- WCIRB Reports Combined Ratio Hits 127%, Highest in 20+ Yearson October 13, 2026 at 9:22 AM
California’s workers’ compensation insurers are on track for their worst underwriting year in more than two decades. The projected combined ratio for accident year 2025 now stands at 127%, meaning insurers are expected to pay out about $1.27 in losses and expenses for every premium dollar earned, according to the Workers’ Compensation Insurance Rating Bureau of California’s (WCIRB) Quarterly Experience Report, valued as of June 30, 2026, and released October 8, 2026.
The WCIRB says the 2025 figure is the second straight year above 120% (accident year 2024 came in at 125%) and the fifth consecutive year above 110%. The bureau notes that the last multi-year stretch with combined ratios above 100% came before the Senate Bill 863 reforms of 2012. By comparison, the ratio bottomed out at 78% in accident year 2016.
The report repeatedly points to cumulative trauma (CT) claims as a principal driver of the deterioration. Citing its June 2026 study, Emerging Patterns of Cumulative Trauma Claims, the WCIRB says CT claims grew from roughly 18% of indemnity claims in 2022 to more than 25%, with the increase concentrated in litigated claims, claims filed after termination, and claims showing little early medical treatment. Indemnity claim frequency rose 7.6% and 8.3% in the two accident-year periods following 2022, slowed to 0.7%, and then climbed another 3.6% in the first half of 2026. Excluding CT claims, the bureau describes recent frequency changes as more modest.
The projected loss and allocated loss adjustment expense (ALAE) ratio for accident year 2025 is 95%, essentially flat with 94% for 2024 but well above the 53% low recorded in 2016. The WCIRB attributes the climb mainly to higher average medical costs, higher ALAE, and rising claim frequency, particularly among CT claims.
Average ALAE per indemnity claim (excluding medical cost containment program costs) jumped 11% to $13,860 for accident year 2025, the fourth straight annual increase, based on data valued as of December 31, 2025. The bureau links the growth partly to CT claims, which are frequently litigated, and to a growing number of injured workers outside Los Angeles being represented by Los Angeles-based law firms.
Medical-legal costs are rising even faster. Indexed to 2014, average medical-legal costs per claim reached 170 in service year 2025, up from 121 in 2022, driven by both greater utilization and higher average payments per service, especially for medical record review. The WCIRB says CT claims use more medical-legal services, including psychological and psychiatric evaluations, and that the increases have been sharper in Southern California. Overall medical paid per claim rose 5% in the most recent service year, following a 10% gain the year before, with average paid per transaction up 4% and transactions per claim up 1%.
Other severity measures were flatter. Projected total loss and ALAE severity for 2025 is $81,460, nearly identical to 2024 and more than 30% above 2016. Indemnity severity slipped slightly to $30,611 but remains 29% above 2016, a rise the bureau ties largely to wage inflation. Medical severity per indemnity claim fell 3% to $34,560. The WCIRB cautions that these recent figures may understate eventual costs: CT claims tend to develop slowly, and roughly a quarter show no medical payments at 18 months.
Only 32% of open indemnity claims closed within the following year for the period ending June 30, 2026, down from a peak of 38% in 2019. The bureau says the decline since 2023 likely reflects more CT claims, heavier use of medical-legal services, and increased litigation, all of which can drag out the claims process.
On the revenue side, statewide written premium has held at roughly $15.7 billion to $15.9 billion annually since 2022. Premium written in the first half of 2026 totaled $8.6 billion, 5% ahead of the same period in 2025, which the WCIRB says points to growth for the full year. The industry average charged rate fell for more than a decade to a low of $1.63 per $100 of payroll in 2025; the preliminary estimate for the first half of 2026 is $1.64, suggesting the long decline may be ending. The report notes that the Insurance Commissioner approved average advisory pure premium rate increases of 8.7% effective September 1, 2025, and 6.6% effective September 1, 2026.
Finally, the WCIRB’s projected ultimate losses remain below what insurers have reported, but the gap has narrowed sharply, from about $16 billion in evaluation years 2017 and 2018 to roughly $2 billion for 2025. The bureau stresses that this comparison does not, by itself, indicate whether insurer reserves are adequate.
The WCIRB flags several limitations. The figures reflect insured employers only and may not represent the experience of self-insured employers. Results are statewide aggregates; individual insurers can differ significantly. Many figures are projections based on data as of June 30, 2026 (some exhibits use December 31, 2025, or June 7, 2026, data), and some rely on partial-period or preliminary data that may change as information matures. COVID-19 claims are included in some exhibits and excluded from others to preserve comparability with pre-pandemic years.
- Healthcare AI Pays Off in Claims and Billing, Not Yet at the Bedsideon October 13, 2026 at 9:22 AM
Healthcare organizations say artificial intelligence is paying for itself fastest in the back office — billing, claims processing and other administrative work — while AI at the bedside is still struggling to earn clinicians’ trust, according to The 2026 Healthcare AI ROI Scorecard, published September 30, 2026, by venture capital firm Bessemer Venture Partners. The report is based on a survey, conducted with Bain & Company, of 226 executives at health insurers (payers), healthcare providers and pharmaceutical companies, covering 65 AI use cases. It follows Bessemer’s 2025 Healthcare AI Adoption Index, which surveyed more than 400 executives using a similar framework.
