Daily News for October 28th, 2026

• Court Limits Attorney Client Privilege in Fair Chance Act Investigation
  on October 28, 2026 at 11:42 AM

  California's Fair Chance Act, Government Code § 12952, bars employers with five or more employees from asking about an applicant's conviction history until after a conditional job offer is made. If the employer then wants to withdraw the offer because of a conviction, it must first conduct an individualized assessment of whether the conviction has a direct and adverse relationship with the specific duties of the job, weighing the nature and gravity of the offense, the time that has passed, and the nature of the job. The employer must then give the applicant written notice of its preliminary decision, allow a response, and consider that response before making the decision final.
  
  In a new court of appeal published opinion, Walter J. interviewed with the City of Torrance for a custodian position in September 2022 and received a contingent offer. A Department of Justice background report showed a string of misdemeanor convictions beginning in 1996, along with a 2001 felony conviction for false personation. Walter submitted materials he believed showed rehabilitation. The City accepted several of his explanations, agreeing that one conviction had been dismissed, that he had rehabilitated from a domestic battery conviction, that the felony was too old to be relevant, and that his driving offenses did not matter for the custodian job. It nonetheless rescinded the offer based on a 2019 conviction for fighting in a public place, concluding the offense was recent and relevant to a job requiring daily interaction with coworkers and the public, and citing its zero-tolerance workplace violence policy.
  
  Walter filed a complaint with the Civil Rights Department (CRD) in October 2023. In its response, the City laid out a narrative of how it had followed the statute, identified the two decision makers who performed the assessment, and asserted that it had complied with section 12952. In October 2024, CRD filed a director's complaint and expanded the matter into a group or class investigation into whether the City was disqualifying applicants based on certain types of crimes without adequate individualized assessments.
  
  CRD served document requests seeking the City's assessment templates, forms, and instructions, along with the assessment and reassessment records for every applicant denied employment because of criminal history since January 1, 2022. Torrance acknowledged it had responsive documents but withheld all of them, asserting attorney-client privilege and work product protection because the assessments were prepared with counsel. An assistant city attorney declared that the two template documents reflected her conclusions about what the law requires, and that two City human resources employees consulted her on each assessment and documented her legal advice. The City refused to produce a privilege log, instead supplying a list of 23 applicants whose criminal histories had been reviewed the same way as Walter's.
  
  CRD petitioned the Los Angeles County Superior Court under Government Code § 12963.5 for an order compelling compliance with its investigative requests. Judge Virginia Keeny granted the petition, finding that the City had waived any privilege by raising the adequacy of its individualized assessments as a defense to CRD's investigation. Relying on Wellpoint Health Networks, Inc. v. Superior Court (1997) 59 Cal.App.4th 110, the court added that applying that rule to CRD investigations was especially appropriate, because otherwise an employer could escape its duty to properly analyze criminal history records simply by handing the task wholesale to in-house counsel. The court also rejected the City's vagueness and overbreadth objections, a ruling the City did not challenge on appeal. Torrance appealed under section 12963.5, subdivision (d), which makes such orders immediately appealable.
  
  In the published case of Civil Rights Department v. City of Torrance, No. B352855 (September 2026), the California Court of Appeal, Second Appellate District, Division One, affirmed the superior court's order compelling the City to produce its Fair Chance Act assessment templates and individualized assessment records, holding that the City waived any attorney-client or work product protection by asserting that it had complied with section 12952. The opinion, authored by Justice Weingart and joined by Presiding Justice Rothschild and Justice Bendix, was filed as unpublished on September 29, 2026, and the court certified it for publication on October 27, 2026.
  
  The court reviewed the privilege ruling for abuse of discretion, citing Costco Wholesale Corp. v. Superior Court (2009) 47 Cal.4th 725. CRD had argued that the documents were never privileged to begin with, because the dominant purpose of the assessments was an ordinary human resources function rather than obtaining legal advice, and that Torrance was routinely involving a lawyer to shield hiring decisions from scrutiny. The panel found it unnecessary to decide that question, resting its decision entirely on waiver.
  
  The court explained that privilege is waived when a party puts an otherwise privileged communication directly at issue and disclosure is essential to a fair adjudication, a rule drawn from Southern Cal. Gas Co. v. Public Utilities Com. (1990) 50 Cal.3d 31 for the attorney-client privilege and People v. Superior Court (Jones) (2021) 12 Cal.5th 348 for work product. Wellpoint applied that principle to an employer defending a hostile work environment claim by pointing to an investigation conducted by attorneys; an employer that relies on the adequacy of such an investigation cannot then invoke privilege to block examination of it.
  
  The panel endorsed the trial court's reasoning, particularly its concern about delegation to counsel. The assistant city attorney had acknowledged she is involved in hiring whenever an applicant has a criminal history, and the City conceded at oral argument that it had withheld every document reflecting both the assessment and reassessment process. By routinely involving a lawyer and then claiming privilege, the court said, Torrance was seeking to shield all internal records of its decision-making.
  
  The court rejected the City's argument that the trial court should have evaluated each document individually. As the party asserting privilege, the City bore the burden of establishing the facts supporting it under Costco, and it offered no basis for distinguishing one document from another. Because CRD is investigating the City's compliance with section 12952, the court saw no reason the waiver would reach some documents but not others.
  
  The court likewise rejected the City's claim that, unlike the employer in Wellpoint, it had never put the sufficiency of its assessments at issue. The City could not simultaneously assert compliance with section 12952 and deny that the adequacy of its assessments was in play, the court reasoned, because compliance turns on whether the assessments considered the statutory factors and the applicant's response. The court pointed to California Code of Regulations, title 2, § 11017.1, subdivision (c)(1), which requires a reasoned, evidence-based determination of whether a conviction is directly and adversely related to the job, and observed that an employer "may not go through the motions." By claiming it complied with the statute and regulations, Torrance put at issue how it performed its individualized assessments and waived any privilege as to their content.
  

• 75% CTE Rate in Post Mortem Study of 2,362 of Former NFL Players
  on October 28, 2026 at 11:42 AM

  About three of every four former National Football League players who died between 2008 and 2023 likely had chronic traumatic encephalopathy, or CTE, according to a Boston University study published October 28, 2026, in JAMA Network Open. The researchers put the bias-adjusted prevalence at 74.5% among the 2,362 former players who died during that 16-year period. News coverage describes it as the first population-level estimate of CTE among deceased NFL players.
  
