- School District COVID Vaccination Mandates Preempted by State Lawon November 23, 2022 at 10:48 AM
In September 2021, the San Diego Unified School District adopted a "Vaccination Roadmap" requiring students ages 16 or older to be vaccinated for COVID-19 in order to attend in-person classes and participate in sports and other extracurricular activities. Unvaccinated students in this group were involuntarily placed on independent study.
In October 2021, Let Them Choose filed a complaint and petition for a writ of mandate challenging the Roadmap. Let Them Choose is "an initiative of Let Them Breathe, California nonprofit public benefit corporation that represents a community of more than 20,000 parents."
About six weeks later, a similar complaint was filed by S.V., the parent of a 16-year-old student. The cases were consolidated for trial.
After conducting a hearing on motions for judgment, the trial court ruled that the District’s COVID-19 immunization requirement is preempted by state law. The trial court noted "I think that the state . . . has fully occupied this field, there’s a statewide standard, and a local school district simply doesn’t have the authority to do something inconsistent with the statewide standard."
The court of appeal affirmed in the published case of Let Them Choose v. San Diego Unified School Dist -D079906 (November 2022).
The issue in this case is whether a school district may require students to be vaccinated for COVID-19 as a condition for both (1) attending in-person class, and (2) participating in extracurricular activities.
A century ago during a smallpox epidemic, the California Supreme Court held that the Legislature may require school children to be vaccinated against that disease. (Abeel v. Clark (1890) 84 Cal. 226, 230.) Since then, the Legislature has required students to be vaccinated for 10 diseases-but COVID-19 is not yet among them.
Health and Safety Code section 120335 provides that a school "shall not unconditionally admit" a pupil who has not been vaccinated for: polio, diphtheria, tetanus, pertussis, hepatitis B, haemophilus influenzae type B (HIB), measles, mumps, rubella, and chicken pox. (§§ 120370, subd. (a)(3), 120335, subd. (b)(1)‒(10).) "Each of the 10 diseases was added . . . through legislative action, after careful consideration of the public health risks of these diseases, cost to the state and health system, communicability, and rates of transmission."
As enacted in 1995, former sections 120365 and 120370 provided exemptions from the vaccination requirements based on personal beliefs or medical reasons. But in 2015, the Legislature eliminated the personal beliefs exemption for the existing 10 specified vaccinations.
At the same time, it also considered whether vaccination should be mandated on a school district by school district basis, or instead statewide. A bill analysis explained that a statewide standard was preferred. "To provide a statewide standard[ ] allows for a consistent policy that can be publicized in a uniform manner, so districts and educational efforts may be enacted with best practices for each district. . . . Further in consultation with various health officers, they believe a statewide policy provides them the tools to protect all children equally from an outbreak."
The Legislature has fully addressed the process of adding diseases to the 10 enumerated ones in section 120335. In subdivision (b)(11) of that statute, the Legislature contemplated new vaccine mandates in the future without further legislative action -but assigned that responsibility not to school authorities, but rather to the Department of Public Health. "The Roadmap’s COVID-19 mandate unlawfully seeks to usurp that authority."
Intrastate preemption occurs when local law duplicates, contradicts, or enters an area fully occupied by general law, either expressly or by legislative implication.
Given the scope of the state statutes, school districts have no remaining discretion in these matters.Thus the Roadmap is preempted because it purports to regulate an area of law that the Legislature has "fully occupied."
- U.C. Berkeley Online Content Violations of ADA Leads to Consent Decreeon November 23, 2022 at 10:48 AM
The Justice Department announced that it has filed a proposed consent decree in federal court to resolve allegations that the Regents of the University of California on behalf of the University of California, Berkeley violated Title II of the Americans with Disabilities Act (ADA) because much of UC Berkeley’s free online content is inaccessible to individuals with hearing, vision, and manual disabilities.
The proposed consent decree was filed together with a complaint setting forth the allegations of discrimination.
UC Berkeley makes conferences, lectures, sporting events, graduation ceremonies, and other University events available to the public on its websites and on other online platforms, including its YouTube and Apple Podcasts channels.
It also makes courses available on its UC BerkeleyX platform. Much of this online content is not accessible to people with disabilities because it lacks captions and transcripts for individuals who are deaf and alternative text describing visual images for individuals who are blind. It is also formatted in a way that does not allow individuals with disabilities to access the content using screen readers or other assistive technology.
"By entering into this consent decree, UC Berkeley will make its content accessible to the many people with disabilities who want to participate in and access the same online educational opportunities provided to people without disabilities," said Assistant Attorney General Kristen Clarke for the Justice Department’s Civil Rights Division. "This decree will provide people with disabilities access to the numerous free online courses, conferences, lectures, performances, and other programming offered by UC Berkeley and its faculty, providing lifelong learning opportunities to millions of people."
"Through this consent decree, the Department of Justice demonstrates its commitment to ensuring compliance with the ADA by providing individuals with disabilities a full and equal opportunity to participate in and enjoy the benefits of UC Berkeley’s services, programs, and activities in equal measure with people without disabilities," said U.S. Attorney Stephanie M. Hinds for the Northern District of California.
Under the three-and-a-half-year long consent decree, which requires court approval, UC Berkeley will make all future and the vast majority of its existing online content accessible to people with disabilities.
This includes BerkeleyX courses, university websites, and video and podcast content on its YouTube, Apple Podcasts, and other third-party platforms. UC Berkeley will also revise its policies, train relevant personnel, designate a web accessibility coordinator, conduct accessibility testing of its online content, and hire an independent auditor to evaluate the accessibility of its content.
- Carriers Not Required to Notify Insured of WCIRB Classification Changeson November 22, 2022 at 11:26 AM
Cover Right is a roofing company. It held a workers’ compensation insurance policy with State Fund in 2017, which covered January 1, 2017 to December 31, 2017 (the 2017 policy). State Fund assigned the 2017 policy a dual wage classification relating to roofing operations.
The 2017 policy automatically renewed after lapsing. The renewed policy with State Fund covered January 1, 2018 to December 31, 2018. State Fund calculated the estimated premium for the 2018 policy under the assumption Cover Right would again be assigned the Class 5553-1 classification. In 2018, the base rate for Class 5553-1 was $26.92 per $100 of payroll, while the base rate for Class 5552-1 was $58.41 per $100 of payroll. Cover Right made $25,445.64 in estimated premium
State Fund performed an audit of the 2018 policy in early 2019. It found Cover Right had paid most of its employees $23 to $24 an hour in 2018, which was less than the new dual wage threshold of $25 an hour. Cover Right owed a final premium of $56,766.72 for the 2018 policy.
Cover Right maintains it did not know the dual wage threshold had changed until it received State Fund’s bill. It did not pay the bill, so State Fund assigned the debt to Creditors Adjustment Bureau who filed suit to collect it. Cover Right then filed a cross-complaint against State Fund, asserting negligence and equitable indemnity claims based on an alleged violation of section 11664, subdivision (e)(6)(A). Specifically, Cover Right contended State Fund failed to provide notice that its base rate would increase from $31.18 per $100 of payroll in 2017 to $58.41 per $100 of payroll in 2018, an increase of over 87 percent.