The headline finding is speed. Respondents had budgeted for AI investments to pay back in roughly 24 months, but report realizing returns in about 12, at an average of 3.5 times cost, with results beating expectations in roughly 40 percent of use cases. Fifty-four percent reported material return on investment inside the first year. Ranked by reported return, provider revenue cycle work led at 4.0 times cost, followed by payer claims and pharmaceutical preclinical discovery at 3.4 times, payer provider-network functions at 3.3 times, member engagement at 3.2 times, provider front-office work at 3.1 times, provider clinical uses at 2.9 times, pharmaceutical commercial uses at 2.6 times and clinical drug development at 2.3 times.
The gap between administrative and clinical AI shows up most clearly in how much work organizations have handed over to autonomous systems. Two-thirds of provider revenue cycle respondents now run semi- or fully autonomous AI agents, as do 62 percent of payers in member engagement, compared with just 4 percent in provider clinical work. The fastest-growing use cases were all administrative: payer contracting management rose from 19 percent to 37 percent adoption, provider credentialing and enrollment from 35 percent to 56 percent, provider contracting from 40 percent to 60 percent and prior authorization from 32 percent to 46 percent. Still, the share of use cases in full production barely moved over the year, and for payers it held flat at 6 percent.
The survey also points to workforce effects. Half of the organizations surveyed said they have already reduced headcount as a direct result of AI or plan to within six months, with cuts averaging 8 to 13 percent of the affected functions. Among payers reporting reductions, 71 percent named claims processing and 68 percent named member services; among providers, 73 percent named revenue cycle and medical billing. Bessemer estimates, as a rough calculation of its own, that this implies about $100 billion in labor-spend disruption across roughly $1 trillion in annual healthcare administrative spending. The authors also argue that healthcare is short of workers in many of these same functions, citing an American Medical Association estimate of a roughly 30 percent medical coder shortage, and suggest that nurses now staffing prior authorization and utilization review could be redeployed to care management rather than simply eliminated.
For the claims side of the business, the report highlights how much AI is being aimed at the same disputes from both directions. Providers ranked denial and appeals management as their top pain point (78 percent) and prior authorization second (61 percent), while payers placed appeals management in their top three (42 percent). Bessemer characterizes the result as “AI-to-AI combat” on mirrored workflows, and argues the larger savings would come from eliminating duplicative processes altogether through aligned incentives and faster payment — something it says AI alone cannot deliver. For scale, it points to a 2021 JAMA Viewpoint, Administrative Simplification and the Potential for Saving a Quarter-Trillion Dollars in Health Care, which estimated roughly $265 billion in potential annual administrative savings (Bessemer cites the figure as $260 billion).
Clinical AI faces steeper obstacles. Only 46 percent of respondents said they trust AI-generated tools to support clinical decision-making, and 77 percent said clinicians override AI suggestions more than half the time. Fifty-eight percent said the treating clinician bears primary accountability for AI-influenced decisions, half cited medico-legal exposure as the main barrier to scaling beyond proof of concept, and 36 percent of providers have delayed or canceled a clinical AI deployment over regulatory and compliance uncertainty. Payment is another hurdle: about 48 percent of payers said they are unwilling to reimburse fully autonomous AI care, versus about 5 percent who object to AI-assisted care in which a clinician reviews and confirms the output. Roughly 44 percent of payers expressed willingness to create payment pathways in narrower areas such as primary and preventive care, diagnostic support and medication management. Bessemer frames the stakes against workforce shortages, citing the Association of American Medical Colleges’ projection in The Complexities of Physician Supply and Demand: Projections From 2021 to 2036 of a shortfall of up to 86,000 physicians by 2036, including 20,200 to 40,400 in primary care.
Buyers are also changing how they purchase AI. Forty-two percent have completed or are running a vendor consolidation, 72 percent now have an AI governance committee, and respondents named regulatory and compliance uncertainty as the top reason deployments are delayed or canceled. More than half of next year’s incremental AI spending is earmarked for scaling proven use cases (35 percent) and integrating them into existing workflows (20 percent). Internal development has faded: 61 percent of organizations said half or fewer of their internally built AI tools are still maintained and in use.
For insurers, claims administrators and employers, the findings suggest that AI-driven automation of claims processing, prior authorization and utilization review is moving from pilots into routine operations, with real staffing consequences, while the unresolved questions around clinical AI — who is liable when a clinician follows or overrides an AI recommendation, and whether payers will pay for AI-delivered care — remain open. The survey covers group health payers, providers and pharmaceutical companies; it does not address workers’ compensation or property-casualty claims specifically.
Several caveats apply. The return figures are self-reported by respondents and reflect deployments that Bessemer says are roughly two years old; the firm presents them as a floor rather than a ceiling, but they have not been independently audited. The published article does not detail how respondents were selected or the survey’s margin of error. Bessemer is a venture investor in healthcare AI companies, and the report names portfolio companies, including Abridge and SmarterDx, among the market’s winners; the firm’s own disclaimer notes that companies discussed may be current or former portfolio companies. Characterizations of trends and opportunities in the report reflect Bessemer’s analysis and investment perspective rather than independent findings.