  CTE is a degenerative brain disease associated with repeated head impacts, and it can be definitively diagnosed only by examining the brain after death. That has long made its true frequency hard to measure. Earlier research relied on brains donated to research banks, and families of players who showed symptoms in life are more likely to donate. A widely cited 2017 Boston University analysis found CTE in 99% of donated NFL players’ brains, a figure critics argued was inflated by that selection effect.
  
  The new study, titled “Bias-Adjusted Prevalence of Chronic Traumatic Encephalopathy Among Deceased National Football League Players,” tries to correct for donation bias. According to reporting by The Boston Globe and Science News, the team started with nearly 400 former players whose brains were in Boston University’s brain bank. About 94% of those donors had CTE. The researchers then used death certificate data from the National Death Index on every former player who died during the study period. They also considered records of dementia and cognitive symptoms, along with age at death, position played, and years in the league. Players with cognitive symptoms were about five times more likely to have their brains donated, and the team adjusted for that difference when extending its estimate to players whose brains were never examined.
  
  ABC News reported that the researchers also estimated 27.2% of the former players had dementia during their lifetimes, a figure the authors said likely understates the true rate. For comparison, the Globe reported that CTE prevalence in the general population is estimated at under 1%. It added that former NFL players may be roughly four times more likely than the general population to develop dementia and other neurodegenerative diseases.
  
  The authors acknowledge that no adjustment can remove every source of bias. Senior author Yorghos Tripodis, a Boston University biostatistics professor, told ABC News that the estimate did not drop below 60% even under very conservative assumptions. Lead author Julia Gallini, a doctoral candidate at the Boston University School of Public Health, cautioned in the Globe that the result is an estimate for deceased former players and does not predict the share of current players who will develop CTE. Not every case of CTE produces symptoms, and symptoms tend to appear in later stages of the disease. The players’ head impacts also often began in youth, high school, or college football rather than in the pros, according to co-author Daniel Daneshvar of Mass General Brigham.
  
  The study refines an August 2026 analysis by several of the same researchers. That earlier work, which Insurance Journal reported was led by Daneshvar, examined former players who died between 2016 and 2021. It set a conservative minimum of about one in four with CTE. ABC News reported that the earlier study’s plausible range ran from 25% to 98%, and Tripodis said the team wanted to narrow that range. Dr. Ramon Diaz-Arrastia of the University of Pennsylvania, who was not involved in the study, told the Globe it is a paper the field “has been waiting on for a long time.”
  
  The NFL pointed to the statement it issued after the August study, saying it continually works to make the game safer and remains committed to providing resources for players’ well-being. The NFL Players Association told the Globe that such studies are critical to understanding football’s long-term effects.
  
  For employers and insurers, the findings bear on the cumulative-trauma and occupational-disease claims that former professional athletes have long pursued, including in California’s workers’ compensation system. A credible population-level estimate of brain disease among NFL veterans could figure in how such claims are evaluated and reserved, although the study itself does not address compensation or causation in any individual case. The researchers’ emphasis on exposure beginning in youth and amateur football may also interest carriers that write coverage for schools, colleges, and youth sports organizations, as well as other contact-sport employers.
  

• Busy Schedule No Defense to State Fund Premium Audit Suit
  on October 27, 2026 at 9:00 AM

  In February 2022, Creditors Adjustment Bureau, Inc., suing as assignee of the State Compensation Insurance Fund, filed a collection action in Fresno County Superior Court against Barry Halajian, doing business as Industrial Electrical. The complaint sought $86,858.26 allegedly owed under four workers’ compensation insurance policies. According to the complaint, the insurer priced each policy at inception using an estimate based on Halajian’s own representations. When the insurer later tried to audit his payroll records as the policies allowed, he refused to cooperate, so the insurer calculated an estimated premium that increased his balance. Halajian refused to pay.
  
  The bureau served Halajian by leaving the summons and complaint at the commercial mailbox center he used for all correspondence on his policies, and then mailing a second copy to that address—the same address Halajian later listed on his own court filings. He did not respond, and the court entered his default on May 25, 2022.
  
  In August 2022, Halajian moved to set aside the default for excusable neglect under Code of Civil Procedure section 473, subdivision (b). He did not challenge service. Instead, he said extensive out-of-town travel and a heavy work schedule kept him from answering. The trial court denied the motion in November 2022, explaining that a “press of business” excuse is generally not a ground for relief and that Halajian had shown no effort to contact a lawyer or ask the plaintiff for more time. Because the court said it strongly preferred to decide the case on the merits, however, it denied the motion without prejudice so he could try again with a better factual showing.
  
  Halajian’s second motion, filed in January 2023, simply elaborated on the same excuse. He declared that a construction project about 90 minutes from Fresno kept him working out of town from January through early April 2022, often 12 to 15 hours a day, and that he sometimes went days without checking his mail. Most of the motion argued the merits of his defenses. In May 2023 the court denied relief with prejudice, finding that neither a busy schedule nor a decision to proceed without counsel amounts to excusable neglect and that the merits of his defense were irrelevant to that question. Reconsideration was denied.
  
  The court entered a default judgment on January 13, 2025. Halajian then moved to vacate it, invoking the court’s equitable power to set aside judgments for extrinsic mistake or fraud. He argued that he never received notice of the request for default judgment, that his defenses were meritorious, that he deserved leniency as a self-represented litigant, and that the bureau lacked standing. The court denied the motion in May 2025, noting he had not attached a proposed answer, that a defaulted party is not entitled to notice of the default judgment request, that he offered no evidence he had paid his premiums, and that he provided no new explanation for failing to answer. A further reconsideration motion was denied, and Halajian appealed in pro. per.
  
  In the unpublished case of Creditors Adjustment Bureau, Inc. v. Halajian, No. F090331 (October 2026), the Fifth District Court of Appeal affirmed the default judgment, holding that the trial court did not abuse its discretion in refusing to set aside either the entry of default or the default judgment. The opinion, filed October 20, 2026, was not certified for publication, so under California’s rules of court it generally may not be cited or relied on by courts or parties in other cases. The court awarded the bureau its costs on appeal to the extent not covered by Halajian’s fee waiver.
  
