identifies items requiring prior authorization. The Board says unlisted equipment also requires a prior authorization request through OnBoard, including a proposed purchase or rental price.