State Fund then moved for summary judgment on Cover Right’s claims. It argued there was no violation of section 11664, subdivision (e)(6)(A), because it did not increase the respective base rates for either Class 5552-1 or Class 5553-1 by more than 25 percent. Instead the WCIB changed the applicable dual wage threshold from $23 per hour in 2017 to $25 per hour in 2018. State Fund asserted the statute does not require notice for such changes.
The trial court agreed with State Fund and granted summary judgment. The court of appeal affirmed in the published case of Cover Right Roofing, Inc. v. State Compensation Ins. Fund -G060210 (November 2022).
This appeal asks the Court of Appeal to interpret Insurance Code section 11664, subdivision (e)(6)(A), which requires workers’ compensation insurers to provide their insureds with notice of certain premium rate increases: "[i]f the premium rate in the governing classification for the insured is to be increased 25 percent or greater and the insurer intends to renew the policy, the insurer shall provide a written notice of a renewal offer not less than 30 days prior to the policy renewal date."
State Fund assigns base rates to its insureds using industry classifications from the Uniform Statistical Rating Plan - 1995 (the USRP). The USRP industry classifications are established by the Workers’ Compensation Insurance Rating Bureau and are codified in the California Code of Regulations, title 10, section 2318.6. The WCIRB also determines the dual wage threshold amount.
It argued there was no violation of section 11664, subdivision (e)(6)(A), because it did not increase the respective base rates for either Class 5552-1 or Class 5553-1 by more than 25 percent. Rather, Cover Right’s classification changed in 2018, which resulted in a higher corresponding base rate. State Fund asserted the statute does not require notice for such changes.
The court of appeal concluded that "in 2017, State Fund did not know the average wage Cover Right would pay its workers in 2018. It could only estimate what that average rate would be. Accordingly, prior to the effective date of the 2018 policy, State Fund could only speculate as to whether Cover Right would be assigned the Class 5552-1 or Class 5553-1 classification for 2018. Given the information it had, at best, State Fund could have provided Cover Right with notice of a potential change to its base rate for the 2018 policy. But the statute does not require notice of potential increases. It only requires notice if premium rate "is to be increased 25 percent or greater."
"We sympathize with Cover Right’s situation. Given all the responsibilities facing small businesses, we do not fault Cover Right for missing the Bureau’s increase of the dual wage threshold. Cover Right likely would have avoided the higher base rate had it known of this change. Nonetheless, as set forth above, section 11664, subdivision (e)(6)(A), does not require an insurer to provide notice in the circumstances at issue here. Further, as a matter of public policy, it would be unreasonable to compel insurers to monitor the Bureau’s changes to the various industry classifications."
- A Work-From-Home Culture Takes Root in Californiaon November 22, 2022 at 11:26 AM
A recent U.S. Census Bureau survey found that about 1 in 5 California adults lived in households in which at least one person had telecommuted or worked from home five or more days the prior week.
Even as pandemic lockdowns fade into memory, COVID-19 has transformed California’s workplace culture in ways researchers say will reverberate well beyond 2022.
According to new data from the U.S. Census Bureau, working from home for some portion of the week has become the new normal for a large segment of Californians. The data shows high-income employees with college degrees are more likely to have access to this hybrid work model, while lower-income employees stay the course with on-site responsibilities and daily commutes.
In addition, researchers say the shift will ripple across the broader economy in ways big and small, as more employees have the flexibility to live farther from a job site and as workplace traditions like lunch outings and bar nights fade or evolve.
The U.S. Census Bureau interviewed roughly 260,000 Americans from June through October, including about 20,000 Californians, as part of a wide-ranging questionnaire called the Household Pulse Survey. Surveyors asked dozens of questions about pandemic-era lifestyle changes, including some about working from home.
The survey found that nearly 20% of California adults lived in households in which at least one person had telecommuted or worked from home five days or more in the previous week. About 33% of California adults lived in households in which someone had worked from home at least one day the previous week.
Nationwide, the survey found that almost 30% of adults lived in households in which at least one person worked from home for some portion of the previous week. About 16% lived in households in which someone worked from home at least five days the previous week.
The results mark a notable shift from previous Census Bureau surveys that asked about working from home, though in different terms. In 2019, before the pandemic, about 6.3% of employed Californians and 5.7% of employed Americans said they "usually worked from home."
And according to the report by California Healthline, researchers who specialize in workforce issues said the findings mirror their own and are indicative of a cultural upheaval that will outlive the pandemic.
Jose Maria Barrero is an academic economist and a co-founder of WFH Research, which is documenting the shift toward working from home. Before the pandemic, about 5% of workdays in the U.S. were conducted from home, according to his group’s analyses. In contrast, its surveys this year show that about 30% of working days in the U.S. are now work-from-home days.
Barrero said employers recognize that many people have found they prefer working from home - and that it gives companies leverage to ask workers to accept less money in exchange. He also said his research also indicates that today’s work models - for both at-home and on-site employees - are likely to endure for months and years.
Andra Ghent, an economist at the University of Utah who studies work-from-home patterns, said tens of millions of Americans are settling into "hybrid" arrangements, in which they work from home a few days a week and occasionally go into the office. Before the home-work option, she said, many didn’t want to live too far from the urban core, concerned that commutes would become unmanageable. But with routine daily commutes out of the picture, many will move to the suburbs or exurbs, where they will have more space, she said.
On the one hand, commuting less, particularly by car, is often good for the health of the environment, Ghent noted. "But if people move to places where the usual mode of transit is cars instead of something that’s more pedestrian- or cyclist-friendly or more likely to use public transit, that’s not such a good thing," Ghent said. "It sort of increases our urban sprawl, which we know is not good for sustainability."
The migration to telecommuting also allows employers to look to other states or even other countries for hires. Tobias Sytsma, an associate economist at the Rand Corp., recently authored a report detailing how U.S. companies may increasingly "offshore" remote work to employees abroad.
- AB-5 "ABC" Test Does Not Apply to Real Estate Agent's PAGA Claimon November 21, 2022 at 10:41 AM
James Whitlach is a former real estate agent who was affiliated with defendant Premier Valley, Inc., doing business as Century 21 MM,, a real estate brokerage firm located in Oakdale California.
He filed a Labor Code Private Attorney General Act of 2004 (PAGA) action against his employer alleging multiple violations of the Labor Code, among other claims. The complaint alleged the class members were misclassified as independent contractors and as a result were not properly paid all wages due and owing, were subjected to unlawful deductions, and were not reimbursed for reasonable and necessary business expenses.
Premier Valley and Century 21 demurred to the Second Amended Complaint. They argued that Whitlach was an independent contractor as a matter of law. The trial court sustained the employer's demurrer and dismissed the Second Amended Complaint without leave to amend.
The Court of Appeal affirmed the trial court in the unpublished case of Whitlach v. Premier Valley F082322 (November 2022).
On appeal Whitlach contends the trial court applied the wrong test for determining whether he was an independent contractor or employee of Premier Valley for purposes of his PAGA cause of action and derivative Labor Code claims. In the alternative, he argues Labor Code section 2778(c)(1) is unconstitutional, and his independent contractor agreement with Premier Valley is unconscionable and unenforceable.