  As a threshold matter, the court rejected the bureau’s argument that the appeal should be dismissed or narrowed. Although it found Halajian’s briefing difficult to parse at times, it liberally construed his notice of appeal and briefs as challenging both the entry of default and the default judgment. That also disposed of the bureau’s contention that reversing only the judgment would be an “idle act” because the underlying default would still stand.
  
  On the merits, the court reviewed the denial of relief for abuse of discretion. It acknowledged the strong policy, stated in Elston v. City of Turlock (1985) 38 Cal.3d 227, that doubts under section 473 are resolved in favor of the party seeking relief and that only very slight evidence is required. But the court emphasized that the policy has limits. The test, under Zamora v. Clayborn Contracting Group, Inc. (2002) 28 Cal.4th 249, is whether a reasonably prudent person in similar circumstances might have made the same error, and California courts have long held that the press of business is not excusable neglect. Elston itself observed that a litigant who was simply busy with other matters would not qualify. The court also relied on Bellm v. Bellia (1984) 150 Cal.App.3d 1036, which upheld denial of relief to a defendant overwhelmed by holiday-season sales orders.
  
  The court analyzed the statutory and equitable requests together because both turned on the same question: why Halajian failed to answer in 2022. Equitable relief requires satisfying the “stringent three-pronged test” described in Rappleyea v. Campbell (1994) 8 Cal.4th 975 and Pittman v. Beck Park Apartments Ltd. (2018) 20 Cal.App.5th 1009: a meritorious defense, a satisfactory excuse for not defending in the first place, and diligence in seeking relief. Under Manson, Iver & York v. Black (2009) 176 Cal.App.4th 36, relief for extrinsic mistake or fraud is unavailable where the moving party’s own negligence allowed the mistake to occur. Across his motions, Halajian offered only his work schedule, and his equitable motion merely pointed back to the justification he had already given. The trial court acted within its discretion in rejecting it.
  
  The court distinguished the cases Halajian relied on. Olivera v. Grace (1942) 19 Cal.2d 570 involved a litigant left mentally incapacitated by a head injury, a condition the opposing party exploited. Rappleyea involved a clerk’s miscommunication about a filing fee after a timely response. Gamet v. Blanchard (2001) 91 Cal.App.4th 1276 involved a disabled, out-of-state litigant whose attorney withdrew and who received confusing orders from the court. Halajian, by contrast, was validly served under Code of Civil Procedure section 415.20, which permits service at a private commercial mailbox, as recognized in Sweeting v. Murat (2013) 221 Cal.App.4th 507. He never disputed service and apparently took no action until August 2022.
  
  Halajian’s reliance on Zamora and Minick v. City of Petaluma (2016) 3 Cal.App.5th 15 for the idea that failing to pick up his mail was an understandable mistake also failed. Both cases involved errors by counsel—a clerical mistake in one and an attorney’s serious illness in the other—raised within about a week. Section 473 distinguishes attorney fault from a client’s own negligence, and Halajian’s default resulted from his own conduct.
  
  Finally, the court rejected Halajian’s remaining arguments. Self-represented litigants are held to the same procedural rules as attorneys, citing County of Orange v. Smith (2005) 132 Cal.App.4th 1434. His challenges to the insurer’s corporate structure and the bureau’s standing to sue on its behalf were summarily rejected as without merit, and due process arguments raised for the first time in his reply brief were not considered.

• SB574 - California is First State to Pass AI Rules for Lawyers
  on October 27, 2026 at 9:00 AM

  California has become the first state to regulate lawyers’ use of generative artificial intelligence by statute. Gov. Gavin Newsom signed Senate Bill 574 on September 30, 2026, and its new rules take effect January 1, 2027. The law bars attorneys from handing the practice of law over to AI tools. It also requires lawyers to verify AI output and to personally verify every citation in a court filing, to disclose AI use to the court, and to keep confidential client information out of AI systems that are not access-restricted. Arbitrators face new limits as well.
  
  SB 574, authored by Sen. Thomas Umberg (D-Santa Ana), was one of 13 AI-related bills the Governor signed the same day. The Governor’s announcement described the measure as keeping lawyers responsible for practicing law by barring them from fully turning over core legal work, such as drafting briefs or exercising legal judgment, to AI. The bill responds to a steady stream of court decisions sanctioning lawyers for filing briefs with fabricated, AI-generated case citations.
  
  The core duties appear in a new Business and Professions Code section 6068.1, which is part of the State Bar Act and applies to all California-licensed attorneys, including in-house counsel. The section provides that an attorney may use generative AI to assist in the practice of law but may not delegate the practice of law to it. Existing duties of competence and diligence are expressly preserved.
  
  On confidentiality, attorneys may not enter confidential, personal identifying, or other nonpublic information into a generative AI system unless access to it is limited to the attorney and people the attorney has authorized who are themselves obligated to protect the information. The law defines personal identifying information broadly to include dates of birth, Social Security and driver’s license numbers, addresses and phone numbers of parties and witnesses, medical or psychiatric information, financial information, account numbers, and sealed or otherwise confidential material. In practical terms, commentators read this as keeping client data out of public, consumer-grade AI tools.
  
  Attorneys using AI must also take reasonable steps to verify the accuracy of its output, including all case and statutory citations, and must correct any erroneous or “hallucinated” output in material they use. That verification duty is not limited to litigation. Finally, attorneys must disclose their use of generative AI to the court for all documents submitted to the court, and must consider whether to disclose AI use in content they provide to the public. The law defines generative AI as a system that can generate derived synthetic content that emulates its training data. That definition covers drafting and research tools but not conventional search engines, predictive analytics, or automated data processing.
  
  Separately, the bill amends Code of Civil Procedure section 128.7, California’s counterpart to federal Rule 11. As amended, any brief, pleading, motion, or other paper filed in any California court may not contain citations that a responsible attorney has not personally verified. That requirement applies whether or not AI supplied the citation, and regardless of where the attorney is licensed. Violations are enforced through section 128.7’s existing sanctions procedures. These include a 21-day safe-harbor period to withdraw or correct a challenged paper, sanctions limited to what is needed to deter repetition, and joint responsibility of the law firm for violations by its partners, associates, and employees absent exceptional circumstances.
  