- No Medi-Cal Clawback of Unused Managed Care Payments From Estateson October 12, 2026 at 12:18 PM
This is a published opinion of the California Court of Appeal, that concerns Medi-Cal estate recovery, the program families and elder law attorneys often call the Medi-Cal “clawback,” under which the state files a claim against a deceased member’s estate to recover what Medi-Cal paid for the member’s care. The case addresses one slice of that clawback: for members in managed care, the Department had been claiming the full monthly payments it sent to the health plan, even when the plan spent far less on the member’s actual care. The dispute that was litigated as a class action.
Medi-Cal clawback is an issue for workers' compensation and personal injury attorneys who settle large cases for clients who concurrently receive means tested social benefits such as Medi-Cal. One strategy is the use of a Special Needs Trust funded by an annuity purchased by the settlement proceeds. The following case adds to the legal precedent that may have some relevance to strategies to protect a litigant's estate from inappropriate clawbacks by social services consistent with law applicable to such cases.
Medi-Cal is California’s Medicaid program, administered by the Department of Health Care Services. When certain Medi-Cal members die, state law requires the Department to seek reimbursement from their estates. Welfare and Institutions Code § 14009.5 sets the recovery amount as the payments for the health care services the member received. Under managed care, however, the Department does not pay for each service. It pays the member’s health plan a fixed monthly “capitation” amount, whether or not the member uses any services.
Theodosia Phillip received Medi-Cal benefits while living in a nursing facility from 2010 until her death in 2015. The Department paid her managed care plan, CenCal Health, $261,957.40 in capitation over that period. The plan, in turn, paid about $106,672.71 for the services she actually received. After her death, the Department sought $407,774.41 from her estate: the full capitation amount, plus $5,852.30 in Medicare Part B premiums and $139,964.71 in interest.
The estate’s trustee disputed the claim, and the Department sued. Theodosia’s beneficiaries, Hardie and Jennifer Phillip, cross-complained on behalf of a certified class of Medi-Cal members’ estates from which the Department had sought to recover capitation in excess of the services received. The class included members who died both before and after January 1, 2017. They asserted quasi-contract and declaratory relief claims and petitioned for a writ of mandate.
The trial court ruled that recovering this “excess capitation” violated both state and federal law, and that its ruling applied retroactively. It entered judgment for the Department only for the capitation reflecting what the plan actually paid for Theodosia’s care, plus prejudgment interest. It also issued a declaratory judgment for the class and a writ of mandate directing the Department to reform its estate recovery practices, stop collecting excess capitation, and reprocess certain class members’ claims. The Department appealed.
In the published case of Phillip v. Baass, No. B341853 (October 2026) the Court of Appeal affirmed the judgment and awarded the Phillips their costs on appeal. Michelle Baass is named as the Department’s Director. The court held that the Department may recover only the portion of capitation that corresponds to services the member actually received.
The court began with the plain language of Welfare and Institutions Code § 14009.5, considering both its pre-2017 version and the version that applies to members who died on or after January 1, 2017. “Health care services” are defined by reference to specific enumerated benefits, and capitation is not among them. Applying the last antecedent rule, the court read the word “received” as modifying “services,” not “payments.” Recovery is therefore tied to services actually received, not to everything the Department paid out. The 2016 amendments, effective for deaths on or after January 1, 2017, narrowed recovery further, to services that federal law requires states to recover.
The court found support in Pottgieser v. Kizer (9th Cir. 1990) 906 F.2d 1319. There, the Ninth Circuit held that California could not collect from a decedent’s estate the Medicare Part B premiums the state had paid on her behalf, because the “medical assistance” subject to recovery covers the cost of services, not premiums. The court rejected the Department’s reliance on In re Estate of Ecklund (Minn. 2025) 20 N.W.3d 351, in which the Minnesota Supreme Court allowed recovery of capitation. In that case, Minnesota sought only the portion of capitation tied to long-term care services, not the whole payment, and the decision did not address California law.
Even if the statute were ambiguous, the court said, the legislative history does not mention excess capitation, and the amendments over time narrowed recovery rather than expanding it.
The court then invalidated the Department’s regulation. California Code of Regulations, title 22, § 50961 provides that the Department’s estate claim includes “payments to managed care plans.” Because that language enlarges the scope of the statute, the regulation is void under Government Code § 11342.2, which bars regulations that conflict with or expand the statutes they implement.
Federal law did not change the result. The federal estate recovery statute, 42 U.S.C. § 1396p(b), requires recovery only for specified categories, chiefly nursing facility services, home and community-based services, and related hospital and prescription drug services. Excess capitation is not among them, and federal law does not require states to recover it. The court gave no weight to the federal State Medicaid Manual, describing it as informal guidance without the force of law that cannot override the statute. The Department also could not rely on the Manual or its regulation to sidestep California’s Administrative Procedure Act.
Finally, the court rejected the Department’s policy arguments, including its warning of serious consequences if excess capitation could not be recovered. If the Legislature wanted that money recovered, the court said, it would have said so; the Department’s concerns belong with the Legislature, not the courts.
- EEOC Seeks End to 2012 Criminal Records Employer Guidanceon October 12, 2026 at 12:18 PM
The U.S. Equal Employment Opportunity Commission (EEOC) has taken the first formal step toward withdrawing its 2012 guidance on how employers may use arrest and conviction records in hiring and other employment decisions. On October 6, 2026, the White House Office of Management and Budget’s Office of Information and Regulatory Affairs (OIRA) logged receipt of a draft final rule from the EEOC titled “Rescission of Enforcement Guidance on the Consideration of Arrest and Conviction Records in Employment Decisions Under Title VII of the Civil Rights Act,” according to Littler Mendelson, Ogletree Deakins in The National Law Review, and Bloomberg Law.