In order for Whitlach to proceed on his PAGA claim, he was required to be an employee of Premier Valley, because PAGA, as well as the Labor Code statutes Whitlach seeks to enforce through PAGA, apply only to employees, and not to independent contractors.
The starting point for this analysis is Labor Code section 2778(c)(1), formerly Labor Code section 2750.3, subdivision (d)(1), which was enacted in 2019 by Assembly Bill No. 5 (AB 5), and became effective on January 1, 2020.
Prior to the enactment of Labor Code section 2778(c)(1), the California Supreme Court decided, in 2018, the watershed Dynamex case which set forth the ABC test to determine if there is an employment relationship. AB 5, provided that multiple occupational classifications were exempted from the sweep of Labor Code section 2775, subdivision (b)(1) which codified Dynamex.
"Real estate licensee" was one of the occupational classifications that was specifically exempted from the purview of Labor Code section 2775, subdivision (b)(1), and in turn from the application of Dynamex and the ABC test for purposes of the Labor Code, Unemployment Insurance Code, and wage orders.
Instead of AB-5, the Court of Appeal concluded the applicable test for the purpose of this case is the test set forth in Unemployment Insurance Code sections 650 and 13004.1, as incorporated in Business and Professions Code section 10032, subdivision (b), which is itself incorporated in Labor Code section 2778, subdivision (c)(1).
The trial court reached the same conclusion and applied the correct test in ruling on defendants’ demurrer. Whitlach’s equal protection claim to the effect that Labor Code section 2778(c)(1) violates equal protection by treating real estate salespersons differently than other workers was rejected.Thus the Court of Appeal affirmed the trial court judgment.
However, the Court of Appeal noted that "Business and Professions Code section 10032(b), creates an express exception for a subpart of the Labor Code, that is, workers compensation, in that it provides that determination of the employee or independent contractor status of real estate agents for purposes of workers compensation is to be made pursuant to the Borello test."
- American Bar Association Lowers the Bar to Law School Admissionon November 21, 2022 at 10:41 AM
The American Bar Association standards currently require law schools to use a "valid and reliable test" in admissions decisions. For years, the only standardized test that automatically met that criteria was the Law School Admission Test (LSAT), though the ABA in November 2021 added the Graduate Record Examinations (GRE) as an acceptable alternative.
The council of the ABA Section of Legal Education and Admissions to the Bar has advanced a proposal to make standardized admissions tests optional at accredited law schools. On Friday, a majority of the council voted for an amendment to its testing mandate, Standard 503, at its hybrid meeting in Atlanta.
The proposal is expected to go to the ABA House of Delegates for consideration at its midyear meeting in New Orleans in February 2023, and was amended Friday to state that if adopted the changes would not be implemented until the fall of 2025.
The push to change Standard 503 comes after the council said in November 2021 that ABA accredited law schools could also use the Graduate Record Examination, or GRE, when considering applicants. The amended standard could end a testing requirement that for more than 50 years has been the foundation of law school admissions.
Plans to alter the standard proved divisive. In May, the council decided to allow public comment for 90 days on the proposed amendments. Those in favor of relaxing Standard 503 said it would open law school doors to more underrepresented students and improve diversity in the legal profession.
According to the Law School Admission Council, which administers the LSAT, from 2017 to 2018, the mean LSAT score for white test-takers was 11.5 points higher than the mean score for Black test-takers. The council’s 2022 report also suggested disparities between white test-takers and Native Americans, Hispanics and other minorities.
"I believe by eliminating the standardized test requirement the legal field could possibly become more diverse and inclusive," wrote Jameelah Kates, an African American woman, who was among the many to write in support of relaxing the standard.
But those opposed to the changes argued the LSAT is still the best way to determine an aspiring lawyer’s readiness to meet the demands of law school and provides an added protection because of the heavy debt burden that attending entails.
In September, 60 law school deans mounted a defense of the standard. They argued that relaxing it would not necessarily even the playing field for underrepresented students. In their letter, the deans feared that the changes would be "premature and could have effects contrary to what is desired."
"Specifically, we fear that an unintended consequence of removing Standard 503’s requirement that JD applicants take a valid and reliable admissions test will be to diminish the diversity of law schools’ incoming classes, by increasing reliance on grade-point average and other criteria that are potentially more infused with bias," the letter states.
David Klieger, director of legal education at ETS, a nonprofit educational testing and assessment organization, echoed those concerns at the council meeting.
"While the future cannot be known with absolute certainty, if the proposal is approved, there is a significant risk that competitive stresses will pressure law schools to consider lowering admission standards," Klieger said. "The stakes here are great. Law school is unlike so many other areas of higher education, and getting this wrong is enormously consequential."
The push to relax Standard 503 is not without precedent. A similar plan was floated in 2018 to get rid of the law school entry exam requirements but was withdrawn shortly before the House of Delegates had a chance to vote on it.
- Former DIR Director Critical of Cal/OSHA's COVID Regulationson November 18, 2022 at 11:15 AM
John Duncan is a former director of the California Department of Industrial Relations and served under two California governors.
He just published a commentary on CalMatters that claims "last minute changes to Cal/OSHA’s COVID regulations are a mistake." And clarifies that there "is a right way and wrong way to draft a new regulation."
He says that when adopting difficult workplace policies, rule makers should notify the public and involve stakeholders. Unfortunately, the California Occupational Safety and Health Agency is poised to make a mistake next month on their two-year extension of California’s COVID rules by squeezing in a significant change at the last minute.
Last month, four members of the Cal/OSHA Standards Board ordered the agency’s staff to rewrite the draft regulations and add exclusion pay, which is essentially paid sick leave for an employee who tests positive or is exposed to COVID. If they change the regulation, stakeholders across California will see a significant change made just before the final vote on this two-year extension of COVID precautions.
The merits of whether Cal/OSHA should continue requiring exclusion pay is not the issue, he says. There is a legitimate discussion about exclusion pay, and another legitimate discussion about whether emergency regulations should be extended past the end of the COVID emergency declaration in a few months. My point here is that resolving complicated and important questions requires time to gather data, talk to affected communities and generate workable solutions.
"In my tenure as director of California’s Department of Industrial Relations, occupational safety and health standards were subject to a thorough vetting process, centered around the goal of establishing consensus by using scientific evidence and other underlying data. Maintaining a fair, even-handed and transparent process is critical for ensuring democratic rulemaking and effective compliance with standards that protect California’s workers and employers alike."
"The question today is how should a regulation be drafted in such a challenging climate?"
He then goes on to say that the answer is with data, careful preparation and stakeholder involvement. In 2009, Cal/OSHA adopted similar regulations for aerosol transmissible diseases in health care settings - and this was not some weak regulation with illusory protections. It was a first-in-the-nation standard and included specific provisions related to training, protective equipment, recordkeeping and more.
Most surprisingly, the rules passed without any opposition when the Cal/OSHA Standards Board voted on it. It was something that may seem unthinkable in today’s divisive times: a consensus regulation based on scientific data, expert stakeholder input and careful discussion.
"Cal/OSHA should look to its past successes and not make such a big change at the last second. Rulemaking is occasionally awkward, loud, disagreeable and painfully slow, but it is the best system out there for such important decisions."