  A new Code of Civil Procedure section 1282.1 bars arbitrators from delegating any part of their decision-making to a generative AI tool. It also bars them from relying on AI-generated information outside the record without first making appropriate disclosures to the parties and, where practical, letting the parties comment. The bill also amends Business and Professions Code section 6173, which concerns State Bar oversight of alternative dispute resolution providers. A new Code of Civil Procedure section 180 directs the Judicial Council to consider whether to update its nonbinding judicial administration standard on judges’ use of generative AI. The Assembly committee analysis of the bill describes its purpose as codifying safeguards for those receiving legal services.
  
  Law firm commentary has broadly agreed that the law codifies duties lawyers already had, while adding statutory teeth and leaving several key terms undefined. The most frequently flagged gap is that the statute never defines what it means to “delegate” the practice of law. The law does not resolve how attorney-client privilege and work-product protection apply to AI-generated material. It further suggests that the arbitrator provisions may be stricter than the American Arbitration Association’s rules for AI-led arbitration, under which an AI drafts a preliminary award for a human arbitrator to review.
  
  King & Spalding flags two drafting questions. First, read literally, the disclosure clause could require an attorney who used AI for anything to say so in every court filing. The firm suggests the better reading limits disclosure to AI use in preparing the particular document. Second, the statute does not say which attorney is “responsible” for verifying citations when several lawyers work on a filing. The firm adds that handing the check to a second AI tool is unlikely to satisfy the personal-verification requirement. It advises companies to make sure their outside-counsel billing guidelines do not discourage the required checks, and to configure internal AI tools to protect confidential information. The Metropolitan News-Enterprise characterized the law as codifying warnings already issued by courts and the State Bar.

• Supreme Ct Sends City of Salinas Case Back for Ct. of Appeal Review
  on October 26, 2026 at 11:17 AM

  Lance D. Miraco, a former City of Salinas police officer, filed a workers' compensation claim in December 2020 alleging cumulative injury through the end of 2013 to his back and right leg, along with gastritis, reflux, insomnia, and hypertensive cardiac disease. After trial, the workers' compensation judge (WCJ) found industrial injury but ruled the heart claim time-barred under Labor Code § 5405, fixing the cardiac date of injury under § 5412 in June 2013.
  
  Miraco filed a timely petition for reconsideration at the Salinas district office on October 16, 2023. Under the version of Labor Code § 5909 then in effect, a petition was deemed denied unless the Workers' Compensation Appeals Board (WCAB) acted within 60 days of filing — here, by December 15, 2023. The petition was scanned into the EAMS system, but the district office did not transmit the case to the Board until January 12, 2024, apparently after Miraco's counsel's office called to check on it. According to Miraco, Board staff said a new decision timeline would run once the file arrived. On March 12, 2024, the Board invoked Shipley v. Workers' Comp. Appeals Bd. (1992) 7 Cal.App.4th 1104, treated its deadline as tolled until it received the file, granted reconsideration, and found the cardiac claim was not time-barred.
  
  The City and its claims administrator, CorVel, petitioned for a writ of review. In a published opinion filed August 20, 2025, City of Salinas v. Workers' Comp. Appeals Bd. (2025) 113 Cal.App.5th 801, No. H052062, the Sixth Appellate District affirmed the Board. The panel agreed with Zurich American Ins. Co. v. Workers' Comp. Appeals Bd. (2023) 97 Cal.App.5th 1213 and the First District's opinion in Mayor v. Workers' Comp. Appeals Bd. (2024) 104 Cal.App.5th 1297 that the 60-day deadline is mandatory and that late action exceeds the Board's jurisdiction. But it went further, holding that the deadline does not touch the Board's fundamental jurisdiction, so equitable tolling remained available in a narrow class of cases. Applying the three-part test of Saint Francis Memorial Hospital v. State Dept. of Public Health (2020) 9 Cal.5th 710 — timely notice, lack of prejudice, and reasonable, good-faith conduct — the court found tolling justified because Miraco acted diligently and was misled by an administrative delay he did not cause. The court also declined the Board's request to wait for the Supreme Court's pending decision in Mayor.
  
  The California Supreme Court granted the City's petition for review on November 19, 2025, and deferred briefing pending its decision in Mayor (S287261), the lead case on the same question.
  
  In a minute order in the case of City of Salinas v. Workers' Compensation Appeals Board (Miraco), No. S293212 (October 2026), the California Supreme Court transferred the matter back to the Sixth Appellate District with directions to vacate its 2025 decision and reconsider the cause in light of Mayor v. Workers' Comp. Appeals Bd. and Ross Valley Sanitation Dist. (2026) 20 Cal.5th 874. The order, a minute order issued Wednesday, October 21, 2026, under California Rules of Court, rule 8.528(d), states that under the court's Administrative Order 2021-04-21 and the comment to rule 8.1115(e)(3), the Court of Appeal's published opinion is now "depublished" or "not citable."
  
  The Sixth District's opinion can no longer be cited as authority, and the Court of Appeal must decide the City's challenge anew. The Supreme Court did not rule on the merits of Miraco's cardiac claim.
  
  A grant-and-transfer order carries no written reasoning of its own; the controlling analysis is in Mayor, decided unanimously on August 24, 2026, in an opinion by Justice Evans. There, the Board had granted an employer's reconsideration petition 144 days after filing, again citing an administrative irregularity and Shipley.
  
  Mayor actually agreed with Salinas on one point: the § 5909 deadline does not implicate the Board's fundamental jurisdiction. But the high court rejected the step that decided Salinas. Equitable tolling, the court explained, excuses litigants from filing deadlines such as statutes of limitations. The Board is neither a party nor a litigant, and § 5909 is not a statute of limitations but a deadline for the adjudicator itself to act. The court said it knew of no precedent applying tolling to a decisional deadline imposed on an adjudicative body, and found that self-tolling conflicts with the statute's evident purpose of keeping reconsideration petitions from languishing. It also held that a writ of mandate in the Court of Appeal is a proper way for an affected party to enforce § 5909.
  
  The court recast Shipley as a due-process decision rather than a tolling decision, and disapproved it to the extent it suggests every party has a due-process right to Board review after the deadline passes. Mayor expressly named City of Salinas as an example of the Board routinely invoking Shipley to work around its own systemic file-transfer failures. The court left open that narrow due-process circumstances might still permit late action, but said it is the adversely affected petitioner — not the Board — who must assert that claim, and that mere expiration of the deadline is not enough.
  