The text of the draft has not been released. Under the federal regulatory review process, OIRA publicly lists a rule’s title, agency, stage, and date of receipt when it begins review, but the document itself generally does not become public until the agency publishes it in the Federal Register. What is known comes from that listing and from practitioner commentary.
First, the action is a complete rescission. The title indicates the EEOC intends to withdraw the 2012 guidance, not revise it. Ogletree’s attorneys wrote that, based on past practice, it is very possible the agency will rescind the guidance without issuing any replacement.
Second, it is styled as a final rule, not a proposed rule. That means no public comment period is expected. Littler’s attorneys noted that if OIRA clears the draft, the EEOC is expected to publish it and repeal the guidance effective on publication, though the timing is unclear.
Third, nothing about the rescission changes the underlying statute. Title VII of the Civil Rights Act of 1964, and the case law interpreting it, remain in place. The guidance was the EEOC’s interpretation of that law, not law itself.
The 2012 Enforcement Guidance, adopted under the Obama administration, consolidated and updated EEOC policy statements dating to 1987 and 1990. It explained that an employer’s use of criminal history can violate Title VII in two ways. The first is disparate treatment: treating applicants differently because of race or national origin, for example by excusing a record for one applicant but not another. The second is disparate impact: applying a neutral screen that disproportionately excludes protected groups and is not justified by the job. The guidance relied on national data showing higher arrest and incarceration rates for Black and Hispanic individuals to support the view that criminal record screens can have a disparate impact.
To defend a screen against a disparate impact claim, an employer must show it is job related and consistent with business necessity. The guidance said the most common way to do that was a targeted screen considering the three “Green factors”: the nature and gravity of the offense, the time elapsed since the offense or completion of sentence, and the nature of the job. It encouraged employers to follow up with an individualized assessment giving the applicant a chance to explain. The guidance also took the position that an arrest alone does not show that criminal conduct occurred, and it discouraged blanket exclusions of anyone with a record. It recognized that federal laws requiring the exclusion of people with certain convictions are a defense to a Title VII claim.
The guidance drew criticism from the start. Texas sued in 2013, arguing it had the right to refuse to hire convicted felons for state jobs. On August 6, 2019, the Fifth Circuit ruled in Texas v. EEOC that the guidance was a substantive rule the EEOC lacked authority to issue. The court barred the EEOC and the Attorney General from treating it as binding against Texas. Business groups argued more broadly that the guidance discouraged legitimate safety screening and exposed employers to liability for following state no-hire laws.
Supporters of the guidance saw it as an important tool for people re-entering the workforce after involvement with the criminal justice system. They argued that blanket exclusions shut a large share of the population out of work and fall hardest on Black and Hispanic workers, and that individualized review lets employers manage real risks without screening out people whose records have nothing to do with the job.
The current effort to withdraw the guidance is part of a broader federal retreat from disparate impact enforcement. As described by Quarles & Brady, President Trump signed Executive Order 14281, “Restoring Equality of Opportunity and Meritocracy,” on April 23, 2025. It directed federal agencies to deprioritize enforcement of disparate impact liability, specifically naming Title VII. EEOC leadership reportedly directed staff to close nearly all pending charges based solely on disparate impact by September 30, 2025. On June 9, 2026, the Department of Justice issued a formal opinion concluding that the EEOC’s existing interpretations of disparate impact liability are unconstitutional and that selection tools such as background checks should be treated as presumptively job related. The EEOC, chaired by Andrea Lucas, voted on June 30, 2026, to rescind its affirmative action guidelines.
Critics of that shift have pushed back. An EEOC administrative judge told HR Dive that the presidential directive was illegal, and the publication noted that a federal judge dismissed a 2025 lawsuit challenging the EEOC’s nonenforcement of disparate impact claims.
Practitioners across the commentary agree on several points. Disparate impact liability remains part of Title VII. The Supreme Court recognized it in Griggs v. Duke Power Co. (1971), and Congress wrote it into the statute in the Civil Rights Act of 1991. The EEOC can decline to pursue such claims, but applicants can still file charges, obtain right-to-sue notices, and bring private lawsuits, including class actions.
The Green factors come from case law, not the guidance. Courts have applied the Eighth Circuit’s framework for decades, and the Third Circuit in El v. SEPTA (2007) required employers to show that a criminal record policy accurately separates applicants who pose an unacceptable risk from those who do not. Quarles & Brady expects courts to keep weighing offense severity, recency, and job relevance, while noting that employers will likely cite the Justice Department’s opinion and that some courts may find it persuasive.
Disparate treatment claims are unaffected. The EEOC is expected to continue investigating uneven application of background check policies across racial or national origin groups. Arrest-only exclusions and blanket bans remain the riskiest practices, because an arrest is not proof of misconduct and courts have long been skeptical of across-the-board exclusions.
The federal Fair Credit Reporting Act’s notice and adverse action requirements, and the growing body of state and local “ban the box” and fair chance laws, are not affected by the rescission. That is especially significant in California. The California Fair Chance Act generally bars employers with five or more employees from asking about conviction history before a conditional job offer. It also requires an individualized assessment, and specific written notices, before an offer is withdrawn based on a conviction. The California Civil Rights Department continues to enforce the law actively, as reflected in its June 2026 settlement with the City of Signal Hill over a rescinded job offer. Ogletree’s attorneys noted that several state agencies have signaled they are prepared to fill the gap left by federal disparate impact enforcement.