He concludes his commentary by saying there is "a slogan many sports teams and athletes follow: respect the process. That is an appropriate theme as California once again strives to lead in addressing an important workplace health and safety issue."
- Temporary Total Disability Rates for 2023 to Increase by 5.16%on November 18, 2022 at 11:15 AM
The Division of Workers’ Compensation (DWC) has announced that the 2023 minimum and maximum temporary total disability (TTD) rates will increase on January 1, 2023. The minimum TTD rate will increase from $230.95 to $242.86 and the maximum TTD rate will increase from $1,539.71 to $1,619.15 per week.
Labor Code Section 4453(a) (10) requires the maximum and minimum weekly earnings upon which TTD is based be increased by an amount equal to percentage increase in the State Average Weekly Wage (SAWW) as compared to the prior year.
The SAWW is defined as the average weekly wage paid to employees covered by unemployment insurance as reported by the U.S. Department of Labor for California for the 12 months ending March 31 in the year preceding the injury. In the 12 months ending March 31, 2022, the SAWW increased from $1,570 to $1,651- an increase of 5.15924 percent.
The calculation of the 2023 SAWW increase is as follows:
- - (2022 SAWW - 2021 SAWW)/2021 SAWW
- - $1,651 - $1,570 = 81/1570 = 5.15924%
The calculation of minimum TTD rate for 2023 is as follows:
- - Minimum earnings for 2023 x SAWW increase x 2/3 = minimum TTD rate for 2023
- - $346.42 x 1.0515924 = $364.29 minimum TTD earnings x 2/3 = $242.86 minimum rate for 2023
The calculation of maximum TTD rate for 2023 is as follows:
- - Maximum earnings for 2023 x SAWW increase x 2/3 = maximum TTD rate for 2023
- - $2,309.56 x 1.0515924 = $2,428.72 maximum TTD earnings x 2/3 = $1,619.15 maximum rate
Under Labor Code Section 4659(c), workers with a date of injury on or after January 1, 2003 who receiving life pension (LP) or permanent total disability (PTD) benefits are also entitled to have their weekly LP or PTD rate adjusted based on the SAWW.
SAWW figures may be verified using the U.S. Department of Labor’s data.
- EK Health Announces New "Billtelligent" Medical Bill Review Technologyon November 17, 2022 at 1:17 PM
EK Health Services Inc. is a national workers’ compensation managed care organization, and is a major vendor of utilization and bill review services for California claims administrators.
EK Health just announced the launch of Billtelligent, a proprietary technology that it says is taking medical bill review in workers’ compensation to the next level. Billtelligent eliminates barriers for EK Health, empowering an independence the national managed care company had not previously realized.
Billtelligent leverages a unique cloud-based, modular design focused on efficient bill handling through innovative strategies, supported by nimble technology. The company says it promotes flexibility through intelligent routing, automation, auto-adjudication and the ability to customize workflows with incredible specificity (without cumbersome management requirements).
"We did not want to create another software for software’s sake," said Eunhee Kim, EK Health’s Owner & CEO. "With Billtelligent, we have control at all levels and we can bring the change our industry deserves. We will be faster, flexible and more accurate. This gives us the ability to better optimize managed care strategies and improve quality of care for injured workers - which is our ultimate focus."
EK Health says it is keeping with its promise to transform the workers’ compensation industry as an innovator dedicated to integrity, transparency, and customer-focused solutions.
"We have been asked many times to ‘demystify medical bill review’, due to the unnecessary complexities, exorbitant fees and undisclosed revenue sharing that exists today," shared Zebrah L. Jahnke, VP of Business Development. "We knew offering transparency required full ownership of our processes and technology."
"It was clear to me that we needed to be free from the constraints of leased software to fully realize our potential. With Billtelligent, we have direct access to PPOs, allowing us to create our own onboarding and custom network design," Kerri Wilson, EK Health’s President & Chief Operating Officer explained.
The company say the benefits and and advantages include:
- - Stands alone in design, functionality, and customization
- - Was built from the ground up by EK Health, giving complete independence and ownership
- - Is a modern bill review technology designed to evolve
- - Removes barriers through automation & limitless creative workflows
- - Replaces complexity with simplicity
- - Supports EK Health client programs with reduced turnaround times
- - Ensures quality results through efficient execution
- - Intelligent trigger-based routing for near real-time bill processing as the rule, batch processing as the exception
- - Real-time access; real-time status; real-time fixes - all before a bill is finalized
- - Sophisticated pended-bills load balancing to optimize workforce productivity
- - User-friendly, customizable client portal allows external users access to view bills for approval/denials within the bill’s life-cycle
- - Highly configurable and flexible system requiring minimal code changes to introduce new features, adapt to future requirements and onboard new clients-
- - Limitless unique bill routing workflows, automate agreements, and manage client-specific network structures
Through this innovative technology, EK Health says it is not just meeting clients where they are today, EK Health is taking them into the future with nimble solutions realizing immediate gains.
- Amazon Plans New Virtual Care Offering Based on Messagingon November 17, 2022 at 1:17 PM
Amazon is stepping back into virtual care with a new service that uses secure messaging to connect patients with doctors for help with nearly two dozen conditions.
The retail giant said it will launch "Amazon Clinic" in 32 states to provide medication refills and care for conditions like allergies, erectile dysfunction, hair loss, migraines and urinary tract infections. That list does not include the flu, COVID-19, ear infections or other urgent care conditions for which patients often seek help through telemedicine.
Amazon said it will work to add other conditions over time to the service, which will not accept insurance. It also plans to expand the service to more states in the coming months.
Virtual care, or telemedicine, exploded in popularity when COVID-19 hit a couple years ago and patients initially hunkered down in their homes to avoid catching the virus. Its use has since waned but remains popular for its convenience and its ability to improve access to care.
Some doctors had started providing care through secure messaging before the pandemic. They began working through companies like 98point6 or CirrusMD, which touts its ability to connect people with a doctor in less than a minute.
Tuesday’s announcement from Amazon comes more than two months after the company said it will shut down Amazon Care, a hybrid virtual, in-home service it spent years developing. The company launched that service in 2019 for its Washington employees. It expanded it last year, allowing private employers nationwide to sign up for the service. But that effort didn’t get much traction.
The company shifted its target, announcing in July that it planned to acquire One Medical, a primary care organization that, as of March, had about 767,000 members and 188 medical offices in 25 markets. The $3.9 billion deal was seen as way for Amazon to reposition its health ambitions towards a model that was more established and could me more profitable. The Federal Trade Commission is reviewing that deal.
The planned purchase of One Medical was the first major acquisition announced under Amazon CEO Andy Jassy, who took over the role from founder Jeff Bezos last year. He has said he sees health care as a growth opportunity for the company beyond its more established retail and cloud computing businesses.
Amazon’s foray into health care also includes Amazon Pharmacy, an online drug store that allows its Prime members to order medication or prescription refills, and have them delivered to their front door in a couple of days. In its announcement on Tuesday, Amazon said Amazon Pharmacy and One Medical were two key parts of its health care plans.
"But we also know that sometimes you just need a quick interaction with a clinician for a common health concern that can be easily addressed virtually," the company said.
Amazon.com Inc. said the price for care will be set by the providers, not Amazon Clinic, and it did not offer a range in a blog post announcing the service.