  On remand, the Sixth District therefore cannot rest on equitable tolling. Absent a due-process showing of the kind Mayor left open — and Miraco's account of assurances from Board staff may prompt that argument — his petition would appear to have been denied by operation of law in December 2023, leaving the WCJ's time-bar finding intact. How the Court of Appeal resolves that question remains to be seen.
  

• L.A. Takedown Charges 15 in $2B Health Insurance Fraud Schemes
  on October 26, 2026 at 11:17 AM

  Federal prosecutors in Los Angeles have charged 15 defendants, six of them medical professionals, in a series of health care fraud cases that together involve about $2 billion in allegedly fraudulent claims to public and private health plans. The centerpiece is a sober-home scheme that the Justice Department describes as the largest substance abuse treatment fraud case it has ever prosecuted, with more than $1.6 billion billed to private insurers. The charges were announced on October 22, 2026, by the U.S. Attorney’s Office for the Central District of California.
  
  Eight defendants were arrested on the day of the announcement, most of them making initial appearances in federal court in downtown Los Angeles and three in federal courts in Texas and Illinois. The investigations were carried out by the FBI, IRS Criminal Investigation, the Drug Enforcement Administration, the HHS Office of Inspector General, the U.S. Marshals Service and, in one case, the California Department of Justice. Prosecutors from the U.S. Attorney’s Office worked alongside trial attorneys from the Justice Department’s National Fraud Enforcement Division, which the department created in April 2026.
  
  The largest case, United States v. Young, charges Nathan Young and his father, David Young, both of Los Angeles, along with Honey Phipps and Cody Phipps of Greenville, Texas. According to the indictment, the Youngs controlled dozens of purported treatment companies in the Los Angeles area and elsewhere and used “body brokers,” including the Phippses, to recruit homeless people and attendees of recovery support groups from around the country. Prosecutors allege the group targeted people whose insurance policies paid the most generous reimbursements, and in many cases fraudulently enrolled them in new policies for which they were not eligible. Recruits were allegedly lured with free flights, cash, housing, cars, gift cards and drugs.
  
  The indictment describes a two-tier system in which “premium” patients with high-paying coverage received hotel stays and private apartments, while others were placed in crowded, unsanitary housing. Prosecutors allege patients were cycled through the facilities to keep billing regardless of medical need, were sometimes sedated or physically prevented from leaving, were coached to fake symptoms to qualify for detox, and in some instances were encouraged to use drugs or alcohol to become eligible for treatment. The billed “therapy” allegedly consisted largely of Zoom sessions with more than 100 attendees, where patients needed only to turn on their cameras. The four defendants face conspiracy, health care fraud and wire fraud charges, along with counts under the Eliminating Kickbacks in Recovery Act (18 U.S.C. § 220), a 2018 law that criminalizes kickbacks for referrals to recovery homes, treatment facilities and laboratories and, unlike the Medicare-focused anti-kickback law, reaches private insurance. A related defendant, Nicholas Moore of North Myrtle Beach, North Carolina, who served as an area manager and nominal owner of several of the Youngs’ facilities, has pleaded guilty to conspiracy and admitted helping submit $199 million in fraudulent claims to insurers.
  
  A second case targets alleged patient harm. Dr. Harold Tabaie, an Anaheim cardiothoracic surgeon, and his business partner Hany Malek, a Tarzana chiropractor, are charged with billing Medicare roughly $135 million for medically unnecessary atherectomies, an invasive procedure that uses a bladed catheter to clear plaque from arteries. The indictment alleges that Malek posed as a medical doctor to diagnose arterial disease, that Tabaie performed procedures on patients without such disease, and that the clinics billed under other providers’ names to hide Tabaie’s unusually high volume. Prosecutors also allege kickbacks to patients in the form of free rides, groceries, gift cards and utility payments. According to the release, the case was flagged by data analytics showing Tabaie was an extreme national outlier for atherectomy billing. Malek separately faces bank fraud charges tied to an allegedly fraudulent Paycheck Protection Program loan.
  
  Three hospice cases account for more than $138 million in alleged Medicare billings. Geoffrey Jimenez of Los Angeles is charged by complaint with enrolling non-terminal seniors, recruited at community centers, in his Transitions Hospice; prosecutors say the company’s non-death discharge rate of about 85 percent was more than four times the national average, and that Jimenez controlled more than a dozen other hospices that billed over $107 million. Dr. Richard Keech, an 83-year-old Torrance physician and hospice medical director, is charged with signing false certifications of terminal illness that caused more than $10 million in claims. Armani Raffi of Van Nuys is charged with running four interconnected Sherman Oaks hospices that allegedly billed about $21 million, with marketers paid $1,500 to $1,800 per referral.
  
  The remaining cases involve kickbacks and drug fraud. Two physicians, Hassan Badday of Los Angeles and Robby Ayoub of Huntington Beach, are charged in separate indictments with taking per-patient kickbacks to sign genetic testing orders billed to Medicare by a Houston laboratory, in violation of the federal Anti-Kickback Statute (42 U.S.C. § 1320a-7b(b)). Thomas Mladinich of Newport Beach, who according to the release has entered a plea agreement, is charged with taking $150,000 to $250,000 in kickbacks for steering addicted patients to a rehab facility that billed private insurance and required a 21-day stay before recruiters were paid; many patients allegedly left on exactly day 21. Christina Mareik of Whittier, first charged by complaint in June 2026, has now been indicted in a roughly $270 million Medi-Cal pharmacy scheme that allegedly exploited the program’s temporary suspension of prior-authorization requirements during a payment-system transition. Finally, Walnut physician Dejun Wang is charged with selling prescription drug samples, including Ozempic, Mounjaro and Rybelsus, to San Gabriel Valley pharmacies that repackaged and dispensed them.
  
  The Young case is a reminder that private commercial coverage, not just Medicare and Medi-Cal, is a primary target of patient-brokering schemes, and that recruiters may manipulate enrollment to steer people into the richest-paying policies. The Tabaie case also illustrates the growing role of outlier analytics in detecting fraud; Assistant Attorney General Colin M. McDonald warned providers that “the data will lead us to you.” Officials’ loss figures vary somewhat: the release headline cites $2 billion, while a statement attributed to FBI Director Kash Patel puts losses at $1.8 billion. The earlier June 2026 Los Angeles takedown, linked above, also included a federal workers’ compensation fraud case against an Orange County psychiatrist.
  