There is no set deadline for OIRA to finish its review. Once the rule is published, the 2012 guidance is expected to be withdrawn immediately. Employers that built their screening programs around the guidance are generally being advised not to dismantle them, because the same practices remain the best defense under Title VII case law and are required by many state and local laws.
- From "Job Killers" to "Cost Drivers" - CalChamber's Legislative Reportson October 8, 2026 at 7:22 AM
The California Chamber of Commerce reported on October 7, 2026 that its 2026 Affordability Agenda produced strong results for business. Of 31 bills it labeled "Cost Drivers" this year, only one was signed into law. The year-end report is the second under a framework that has taken the place of the chamber's best-known advocacy tool, the annual "Job Killer" list, which CalChamber last published as a standalone list in 2024.
For more than 25 years, the Job Killer label was CalChamber's way of marking the legislation it considered most damaging to employment and economic growth in California. The list began in 1997 with 57 bills, according to a May 2024 Capitol Weekly analysis, which counted 844 bills tagged through 2023, of which 64 became law. CalChamber has described the record as more than 93 percent of tagged bills halted. The final list, for 2024, contained 18 bills. In its October 2024 wrap-up, CalChamber reported that only one of them reached the governor: SB 399, which restricts mandatory employer meetings on political and religious matters. It was signed.
The same Capitol Weekly analysis noted that the list had shrunk to its smallest size in more than two decades and questioned how much it still mattered. An unnamed longtime Capitol lobbyist told the publication the label counts mainly when a bill needs Republican votes, which is rarely the case under a Democratic supermajority. California Business Roundtable President Rob Lapsley, a former chamber political director, defended the list as a way to focus on bills with the broadest impact on employers. Then-Senator Steve Glazer, whose digital advertising tax bill carried the tag, said it made the chamber's advocacy "a lot less effective" on narrowly drafted measures.
The shift came in April 2025, when CalChamber announced its first Affordability Agenda. The new framework sorts legislation into two groups: Cost Drivers, which CalChamber says raise costs for businesses and consumers, and Cost Cutters, which it says lower them. The initial 2025 release identified 10 Cost Drivers and three Cost Cutters. CalChamber said the Job Killer list had served it well, but that a focus on jobs alone was no longer enough. President and CEO Jennifer Barrera said that "California businesses and consumers alike are focused on the affordability of everyday life," and pointed to the 2024 election as showing that affordability was a leading concern for voters.
The timing tracked a broader change in Sacramento. After Democrats lost legislative seats and voters rejected several progressive ballot measures in November 2024, Assembly Speaker Robert Rivas urged lawmakers to frame their bills around affordability, CalMatters reported in February 2025. A CalChamber executive vice president welcomed the focus in that report and called for bills that reduce costs and regulation for businesses and customers.
CalChamber has not formally announced the end of the Job Killer list. Its Job Killer page still links to lists from 2021 through 2024 alongside the current Affordability Agenda, and CalChamber describes the agenda as building on the Job Killer lists while also weighing regulatory burdens and incentives for economic growth. In practice, the Affordability Agenda has been its headline bill-tracking tool for the past two sessions. CalChamber said in March 2026 that all but one of its 2025 Cost Drivers failed to move forward.
The 2026 agenda launched in March with nine Cost Drivers and two Cost Cutters, and grew over the session to 31 Cost Drivers and six Cost Cutters. Barrera said at the launch that no bill should come up for a vote this year "without taking stock of its impact." The Cost Drivers ranged across air quality, antitrust, climate liability, energy, health care, privacy, taxation and employment. Bills restricting artificial intelligence and automated decision systems in the workplace made up the largest group of employment measures.
According to CalChamber's year-end report, only two Cost Drivers reached Governor Gavin Newsom. He signed AB 2646 by Assemblymember Maggy Krell, which sets an industry-specific minimum wage of 19.75 dollars an hour for H-2A agricultural workers and comparable domestic workers in the same county. CalChamber says the law will raise farm labor costs and, eventually, food prices. He vetoed AB 2575 by Assemblymember Liz Ortega, which would have imposed disclosure and liability rules on the use of AI in health care facilities. Two Cost Cutters also reached the governor. He signed AB 1693 by Assemblymember Rick Zbur, which streamlines permitting for retail tenant improvements by letting licensed architects or engineers certify code compliance and setting deadlines for local action. He vetoed AB 2124 by Assemblymember Blanca Pacheco, which would have required independent review of the effect of energy legislation on utility ratepayers, citing existing analytical resources and the lack of budget funding.
The headline tally does not capture every bill the chamber fought. During the session CalChamber removed the Cost Driver tag from several bills after amendments while continuing to oppose some of them and urging vetoes. Three of those were signed on September 30 as part of a package of workplace AI and surveillance laws, according to KQED and the governor's office. SB 947 by Senator Jerry McNerney bars employers from relying solely on an automated system to discipline or fire workers. SB 951 by Senator Eloise GÓmez Reyes requires notice when technology displaces workers in a layoff, relocation or termination. AB 1331 by Assemblymember Mark GonzÁlez Elhawary restricts certain workplace surveillance. California Federation of Labor Unions President Lorena Gonzalez praised the package as putting "guardrails on AI at work." KQED reported that CalChamber did not respond to a request for comment. Other Cost Drivers died before reaching the governor, including AB 2564 on litigation exposure for discount offers and AB 1018 on impact assessments for automated decision systems.