- School District COVID Vaccination Mandates Preempted by State Lawon November 23, 2022 at 10:48 AM
In September 2021, the San Diego Unified School District adopted a "Vaccination Roadmap" requiring students ages 16 or older to be vaccinated for COVID-19 in order to attend in-person classes and participate in sports and other extracurricular activities. Unvaccinated students in this group were involuntarily placed on independent study.
In October 2021, Let Them Choose filed a complaint and petition for a writ of mandate challenging the Roadmap. Let Them Choose is "an initiative of Let Them Breathe, California nonprofit public benefit corporation that represents a community of more than 20,000 parents."
About six weeks later, a similar complaint was filed by S.V., the parent of a 16-year-old student. The cases were consolidated for trial.
After conducting a hearing on motions for judgment, the trial court ruled that the District’s COVID-19 immunization requirement is preempted by state law. The trial court noted "I think that the state . . . has fully occupied this field, there’s a statewide standard, and a local school district simply doesn’t have the authority to do something inconsistent with the statewide standard."
The court of appeal affirmed in the published case of Let Them Choose v. San Diego Unified School Dist -D079906 (November 2022).
The issue in this case is whether a school district may require students to be vaccinated for COVID-19 as a condition for both (1) attending in-person class, and (2) participating in extracurricular activities.
A century ago during a smallpox epidemic, the California Supreme Court held that the Legislature may require school children to be vaccinated against that disease. (Abeel v. Clark (1890) 84 Cal. 226, 230.) Since then, the Legislature has required students to be vaccinated for 10 diseases-but COVID-19 is not yet among them.
Health and Safety Code section 120335 provides that a school "shall not unconditionally admit" a pupil who has not been vaccinated for: polio, diphtheria, tetanus, pertussis, hepatitis B, haemophilus influenzae type B (HIB), measles, mumps, rubella, and chicken pox. (§§ 120370, subd. (a)(3), 120335, subd. (b)(1)‒(10).) "Each of the 10 diseases was added . . . through legislative action, after careful consideration of the public health risks of these diseases, cost to the state and health system, communicability, and rates of transmission."
As enacted in 1995, former sections 120365 and 120370 provided exemptions from the vaccination requirements based on personal beliefs or medical reasons. But in 2015, the Legislature eliminated the personal beliefs exemption for the existing 10 specified vaccinations.
At the same time, it also considered whether vaccination should be mandated on a school district by school district basis, or instead statewide. A bill analysis explained that a statewide standard was preferred. "To provide a statewide standard[ ] allows for a consistent policy that can be publicized in a uniform manner, so districts and educational efforts may be enacted with best practices for each district. . . . Further in consultation with various health officers, they believe a statewide policy provides them the tools to protect all children equally from an outbreak."
The Legislature has fully addressed the process of adding diseases to the 10 enumerated ones in section 120335. In subdivision (b)(11) of that statute, the Legislature contemplated new vaccine mandates in the future without further legislative action -but assigned that responsibility not to school authorities, but rather to the Department of Public Health. "The Roadmap’s COVID-19 mandate unlawfully seeks to usurp that authority."
Intrastate preemption occurs when local law duplicates, contradicts, or enters an area fully occupied by general law, either expressly or by legislative implication.
Given the scope of the state statutes, school districts have no remaining discretion in these matters.Thus the Roadmap is preempted because it purports to regulate an area of law that the Legislature has "fully occupied." - U.C. Berkeley Online Content Violations of ADA Leads to Consent Decreeon November 23, 2022 at 10:48 AM
The Justice Department announced that it has filed a proposed consent decree in federal court to resolve allegations that the Regents of the University of California on behalf of the University of California, Berkeley violated Title II of the Americans with Disabilities Act (ADA) because much of UC Berkeley’s free online content is inaccessible to individuals with hearing, vision, and manual disabilities.
The proposed consent decree was filed together with a complaint setting forth the allegations of discrimination.
UC Berkeley makes conferences, lectures, sporting events, graduation ceremonies, and other University events available to the public on its websites and on other online platforms, including its YouTube and Apple Podcasts channels.
It also makes courses available on its UC BerkeleyX platform. Much of this online content is not accessible to people with disabilities because it lacks captions and transcripts for individuals who are deaf and alternative text describing visual images for individuals who are blind. It is also formatted in a way that does not allow individuals with disabilities to access the content using screen readers or other assistive technology.
"By entering into this consent decree, UC Berkeley will make its content accessible to the many people with disabilities who want to participate in and access the same online educational opportunities provided to people without disabilities," said Assistant Attorney General Kristen Clarke for the Justice Department’s Civil Rights Division. "This decree will provide people with disabilities access to the numerous free online courses, conferences, lectures, performances, and other programming offered by UC Berkeley and its faculty, providing lifelong learning opportunities to millions of people."
"Through this consent decree, the Department of Justice demonstrates its commitment to ensuring compliance with the ADA by providing individuals with disabilities a full and equal opportunity to participate in and enjoy the benefits of UC Berkeley’s services, programs, and activities in equal measure with people without disabilities," said U.S. Attorney Stephanie M. Hinds for the Northern District of California.
Under the three-and-a-half-year long consent decree, which requires court approval, UC Berkeley will make all future and the vast majority of its existing online content accessible to people with disabilities.
This includes BerkeleyX courses, university websites, and video and podcast content on its YouTube, Apple Podcasts, and other third-party platforms. UC Berkeley will also revise its policies, train relevant personnel, designate a web accessibility coordinator, conduct accessibility testing of its online content, and hire an independent auditor to evaluate the accessibility of its content. - Carriers Not Required to Notify Insured of WCIRB Classification Changeson November 22, 2022 at 11:26 AM
Cover Right is a roofing company. It held a workers’ compensation insurance policy with State Fund in 2017, which covered January 1, 2017 to December 31, 2017 (the 2017 policy). State Fund assigned the 2017 policy a dual wage classification relating to roofing operations.
The 2017 policy automatically renewed after lapsing. The renewed policy with State Fund covered January 1, 2018 to December 31, 2018. State Fund calculated the estimated premium for the 2018 policy under the assumption Cover Right would again be assigned the Class 5553-1 classification. In 2018, the base rate for Class 5553-1 was $26.92 per $100 of payroll, while the base rate for Class 5552-1 was $58.41 per $100 of payroll. Cover Right made $25,445.64 in estimated premium
State Fund performed an audit of the 2018 policy in early 2019. It found Cover Right had paid most of its employees $23 to $24 an hour in 2018, which was less than the new dual wage threshold of $25 an hour. Cover Right owed a final premium of $56,766.72 for the 2018 policy.
Cover Right maintains it did not know the dual wage threshold had changed until it received State Fund’s bill. It did not pay the bill, so State Fund assigned the debt to Creditors Adjustment Bureau who filed suit to collect it. Cover Right then filed a cross-complaint against State Fund, asserting negligence and equitable indemnity claims based on an alleged violation of section 11664, subdivision (e)(6)(A). Specifically, Cover Right contended State Fund failed to provide notice that its base rate would increase from $31.18 per $100 of payroll in 2017 to $58.41 per $100 of payroll in 2018, an increase of over 87 percent.