  All of these charges are allegations. As the Justice Department notes, indictments, complaints and informations are not evidence of guilt, and every defendant is presumed innocent unless and until proven guilty beyond a reasonable doubt. Victims in the Tabaie matter can find case information on the department’s victim notification page, and more on the national strike force program is available from the Health Care Fraud Unit.

• Physicians' Liens Fail for Lack of Causation Substantial Evidence
  on October 22, 2026 at 9:33 AM

  Ann Lindley worked as an administrator for Golden State Manor/Tao Tai Homes. In 2017 she filed several workers' compensation claims. Among them were specific injury claims for September 1, 2016 and October 1, 2016 involving her right arm, left foot, leg, and ankle, and a cumulative trauma claim for January 1, 2003 through October 17, 2016. In stipulations, the cumulative claim was described as covering her neck, arms, wrists, back, legs, and other orthopedic body parts. The claims involved several carriers, including Oak River Insurance Company (administered by Berkshire Hathaway HomeState Companies) and AIG Claims Services.
  
  Lindley never obtained an award on these claims. She resolved them, along with two related claims, through compromise and release agreements approved in 2020 and 2021. The 2021 settlement cited a good faith dispute over liability. That left the liens of two physicians who had treated her: Edwin Haronian, M.D., whose lien was for $11,188.97, and Jonathan Kohan, M.D., a secondary treating physician in pain management.
  
  Two orthopedic panel qualified medical evaluators (PQMEs) had examined Lindley. Dr. Schaffzin reviewed more than 7,500 pages of records. Both he and Dr. Halbrecht took detailed histories and concluded that her complaints were not industrial. Both attributed her right elbow and related upper extremity conditions to a July 18, 2007 motor vehicle accident and the elbow surgery that followed. Dr. Halbrecht described the 2007 accident as occurring while Lindley worked for a different employer.
  
  The lien claims went to trial on June 16, 2022, on a single issue: whether Lindley sustained an injury arising out of and in the course of employment (AOE/COE). Testimony was not taken, and the matter was submitted on the documentary record. In a July 6, 2022 decision, the workers' compensation judge (WCJ) found no industrial injury on any of the claimed dates or during the cumulative period. The WCJ found the PQME reports more reliable and concluded that the reports of Drs. Haronian and Kohan were not substantial medical evidence. Both liens were ordered to take nothing and dismissed with prejudice. Dr. Haronian petitioned for reconsideration, which the Board granted to allow further study.
  
  In the WCAB panel decision of Lindley v. Golden State Manor/Tao Tai Homes, Nos. ADJ10895246, ADJ10895160, ADJ10629441 (October 2026), the Workers' Compensation Appeals Board affirmed the WCJ's decision. That left in place the findings that Lindley sustained no industrial injury and that the lien claimants - Drs. Haronian and Kohan - take nothing. Commissioner Jose H. Razo wrote the opinion. Deputy Commissioner Patricia A. Garcia and Commissioner Joseph V. Capurro concurred.
  
  The Board started with the burden of proof. An applicant must prove industrial causation by a preponderance of the evidence under Labor Code sections 3202.5 and 3600. Citing South Coast Framing, Inc. v. Workers' Comp. Appeals Bd. (2015) 61 Cal.4th 291, the panel addressed the standard for proving industrial causation. A lien claimant litigating its right to payment "stands in the shoes" of the employee, and under Labor Code § 5705 and the Board's en banc decision in Kunz v. Patterson Floor Coverings, Inc. (2002) 67 Cal.Comp.Cases 1588, it must prove every element of its claim, including injury AOE/COE. Because Lindley settled without a finding of industrial injury, Drs. Haronian and Kohan had to establish industrial causation themselves.
  
  The Board then applied the familiar standard for substantial medical evidence. A medical report does not qualify if it rests on an inadequate history or examination, an incorrect legal theory, or speculation, or if it fails to explain its reasoning. The panel cited E.L. Yeager Construction v. Workers' Comp. Appeals Bd. (Gatten) (2006) 145 Cal.App.4th 922, Braewood Convalescent Hospital v. Workers' Comp. Appeals Bd. (Bolton) (1983) 34 Cal.3d 159, and Kaiser Foundation Hospitals v. Workers' Comp. Appeals Bd. (Martin) (1985) 39 Cal.3d 57. It also cited Rosas v. Workers' Comp. Appeals Bd. (1993) 16 Cal.App.4th 1692 and Kyle v. Workers' Comp. Appeals Bd. (1987) 195 Cal.App.3d 614 for related principles governing the Board's review of medical evidence.
  
  Measured against that standard, Dr. Haronian's October 2020 report fell short. The panel agreed with the WCJ that it did not fully review Lindley's medical history. In particular, it did not discuss her prior injuries, including the 2007 car accident and resulting elbow surgery, and it appeared to include no review of records from before 2017. The report also did not explain why Dr. Haronian disagreed with the PQMEs. Dr. Kohan's report likewise lacked a complete history and analysis and did not address causation for the cervical spine, right shoulder, left ankle, or right elbow.
  
  By contrast, the panel found that both PQMEs had completed full evaluations, reviewed extensive records, taken detailed histories, and explained their conclusions. Their reports were therefore substantial medical evidence supporting the finding of no industrial injury. Dr. Haronian had argued that the PQMEs' apportionment discussions, histories, and examinations were inadequate and had asked, in the alternative, for new PQME reports. Having found the PQME reports sufficient, the Board left the WCJ's decision in place without ordering further development of the record.
  

• Newsom Signs Three New Workplace A.I. Laws for 2027
  on October 22, 2026 at 9:33 AM

  California employers will face three new sets of laws on artificial intelligence in the workplace beginning in 2027. Governor Gavin Newsom signed the bills on September 30, 2026. One requires human review before AI-driven discipline or termination. Another bans AI tools that read employees' emotions or nervous-system activity. The third requires employers to say so in their layoff notices when AI or automation is behind a mass layoff. The bills were part of a package of 13 AI measures announced in a Governor's press release that described several as first-in-the-nation worker protections. "AI should expand opportunity — not come at the expense of workers and families," Newsom said in the release.
  