For the workers' compensation community, the 2026 list included one claims measure. CalChamber tagged SB 632 by Senator Jesse ArreguÍn, which would have created presumptions of industrial injury for hospital employees providing direct patient care, and the bill did not advance. The year's significant comp changes, including the Subsequent Injuries Benefits Trust Fund reforms in SB 171, came instead through the state budget process and were not part of the agenda.
The "Cost Driver" and "Cost Cutter" labels and the descriptions of each bill's effects are CalChamber's own advocacy positions. Supporters of the bills generally regard them as worker, consumer or public health protections, and the chamber's tallies count only bills that still carried its tags at the end of the session. Readers should consult CalChamber's Affordability Agenda bill list and the individual bills for complete details and final status.
- Blue Cross Says AI Coding Added $942 Million to Hospital Billson October 8, 2026 at 7:22 AM
Workers' compensation carriers and self-insured employers pay hospital bills under fee schedules built on the same diagnosis codes that group health insurers use, so a dispute now playing out between the nation's largest insurer federation and the hospital industry deserves close attention from claims and bill review professionals. On September 24, 2026, the Blue Cross Blue Shield Association (BCBSA) released a claims analysis concluding that hospitals' growing use of artificial intelligence to document and code inpatient stays has made patients look sicker on paper without any matching change in the care they received. As Fierce Healthcare reported, the association put the price of that shift at an estimated $942 million in added costs to Blue plans over 2024 and 2025, measured against a 2023 baseline.
To follow the argument, it helps to understand how a hospital stay is priced. Most inpatient admissions are paid as a single lump sum determined by a diagnosis-related group, or DRG. Each DRG family typically comes in tiers. The same operation pays one amount for an uncomplicated patient, more if the record lists a "complication or comorbidity," and more still if it lists a "major" one. A single secondary diagnosis, such as anemia from blood loss, a low sodium level, or malnutrition, can move a stay up a tier and add thousands of dollars to the payment even though the surgery itself is unchanged.
That is where the new software comes in. AI revenue cycle tools scan physician notes, laboratory results and other chart entries for conditions that qualify as secondary diagnoses, and ambient "scribe" products listen to patient encounters and draft the clinical note. Hospitals say these tools capture conditions that busy clinicians always treated but did not always write down. Insurers say they are finding billable diagnoses that made no difference to the patient's care.
BCBSA's analysis, a short white paper covering claims from the first quarter of 2023 through the end of 2025, found that the share of inpatient cases billed to Blue plans as medically complex rose from 37 percent to 40 percent. About 70 percent of the increase came from more than 55,000 additional cases in which a secondary diagnosis pushed the claim into a higher-paying DRG. Those cases accounted for $653 million of the total, or roughly $11,000 per case. The paper used major bowel surgery as its example: claims in the highest severity tier climbed to 22.7 percent while uncomplicated cases fell from 36.6 percent to 32.8 percent.
The association's central evidence is what it calls a disconnect between coding and treatment. Hospitals in the top quarter for growth in complex coding showed similar or lower rates of intensive care use, transfusion, reoperation and length of stay than their peers. For acute blood loss anemia, which BCBSA describes as a common "bump" code, the hospitals that diagnosed it most often actually transfused those patients less often, 16.9 percent compared with 19.3 percent elsewhere. Luke Chalker, the association's senior vice president of product and data science, told reporters the data showed "no change in corresponding care for a more complex patient." The September paper follows a March 2026 BCBSA and Blue Health Intelligence study that attributed about one-fifth of a 9 percent rise in per-member inpatient costs to coding intensity.
Hospitals reject the conclusion. In an October 5 response, the American Hospital Association said patients today are older and more clinically complex and that AI tools help providers record their conditions accurately. "The question is whether the patient's medical record supports those diagnoses," two AHA policy executives wrote, noting that BCBSA reviewed claims rather than charts and did not identify which claims actually involved AI. The AHA made similar points in an August fact sheet, and in a statement to CNBC it criticized insurers for raising coding concerns while relying on their own automated downcoding and denial systems.
The study's limits are real, and BCBSA concedes the main one. It relied on claims data, not medical records, so it cannot show that any particular diagnosis was unsupported. The link to AI rests on timing and on survey figures showing that most hospital systems now use AI somewhere in the revenue cycle, not on claims traced to specific software. The white paper is not peer reviewed, it names no hospitals, and it arrived during a period of difficult contract negotiations between plans and hospital systems. Independent researchers had nonetheless raised the same concern before the insurers did. A January 2026 viewpoint in JAMA Health Forum warned that ambient scribes marketed for their ability to capture more and more severe diagnoses could drive spending upward, and an April report from the Peterson Health Technology Institute described a payer-provider AI "arms race" that raises billing intensity without fixing underlying inefficiency.