State Fund then moved for summary judgment on Cover Right’s claims. It argued there was no violation of section 11664, subdivision (e)(6)(A), because it did not increase the respective base rates for either Class 5552-1 or Class 5553-1 by more than 25 percent. Instead the WCIB changed the applicable dual wage threshold from $23 per hour in 2017 to $25 per hour in 2018. State Fund asserted the statute does not require notice for such changes.
The trial court agreed with State Fund and granted summary judgment. The court of appeal affirmed in the published case of Cover Right Roofing, Inc. v. State Compensation Ins. Fund -G060210 (November 2022).
This appeal asks the Court of Appeal to interpret Insurance Code section 11664, subdivision (e)(6)(A), which requires workers’ compensation insurers to provide their insureds with notice of certain premium rate increases: "[i]f the premium rate in the governing classification for the insured is to be increased 25 percent or greater and the insurer intends to renew the policy, the insurer shall provide a written notice of a renewal offer not less than 30 days prior to the policy renewal date."
State Fund assigns base rates to its insureds using industry classifications from the Uniform Statistical Rating Plan - 1995 (the USRP). The USRP industry classifications are established by the Workers’ Compensation Insurance Rating Bureau and are codified in the California Code of Regulations, title 10, section 2318.6. The WCIRB also determines the dual wage threshold amount.
It argued there was no violation of section 11664, subdivision (e)(6)(A), because it did not increase the respective base rates for either Class 5552-1 or Class 5553-1 by more than 25 percent. Rather, Cover Right’s classification changed in 2018, which resulted in a higher corresponding base rate. State Fund asserted the statute does not require notice for such changes.
The court of appeal concluded that "in 2017, State Fund did not know the average wage Cover Right would pay its workers in 2018. It could only estimate what that average rate would be. Accordingly, prior to the effective date of the 2018 policy, State Fund could only speculate as to whether Cover Right would be assigned the Class 5552-1 or Class 5553-1 classification for 2018. Given the information it had, at best, State Fund could have provided Cover Right with notice of a potential change to its base rate for the 2018 policy. But the statute does not require notice of potential increases. It only requires notice if premium rate "is to be increased 25 percent or greater."
"We sympathize with Cover Right’s situation. Given all the responsibilities facing small businesses, we do not fault Cover Right for missing the Bureau’s increase of the dual wage threshold. Cover Right likely would have avoided the higher base rate had it known of this change. Nonetheless, as set forth above, section 11664, subdivision (e)(6)(A), does not require an insurer to provide notice in the circumstances at issue here. Further, as a matter of public policy, it would be unreasonable to compel insurers to monitor the Bureau’s changes to the various industry classifications." - A Work-From-Home Culture Takes Root in Californiaon November 22, 2022 at 11:26 AM
A recent U.S. Census Bureau survey found that about 1 in 5 California adults lived in households in which at least one person had telecommuted or worked from home five or more days the prior week.
Even as pandemic lockdowns fade into memory, COVID-19 has transformed California’s workplace culture in ways researchers say will reverberate well beyond 2022.
According to new data from the U.S. Census Bureau, working from home for some portion of the week has become the new normal for a large segment of Californians. The data shows high-income employees with college degrees are more likely to have access to this hybrid work model, while lower-income employees stay the course with on-site responsibilities and daily commutes.
In addition, researchers say the shift will ripple across the broader economy in ways big and small, as more employees have the flexibility to live farther from a job site and as workplace traditions like lunch outings and bar nights fade or evolve.
The U.S. Census Bureau interviewed roughly 260,000 Americans from June through October, including about 20,000 Californians, as part of a wide-ranging questionnaire called the Household Pulse Survey. Surveyors asked dozens of questions about pandemic-era lifestyle changes, including some about working from home.
The survey found that nearly 20% of California adults lived in households in which at least one person had telecommuted or worked from home five days or more in the previous week. About 33% of California adults lived in households in which someone had worked from home at least one day the previous week.
Nationwide, the survey found that almost 30% of adults lived in households in which at least one person worked from home for some portion of the previous week. About 16% lived in households in which someone worked from home at least five days the previous week.
The results mark a notable shift from previous Census Bureau surveys that asked about working from home, though in different terms. In 2019, before the pandemic, about 6.3% of employed Californians and 5.7% of employed Americans said they "usually worked from home."
And according to the report by California Healthline, researchers who specialize in workforce issues said the findings mirror their own and are indicative of a cultural upheaval that will outlive the pandemic.
Jose Maria Barrero is an academic economist and a co-founder of WFH Research, which is documenting the shift toward working from home. Before the pandemic, about 5% of workdays in the U.S. were conducted from home, according to his group’s analyses. In contrast, its surveys this year show that about 30% of working days in the U.S. are now work-from-home days.
Barrero said employers recognize that many people have found they prefer working from home - and that it gives companies leverage to ask workers to accept less money in exchange. He also said his research also indicates that today’s work models - for both at-home and on-site employees - are likely to endure for months and years.
Andra Ghent, an economist at the University of Utah who studies work-from-home patterns, said tens of millions of Americans are settling into "hybrid" arrangements, in which they work from home a few days a week and occasionally go into the office. Before the home-work option, she said, many didn’t want to live too far from the urban core, concerned that commutes would become unmanageable. But with routine daily commutes out of the picture, many will move to the suburbs or exurbs, where they will have more space, she said.
On the one hand, commuting less, particularly by car, is often good for the health of the environment, Ghent noted. "But if people move to places where the usual mode of transit is cars instead of something that’s more pedestrian- or cyclist-friendly or more likely to use public transit, that’s not such a good thing," Ghent said. "It sort of increases our urban sprawl, which we know is not good for sustainability."
The migration to telecommuting also allows employers to look to other states or even other countries for hires. Tobias Sytsma, an associate economist at the Rand Corp., recently authored a report detailing how U.S. companies may increasingly "offshore" remote work to employees abroad. - AB-5 "ABC" Test Does Not Apply to Real Estate Agent's PAGA Claimon November 21, 2022 at 10:41 AM
James Whitlach is a former real estate agent who was affiliated with defendant Premier Valley, Inc., doing business as Century 21 MM,, a real estate brokerage firm located in Oakdale California.
He filed a Labor Code Private Attorney General Act of 2004 (PAGA) action against his employer alleging multiple violations of the Labor Code, among other claims. The complaint alleged the class members were misclassified as independent contractors and as a result were not properly paid all wages due and owing, were subjected to unlawful deductions, and were not reimbursed for reasonable and necessary business expenses.
Premier Valley and Century 21 demurred to the Second Amended Complaint. They argued that Whitlach was an independent contractor as a matter of law. The trial court sustained the employer's demurrer and dismissed the Second Amended Complaint without leave to amend.
The Court of Appeal affirmed the trial court in the unpublished case of Whitlach v. Premier Valley F082322 (November 2022).
On appeal Whitlach contends the trial court applied the wrong test for determining whether he was an independent contractor or employee of Premier Valley for purposes of his PAGA cause of action and derivative Labor Code claims. In the alternative, he argues Labor Code section 2778(c)(1) is unconstitutional, and his independent contractor agreement with Premier Valley is unconscionable and unenforceable.