  SB 947, by Senator Jerry McNerney (D-Pleasanton) and sponsored by the California Federation of Labor Unions, dubbed the "No Robo Bosses Act of 2026," is a narrower version of SB 7, which Newsom vetoed in October 2025. In his veto message on SB 7, the Governor called its notice requirements "unfocused" and its restrictions "overly broad." The new bill drops SB 7's advance notice requirement for applicants and employees and concentrates on discipline and termination decisions. Its core requirements take effect July 1, 2027, according to several law firm analyses.
  
  The law applies to "automated decision systems," which it defines broadly as computational processes using machine learning, statistical modeling, data analytics, or AI that produce a score, classification, or recommendation used to assist or replace human discretionary decisions. Routine tools such as spam filters, firewalls, and calculators are excluded. Employers may not rely solely on such a system to discipline or fire an employee. When an employer primarily relies on a system's output, a human must investigate and corroborate it. The employer may not act on output that cannot be corroborated or is inaccurate, incomplete, or misleading. The employer must then give the employee a written, plain-language notice stating that it relied on the system, that a person corroborated the output, and that the employee may request a description of the data analyzed. The law also bars using these systems to infer protected characteristics, to undermine compliance with workplace laws, or to retaliate against workers for exercising their rights.
  
  The Labor Commissioner and public prosecutors enforce the law, with a $500 civil penalty per violation. Injunctive relief, punitive damages, and attorney fees are available in civil actions. Commentators note that the law creates no express private right of action, but they expect plaintiffs to seek the penalties through the Private Attorneys General Act (PAGA). Employees covered by a collective bargaining agreement that clearly waives the law and provides its own protection from algorithmic management are exempt. Independent contractors, who were covered in earlier drafts, are not.
  
  McNerney said in a statement that "AI must remain a tool controlled by humans." Management-side firms, while generally describing the laws as narrower than earlier proposals, have flagged undefined terms and the risk of PAGA exposure.
  
  AB 1883, by Assemblymember Isaac Bryan (D-Los Angeles), takes effect January 1, 2027. It prohibits employers from using a "workplace surveillance tool" that incorporates AI to recognize, infer, or predict an employee's emotional state, or to collect "neural data." That term covers information from measuring activity of the central or peripheral nervous system, such as readings from an EEG headband, but not data merely inferred from other sources. A workplace surveillance tool is any system or device that collects data about employees' activities, communications, biometrics, or behavior by means other than direct human observation. Examples include video, audio, time-tracking, and geolocation tools. According to Fisher Phillips, the ban could reach AI sentiment analysis of employee emails, chats, or call transcripts, and it applies even if the employer never uses the data for an employment decision.
  
  The law covers private employers of every size and public employers, as well as labor contractors and their client employers. It does not prohibit using a surveillance tool "to ensure safety," and commentators disagree about how broadly that exception reaches. A narrow exemption applies to certain federally required defense, aerospace, and national security work. Enforcement mirrors SB 947: the Labor Commissioner and public prosecutors may act, with penalties of up to $500 per violation and the possibility of injunctive relief and punitive damages. There is no express private right of action. Job applicants and independent contractors are not covered. A companion bill signed the same day, AB 1331, separately restricts workplace surveillance in bathrooms and similar private areas.
  
  SB 951, by Senator Eloise Gomez Reyes (D-Colton), amends the California WARN Act, effective January 1, 2027. The Cal-WARN Act already requires covered establishments, those with 75 or more employees in the preceding 12 months, to give 60 days' notice of a mass layoff, relocation, or termination. Under SB 951, when the action is caused "in whole or in substantial part" by AI or other automated technology, the notice must carry the statement "This notice is for a technology displacement" at the top. It must also identify the number of affected workers, their occupations and work locations, the job functions the technology will perform, and the type of technology involved.
  
  The Employment Development Department must publish summaries of these notices and a quarterly statewide summary of technology-driven displacement. By January 1, 2028, it must also report to the Legislature on AI's effects on hiring. Existing Cal-WARN remedies, back pay and benefits and a civil penalty of up to $500 per day, are unchanged. The amendments build on SB 617, which expanded required notice content as of January 1, 2026.
  
  The new statutes add to obligations employers already face under the Civil Rights Council's regulations on automated-decision systems under the Fair Employment and Housing Act. Employers will also face the California Privacy Protection Agency's rules on automated decisionmaking technology, which begin to apply to significant employment decisions in 2027.
  

• Non-Opioid Pain Injection Beats Exparel in Phase 3 Trial
  on October 21, 2026 at 9:11 AM

  The first few days after orthopedic surgery are when many injured workers receive their first opioid prescription, and research has long linked early opioid exposure in workers' compensation claims to longer disability and higher claim costs. That makes any treatment that controls post-surgical pain without opioids worth watching for adjusters, utilization reviewers and attorneys.
  
  On October 19, 2026, TLC BioSciences, a company based in Taipei and South San Francisco, announced positive topline results from a pivotal Phase 3 trial of TLC590, an injectable, extended-release local anesthetic. In patients recovering from bunion surgery, a single dose reduced pain and opioid use compared with both a placebo and Exparel, the long-acting local anesthetic that is now the market leader in this category.
  
  A local anesthetic numbs the tissue where it is injected. Surgeons commonly infiltrate the surgical site with one at the end of an operation, but standard formulations wear off within hours, which is often when patients reach for opioids. Extended-release products are designed to stretch that numbing effect across the first several days, the period of most intense post-surgical pain.
  
  TLC590 uses ropivacaine, a widely used anesthetic, packaged in the company's proprietary liposomes, tiny fat-based particles that form a depot at the injection site and release the drug slowly. Exparel, made by Pacira BioSciences, uses a similar liposomal approach with a different drug, bupivacaine. TLC has long pointed to earlier research finding that ropivacaine carries less cardiovascular and central nervous system toxicity than bupivacaine, though the new announcement makes no safety comparison beyond reporting similar side-effect profiles. The product has been in development for years; TLC began human trials in hernia repair patients in 2018 and moved to bunion surgery with a Phase 2 study in 2019.
  
  The Phase 3 trial, registered as NCT07222748, enrolled 304 adults at U.S. sites who underwent bunionectomy, a surgery to correct a bony deformity at the base of the big toe that involves cutting and fixing bone. Patients were randomly assigned in equal numbers to TLC590 (100 patients), Exparel (102) or saline placebo (102), with neither patients nor investigators knowing which they received. Bunion surgery is a standard testing ground for post-surgical pain drugs because it is reliably painful and fairly uniform from patient to patient.
  