For workers' compensation payers the relevance is direct, even though the study examined commercial health claims and its examples were bowel surgery and, earlier, maternity care. California's Official Medical Fee Schedule prices inpatient hospital stays using Medicare's DRG system with a multiplier, as do the fee schedules of many other states. The DRG families that dominate comp inpatient spending, including spinal fusion, major joint replacement and fracture repair, are tiered by complications and comorbidities in the same way. Acute blood loss anemia, the code BCBSA singled out, is one of the diagnoses most frequently recorded after orthopedic surgery. A hospital that deploys AI coding software applies it to every payer's claims, not just those of Blue plans.
That raises several practical points. First, bill review programs that validate only the fee schedule calculation will not catch severity drift, because a correctly priced DRG can still rest on a secondary diagnosis the record does not support. Clinical validation, which compares the coded diagnoses against the treatment actually delivered, is the test BCBSA applied in aggregate and the one payers can apply claim by claim. Second, any objection must still be made within the deadlines and explanation-of-review requirements of Labor Code § 4603.2, and unresolved payment disputes proceed through second review and independent bill review. Third, the issue cuts both ways. Applicants' attorneys and providers will point out that more complete documentation of comorbidities is legitimate and may bear on apportionment, causation and future medical needs, while defense counsel may question whether a newly charted secondary condition was ever clinically significant.
Payers should also expect scrutiny of their own automation. According to an Orthopedics This Week commentary, Indiana now bars health plans from using an automated tool as the sole basis for downcoding a claim without reviewing the medical record, and lawmakers in California and several other states introduced downcoding bills this year. Those measures are aimed at health plans, but they signal where regulators are heading.
BCBSA says further analyses are coming, including outpatient care and additional DRGs, and orthopedic and spine procedures are obvious candidates. The broader cost pressure is not in dispute. CNBC reported that benefits consultant Marsh projects employer health costs per employee will rise 8.2 percent in 2027. Whether AI-assisted coding represents accurate documentation finally catching up with reality or technology-enabled upcoding is a question the claims data alone cannot answer. For comp payers, the prudent step is to find out whether their bill review vendor tracks DRG severity mix over time and tests secondary diagnoses against the treatment record.
- Psychologist's License Probation for WC Fraud Conviction Upheldon October 7, 2026 at 12:14 PM
Morella Bombardini has been licensed as a psychologist in California since 2011. On November 4, 2018 she was convicted in Los Angeles County, on a plea of no contest, of a misdemeanor violation of Insurance Code § 1871.4, subdivision (a)(1), the workers' compensation fraud statute. She was ordered to perform community service and pay more than 11,000 dollars in restitution to her employer. The conviction was dismissed in 2019 under Penal Code § 1203.4.
The opinion gives only a limited account of the underlying offense. The claim arose from her work as a psychologist at Kaiser Permanente and involved carpal tunnel syndrome. The criminal complaint originally alleged three felony counts, and the court's minute order placed the incident on or about July 11, 2014. The Board found that she made a fraudulent workers' compensation claim in connection with that employment, but the opinion does not say which statement or representation was false. Bombardini testified that she left Kaiser because she was in severe pain and filed the claim to obtain physical therapy for her hands. She also referred to an accusation that she had lied in a deposition about carpal tunnel syndrome, and said she wanted to show that she did have the condition. The Board treated the conviction as a crime substantially related to the practice of psychology because it involved fiscal dishonesty.
The Board of Psychology brought a disciplinary accusation based on the conviction. It also alleged that she had obtained her license by fraud by failing to disclose a 1984 conviction for writing checks with insufficient funds, but that charge was dismissed because the Board had known of the 1984 conviction before it licensed her. After a hearing held remotely in 2020, at which Bombardini represented herself, the Board placed her license on probation for five years, effective April 23, 2021. The conditions included a practice monitor, an ethics examination, coursework, quarterly reports and reimbursement of investigation costs. She did not seek judicial review within the 30 days allowed by Government Code § 11523.
Bombardini moved to Maryland in 2021 and to Oregon in 2022, which tolled the probation, and returned to California in 2023. In July 2023 she petitioned the Board for early termination of probation. At the administrative hearing she maintained that she had never intended to commit fraud and that she had in fact suffered from carpal tunnel syndrome. The Board denied the petition in a decision effective May 23, 2024. It found she had not shown rehabilitation by clear and convincing evidence because she continued to deny her criminal conduct, claimed she was being unfairly punished, and described herself as a victim of circumstances.
Bombardini filed a petition for writ of administrative mandate under Code of Civil Procedure § 1094.5 in Sacramento County Superior Court, challenging both the 2021 probation order and the 2024 denial. Judge Jennifer K. Rockwell denied the petition in its entirety. The court ruled that the challenge to the 2021 decision was untimely and, applying the substantial evidence test, that the 2024 decision was supported by the evidence. Bombardini appealed.
In the partially published case of Bombardini v. Board of Psychology, No. C104172 (October 2026), the Third Appellate District affirmed the judgment denying the writ petition. The opinion is certified for publication except for parts II, III and IV of the Discussion, so only part I, on the standard of review, may be cited as precedent.
In the published portion, the court addressed which test a trial court applies when a licensee seeks review of a board's refusal to lift probation early. The answer depends on whether the decision affects what the cases call a "fundamental vested right." A person who already holds a professional license has such a right to continue practicing, so a decision revoking, suspending or restricting the license receives independent judgment review, in which the trial court reweighs the evidence. The court cited Hughes v. Board of Architectural Examiners (1998) 17 Cal.4th 763 for that principle.