In order for Whitlach to proceed on his PAGA claim, he was required to be an employee of Premier Valley, because PAGA, as well as the Labor Code statutes Whitlach seeks to enforce through PAGA, apply only to employees, and not to independent contractors.
The starting point for this analysis is Labor Code section 2778(c)(1), formerly Labor Code section 2750.3, subdivision (d)(1), which was enacted in 2019 by Assembly Bill No. 5 (AB 5), and became effective on January 1, 2020.
Prior to the enactment of Labor Code section 2778(c)(1), the California Supreme Court decided, in 2018, the watershed Dynamex case which set forth the ABC test to determine if there is an employment relationship. AB 5, provided that multiple occupational classifications were exempted from the sweep of Labor Code section 2775, subdivision (b)(1) which codified Dynamex.
"Real estate licensee" was one of the occupational classifications that was specifically exempted from the purview of Labor Code section 2775, subdivision (b)(1), and in turn from the application of Dynamex and the ABC test for purposes of the Labor Code, Unemployment Insurance Code, and wage orders.
Instead of AB-5, the Court of Appeal concluded the applicable test for the purpose of this case is the test set forth in Unemployment Insurance Code sections 650 and 13004.1, as incorporated in Business and Professions Code section 10032, subdivision (b), which is itself incorporated in Labor Code section 2778, subdivision (c)(1).
The trial court reached the same conclusion and applied the correct test in ruling on defendants’ demurrer. Whitlach’s equal protection claim to the effect that Labor Code section 2778(c)(1) violates equal protection by treating real estate salespersons differently than other workers was rejected.Thus the Court of Appeal affirmed the trial court judgment.
However, the Court of Appeal noted that "Business and Professions Code section 10032(b), creates an express exception for a subpart of the Labor Code, that is, workers compensation, in that it provides that determination of the employee or independent contractor status of real estate agents for purposes of workers compensation is to be made pursuant to the Borello test." - American Bar Association Lowers the Bar to Law School Admissionon November 21, 2022 at 10:41 AM
The American Bar Association standards currently require law schools to use a "valid and reliable test" in admissions decisions. For years, the only standardized test that automatically met that criteria was the Law School Admission Test (LSAT), though the ABA in November 2021 added the Graduate Record Examinations (GRE) as an acceptable alternative.
The council of the ABA Section of Legal Education and Admissions to the Bar has advanced a proposal to make standardized admissions tests optional at accredited law schools. On Friday, a majority of the council voted for an amendment to its testing mandate, Standard 503, at its hybrid meeting in Atlanta.
The proposal is expected to go to the ABA House of Delegates for consideration at its midyear meeting in New Orleans in February 2023, and was amended Friday to state that if adopted the changes would not be implemented until the fall of 2025.
The push to change Standard 503 comes after the council said in November 2021 that ABA accredited law schools could also use the Graduate Record Examination, or GRE, when considering applicants. The amended standard could end a testing requirement that for more than 50 years has been the foundation of law school admissions.
Plans to alter the standard proved divisive. In May, the council decided to allow public comment for 90 days on the proposed amendments. Those in favor of relaxing Standard 503 said it would open law school doors to more underrepresented students and improve diversity in the legal profession.
According to the Law School Admission Council, which administers the LSAT, from 2017 to 2018, the mean LSAT score for white test-takers was 11.5 points higher than the mean score for Black test-takers. The council’s 2022 report also suggested disparities between white test-takers and Native Americans, Hispanics and other minorities.
"I believe by eliminating the standardized test requirement the legal field could possibly become more diverse and inclusive," wrote Jameelah Kates, an African American woman, who was among the many to write in support of relaxing the standard.
But those opposed to the changes argued the LSAT is still the best way to determine an aspiring lawyer’s readiness to meet the demands of law school and provides an added protection because of the heavy debt burden that attending entails.
In September, 60 law school deans mounted a defense of the standard. They argued that relaxing it would not necessarily even the playing field for underrepresented students. In their letter, the deans feared that the changes would be "premature and could have effects contrary to what is desired."
"Specifically, we fear that an unintended consequence of removing Standard 503’s requirement that JD applicants take a valid and reliable admissions test will be to diminish the diversity of law schools’ incoming classes, by increasing reliance on grade-point average and other criteria that are potentially more infused with bias," the letter states.
David Klieger, director of legal education at ETS, a nonprofit educational testing and assessment organization, echoed those concerns at the council meeting.
"While the future cannot be known with absolute certainty, if the proposal is approved, there is a significant risk that competitive stresses will pressure law schools to consider lowering admission standards," Klieger said. "The stakes here are great. Law school is unlike so many other areas of higher education, and getting this wrong is enormously consequential."
The push to relax Standard 503 is not without precedent. A similar plan was floated in 2018 to get rid of the law school entry exam requirements but was withdrawn shortly before the House of Delegates had a chance to vote on it. - Former DIR Director Critical of Cal/OSHA's COVID Regulationson November 18, 2022 at 11:15 AM
John Duncan is a former director of the California Department of Industrial Relations and served under two California governors.
He just published a commentary on CalMatters that claims "last minute changes to Cal/OSHA’s COVID regulations are a mistake." And clarifies that there "is a right way and wrong way to draft a new regulation."
He says that when adopting difficult workplace policies, rule makers should notify the public and involve stakeholders. Unfortunately, the California Occupational Safety and Health Agency is poised to make a mistake next month on their two-year extension of California’s COVID rules by squeezing in a significant change at the last minute.
Last month, four members of the Cal/OSHA Standards Board ordered the agency’s staff to rewrite the draft regulations and add exclusion pay, which is essentially paid sick leave for an employee who tests positive or is exposed to COVID. If they change the regulation, stakeholders across California will see a significant change made just before the final vote on this two-year extension of COVID precautions.
The merits of whether Cal/OSHA should continue requiring exclusion pay is not the issue, he says. There is a legitimate discussion about exclusion pay, and another legitimate discussion about whether emergency regulations should be extended past the end of the COVID emergency declaration in a few months. My point here is that resolving complicated and important questions requires time to gather data, talk to affected communities and generate workable solutions.
"In my tenure as director of California’s Department of Industrial Relations, occupational safety and health standards were subject to a thorough vetting process, centered around the goal of establishing consensus by using scientific evidence and other underlying data. Maintaining a fair, even-handed and transparent process is critical for ensuring democratic rulemaking and effective compliance with standards that protect California’s workers and employers alike."
"The question today is how should a regulation be drafted in such a challenging climate?"
He then goes on to say that the answer is with data, careful preparation and stakeholder involvement. In 2009, Cal/OSHA adopted similar regulations for aerosol transmissible diseases in health care settings - and this was not some weak regulation with illusory protections. It was a first-in-the-nation standard and included specific provisions related to training, protective equipment, recordkeeping and more.
Most surprisingly, the rules passed without any opposition when the Cal/OSHA Standards Board voted on it. It was something that may seem unthinkable in today’s divisive times: a consensus regulation based on scientific data, expert stakeholder input and careful discussion.
"Cal/OSHA should look to its past successes and not make such a big change at the last second. Rulemaking is occasionally awkward, loud, disagreeable and painfully slow, but it is the best system out there for such important decisions."