  According to the company, TLC590 met the trial's primary goal, significantly reducing cumulative pain with movement over the first 72 hours compared with placebo (p=0.0024), and patients also used significantly fewer rescue opioids during that period (p=0.0109). In the head-to-head comparison, TLC590 was statistically superior to Exparel on both cumulative pain (p=0.0202) and opioid consumption (p=0.0177). The company reported that the pain advantage over both comparators held through 168 hours, or seven days. It described TLC590 as generally well tolerated, with a safety profile similar to placebo and Exparel and no drug-related serious adverse events.
  
  TLC chief executive George Yeh called the results a potential "paradigm shift in postsurgical care," and a trial investigator said the data suggest pain control through the first postoperative week with less reliance on opioids. The company said it will complete the full analysis and prepare a New Drug Application to the U.S. Food and Drug Administration.
  
  Several cautions apply. These are topline results announced by the drug's maker in a press release; they have not been peer reviewed or published, and the release reports p-values without the actual pain scores or opioid amounts in each group, so the size of the advantage cannot yet be judged. Statistical significance is not the same as a difference patients would notice. The study covered one procedure in relatively healthy adults, and the eligibility criteria excluded patients with positive urine drug screens, a group that is not rare among injured workers with chronic pain. TLC590 is not approved, and any FDA label would initially be tied to the evidence submitted.
  
  TLC590 joins a broader push toward non-opioid pain control that already includes Exparel and Vertex's oral drug Journavx (suzetrigine). The next milestones are publication of the full trial data, the FDA submission and review, and results in other surgical models; the company has run a separate Phase 2 study that includes total knee replacement. Pricing will matter as much as performance for payers. Claims professionals should treat the current results as promising but preliminary, and look for peer-reviewed data on opioid reduction, function and return to work before treating this or any extended-release anesthetic as a cost saver.
  

• Instacart to Pay $5M to Settle DOJ, EEOC Claims
  on October 21, 2026 at 9:11 AM

  Maplebear Inc., the San Francisco company that does business as Instacart, has agreed to pay up to $5 million to resolve federal allegations that its recruitment for green card sponsorship favored foreign workers on temporary visas over U.S. workers. The Justice Department's Civil Rights Division and the U.S. Equal Employment Opportunity Commission (EEOC) announced the joint settlement in an October 20, 2026 press release. Instacart has not admitted wrongdoing.
  
  The case involves the Permanent Labor Certification, or PERM, process, the first step for many employers sponsoring a foreign worker for permanent residence. Before the Department of Labor will certify that no qualified U.S. worker is available for a position, the employer must test the labor market by advertising the job and considering U.S. applicants under 20 C.F.R. § 656.17. According to the Justice Department, Instacart required applicants for jobs advertised through PERM to mail in paper applications, even though its standard recruitment process accepted applications electronically. The department said that requirement burdened U.S. workers and that many who did apply were not considered in a timely way. The EEOC said its own investigation turned up similar evidence.
  
  The agencies alleged that the practice amounted to citizenship status discrimination under the anti-discrimination provision of the Immigration and Nationality Act, 8 U.S.C. § 1324b, and to national origin discrimination against American workers under Title VII of the Civil Rights Act of 1964, 42 U.S.C. § 2000e-2. The government characterized the preference for visa holders as intentional. Those are the agencies' allegations; the matter was resolved by agreement, and no court has made findings.
  
  Under the settlement summary, Instacart will establish a fund of up to $4 million to compensate people who applied for its PERM positions, or were deterred from applying, between December 2023 and February 2026. A claims administrator will contact eligible claimants and decide eligibility for back pay and compensatory damages. The company will also pay a $1 million civil penalty to the United States. Instacart must post PERM positions on its public careers website and accept electronic applications, revise its PERM-related policies, and train personnel annually on the anti-discrimination rules. It must also appoint a monitor to oversee its PERM program and submit compliance reports. The summary does not state how long the monitoring and reporting obligations last. Workers who believe they were affected can email Instacart@eeoc.gov so the agencies can pass their information to the administrator.
  
  An Instacart spokesperson told Fox News Digital that "we maintain that our practices complied with all applicable laws and regulations." The spokesperson said the company was pleased to resolve the matter.
  
  Assistant Attorney General Harmeet K. Dhillon said in the release that the division "will not stop fighting for U.S. workers until there is a fair playing field." EEOC Chair Andrea Lucas said that discrimination based on American national origin "has no place in our economy."
  
  The Justice Department said the agreement is the fifteenth reached since it relaunched its Protecting U.S. Workers Initiative in 2025. It said the initiative has produced more than $34 million in back pay and more than $16 million in civil penalties since its original launch. The Instacart allegations closely track those in an August 2026 settlement with OpenAI and its subsidiary Statsig. In that case, the companies agreed to a $1.2 million civil penalty and a $2 million back pay fund over allegations that they kept PERM postings off their careers site, required paper applications, and advertised the jobs on late-night radio.
  
  For the EEOC, the release describes the Instacart deal as its fourth public settlement since 2025 involving discrimination against workers because they are American. It also says five such lawsuits are pending in federal court under Project Firewall. The Department of Labor launched that initiative in September 2025 to investigate H-1B program abuse, and the EEOC has since joined it. In November 2025, the EEOC issued technical assistance stating that favoring foreign or visa-holding workers over Americans can violate Title VII. Commentators have tracked a growing number of EEOC actions on this theory, including settlements with an agricultural employer and a Guam hospitality company, according to Today's General Counsel.
  
  For employers that sponsor foreign workers, the settlement is the latest sign that PERM recruitment is getting close scrutiny from two agencies at once, under both immigration and Title VII law. Steps that diverge from an employer's normal hiring process can draw allegations of intentional discrimination, as the Instacart and OpenAI cases show. Examples include requiring paper or mailed applications, keeping postings off the company's own careers page, or running ads in hard-to-find outlets. For employers and their employment practices liability carriers, the combination of a back pay fund, a civil penalty, and an outside monitor is worth noting. Policies commonly exclude fines and penalties, so coverage for a resolution of this kind depends on the specific policy wording.

Archived Daily News Stories