He concludes his commentary by saying there is "a slogan many sports teams and athletes follow: respect the process. That is an appropriate theme as California once again strives to lead in addressing an important workplace health and safety issue." - Temporary Total Disability Rates for 2023 to Increase by 5.16%on November 18, 2022 at 11:15 AM
The Division of Workers’ Compensation (DWC) has announced that the 2023 minimum and maximum temporary total disability (TTD) rates will increase on January 1, 2023. The minimum TTD rate will increase from $230.95 to $242.86 and the maximum TTD rate will increase from $1,539.71 to $1,619.15 per week.
Labor Code Section 4453(a) (10) requires the maximum and minimum weekly earnings upon which TTD is based be increased by an amount equal to percentage increase in the State Average Weekly Wage (SAWW) as compared to the prior year.
The SAWW is defined as the average weekly wage paid to employees covered by unemployment insurance as reported by the U.S. Department of Labor for California for the 12 months ending March 31 in the year preceding the injury. In the 12 months ending March 31, 2022, the SAWW increased from $1,570 to $1,651- an increase of 5.15924 percent.
The calculation of the 2023 SAWW increase is as follows:
- - (2022 SAWW - 2021 SAWW)/2021 SAWW
- - $1,651 - $1,570 = 81/1570 = 5.15924%
The calculation of minimum TTD rate for 2023 is as follows:
- - Minimum earnings for 2023 x SAWW increase x 2/3 = minimum TTD rate for 2023
- - $346.42 x 1.0515924 = $364.29 minimum TTD earnings x 2/3 = $242.86 minimum rate for 2023
The calculation of maximum TTD rate for 2023 is as follows:
- - Maximum earnings for 2023 x SAWW increase x 2/3 = maximum TTD rate for 2023
- - $2,309.56 x 1.0515924 = $2,428.72 maximum TTD earnings x 2/3 = $1,619.15 maximum rate
Under Labor Code Section 4659(c), workers with a date of injury on or after January 1, 2003 who receiving life pension (LP) or permanent total disability (PTD) benefits are also entitled to have their weekly LP or PTD rate adjusted based on the SAWW.
SAWW figures may be verified using the U.S. Department of Labor’s data. - EK Health Announces New "Billtelligent" Medical Bill Review Technologyon November 17, 2022 at 1:17 PM
EK Health Services Inc. is a national workers’ compensation managed care organization, and is a major vendor of utilization and bill review services for California claims administrators.
EK Health just announced the launch of Billtelligent, a proprietary technology that it says is taking medical bill review in workers’ compensation to the next level. Billtelligent eliminates barriers for EK Health, empowering an independence the national managed care company had not previously realized.
Billtelligent leverages a unique cloud-based, modular design focused on efficient bill handling through innovative strategies, supported by nimble technology. The company says it promotes flexibility through intelligent routing, automation, auto-adjudication and the ability to customize workflows with incredible specificity (without cumbersome management requirements).
"We did not want to create another software for software’s sake," said Eunhee Kim, EK Health’s Owner & CEO. "With Billtelligent, we have control at all levels and we can bring the change our industry deserves. We will be faster, flexible and more accurate. This gives us the ability to better optimize managed care strategies and improve quality of care for injured workers - which is our ultimate focus."
EK Health says it is keeping with its promise to transform the workers’ compensation industry as an innovator dedicated to integrity, transparency, and customer-focused solutions.
"We have been asked many times to ‘demystify medical bill review’, due to the unnecessary complexities, exorbitant fees and undisclosed revenue sharing that exists today," shared Zebrah L. Jahnke, VP of Business Development. "We knew offering transparency required full ownership of our processes and technology."
"It was clear to me that we needed to be free from the constraints of leased software to fully realize our potential. With Billtelligent, we have direct access to PPOs, allowing us to create our own onboarding and custom network design," Kerri Wilson, EK Health’s President & Chief Operating Officer explained.
The company say the benefits and and advantages include:
- - Stands alone in design, functionality, and customization
- - Was built from the ground up by EK Health, giving complete independence and ownership
- - Is a modern bill review technology designed to evolve
- - Removes barriers through automation & limitless creative workflows
- - Replaces complexity with simplicity
- - Supports EK Health client programs with reduced turnaround times
- - Ensures quality results through efficient execution
- - Intelligent trigger-based routing for near real-time bill processing as the rule, batch processing as the exception
- - Real-time access; real-time status; real-time fixes - all before a bill is finalized
- - Sophisticated pended-bills load balancing to optimize workforce productivity
- - User-friendly, customizable client portal allows external users access to view bills for approval/denials within the bill’s life-cycle
- - Highly configurable and flexible system requiring minimal code changes to introduce new features, adapt to future requirements and onboard new clients-
- - Limitless unique bill routing workflows, automate agreements, and manage client-specific network structures
Through this innovative technology, EK Health says it is not just meeting clients where they are today, EK Health is taking them into the future with nimble solutions realizing immediate gains. - Amazon Plans New Virtual Care Offering Based on Messagingon November 17, 2022 at 1:17 PM
Amazon is stepping back into virtual care with a new service that uses secure messaging to connect patients with doctors for help with nearly two dozen conditions.
The retail giant said it will launch "Amazon Clinic" in 32 states to provide medication refills and care for conditions like allergies, erectile dysfunction, hair loss, migraines and urinary tract infections. That list does not include the flu, COVID-19, ear infections or other urgent care conditions for which patients often seek help through telemedicine.
Amazon said it will work to add other conditions over time to the service, which will not accept insurance. It also plans to expand the service to more states in the coming months.
Virtual care, or telemedicine, exploded in popularity when COVID-19 hit a couple years ago and patients initially hunkered down in their homes to avoid catching the virus. Its use has since waned but remains popular for its convenience and its ability to improve access to care.
Some doctors had started providing care through secure messaging before the pandemic. They began working through companies like 98point6 or CirrusMD, which touts its ability to connect people with a doctor in less than a minute.
Tuesday’s announcement from Amazon comes more than two months after the company said it will shut down Amazon Care, a hybrid virtual, in-home service it spent years developing. The company launched that service in 2019 for its Washington employees. It expanded it last year, allowing private employers nationwide to sign up for the service. But that effort didn’t get much traction.
The company shifted its target, announcing in July that it planned to acquire One Medical, a primary care organization that, as of March, had about 767,000 members and 188 medical offices in 25 markets. The $3.9 billion deal was seen as way for Amazon to reposition its health ambitions towards a model that was more established and could me more profitable. The Federal Trade Commission is reviewing that deal.
The planned purchase of One Medical was the first major acquisition announced under Amazon CEO Andy Jassy, who took over the role from founder Jeff Bezos last year. He has said he sees health care as a growth opportunity for the company beyond its more established retail and cloud computing businesses.
Amazon’s foray into health care also includes Amazon Pharmacy, an online drug store that allows its Prime members to order medication or prescription refills, and have them delivered to their front door in a couple of days. In its announcement on Tuesday, Amazon said Amazon Pharmacy and One Medical were two key parts of its health care plans.
"But we also know that sometimes you just need a quick interaction with a clinician for a common health concern that can be easily addressed virtually," the company said.
Amazon.com Inc. said the price for care will be set by the providers, not Amazon Clinic, and it did not offer a range in a blog post announcing the service.