Decisions on applications for a license are treated differently. There, courts have largely deferred to the agency's expertise and ask only whether substantial evidence in the whole record supports its findings, as explained in Bixby v. Pierno (1971) 4 Cal.3d 130. The same deferential review applies to a person seeking reinstatement of a revoked license, who has no greater rights than a first-time applicant under Flanzer v. Board of Dental Examiners (1990) 220 Cal.App.3d 1392.
The court placed a petition for early termination of probation in the second category. Bombardini was not defending her license against new discipline. She was asking the Board to remove restrictions that were already final, which the court considered closer to an application for an unrestricted license. Whether a probationer can safely return to unsupervised practice is, like initial qualification, a judgment that calls on the board's expertise. The trial court therefore applied the correct test.
On the merits, the court found substantial evidence for the Board's conclusion that rehabilitation had not been shown. The Board's disciplinary guidelines look both to the licensee's state of mind, meaning appreciation of the gravity of the misconduct and remorse, and to a course of conduct showing the public would be safe. Citing Seide v. Committee of Bar Examiners (1989) 49 Cal.3d 933, the court said that acknowledging wrongdoing is an essential step toward rehabilitation. Bombardini's statements that she never intended fraud, that she was being treated as a criminal, and that her attorneys had advised the no contest plea supported the Board's finding that she had not accepted responsibility. Compliance with probation terms carried little weight, because good conduct is expected of someone under supervision. Supporting letters were discounted because they predated the conviction or came from authors who did not appear to know the full facts.
- SIBTF Overhaul Leads Short List of 2026 Legislative Changeson October 7, 2026 at 12:14 PM
California's 2026 legislative session produced two enacted workers' compensation measures that claims administrators, employers and practitioners will carry into 2027: a budget trailer bill that rewrites eligibility for the Subsequent Injuries Benefits Trust Fund (SIBTF) and makes the current reconsideration deadline permanent, and a short bill that keeps prepaid card indemnity payments available indefinitely. Several other closely watched proposals, including a permanent disability rate increase, did not reach the governor. The governor's deadline to act on bills passed this year was September 30.
This report was compiled from the chaptered bill digests, the governor's signing announcements and legislative tracking by the Commission on Health and Safety and Workers' Compensation (CHSWC). The California Workers' Compensation Institute has issued its own summary of the 2026 session as a Bulletin, which is available to CWCI members and subscribers through its Bulletins page.
The centerpiece is Senate Bill 171, a labor budget trailer bill approved by Governor Gavin Newsom on July 13, 2026 and chaptered as Chapter 83, Statutes of 2026. As a budget measure it took effect immediately. The Legislative Counsel's digest explains that case law had treated a prior condition as "labor disabling" if it could have supported an award had it been industrial, without requiring any showing of lost earnings. SB 171 replaces that approach with a statutory definition: the impairment must have caused a loss of earnings, interfered with the employee's work in their occupation, or otherwise had a demonstrable impact on the ability to work.
The bill also changes how the preexisting disability is proved. Its existence at the time of the later industrial injury must be shown by substantial evidence drawn from medical records, testimony and other evidence that already existed before that injury. In determining whether the subsequent injury meets the statutory threshold, the bill excludes any adjustment for future earning capacity or the corresponding adjustment factor. It sets a filing deadline for SIBTF claims of five years from the date of the subsequent injury or six months from the resolution of permanent disability in the underlying claim, whichever is later.
How the new rules apply to the existing backlog was the most contested question. The digest states that claims filed on or before July 1, 2020, and claims that had reached a specified procedural status on or before June 1, 2026, are exempt from the changes, and that those provisions become inoperative on July 1, 2031 and are repealed on January 1, 2032.
SB 171 makes administrative changes to the fund as well. The Director of Industrial Relations, as trustee of the SIBTF, replaces the State Compensation Insurance Fund as the entity that pays awards, and State Fund's authority to reimburse itself for related costs is deleted. A Senate Republican Caucus summary of the enacted budget reports 13 million dollars and 57 positions to work down backlogged SIBTF claims. That is in line with the 12.7 million dollars and 57 positions the administration requested in January, a request that CHSWC's June legislative update said would grow to 36.5 million dollars and 177 positions by fiscal year 2030-31.
The reforms respond to rapid growth in the program. A July 2025 report by the Legislative Analyst's Office found a backlog of more than 25,000 claims and estimated lifetime benefit costs of 2 billion to 3 billion dollars for each annual cohort of claims, costs that are funded through assessments on employers.
The second major workers' compensation provision in SB 171 concerns petitions for reconsideration under Labor Code § 5909. Since 2024, a petition has been deemed denied unless the Workers' Compensation Appeals Board acts within 60 days of the date the trial judge transmits the case to the Board. That rule was scheduled to expire on July 1, 2026, when the clock would again have started on the date the petition was filed. SB 171 removes the sunset, so the transmission-based deadline is now permanent.
Two further provisions affect payers directly. Workers' compensation surcharges and assessments must now be paid by electronic funds transfer, and the bill imposes a 10 percent penalty on late or unpaid amounts and on payments not made electronically, with the penalties deposited in the Workers' Compensation Administration Revolving Fund. The bill also removes the Administrative Director of the Division of Workers' Compensation from a statutory salary schedule.
The other enacted measure is Assembly Bill 1683, an Assembly Insurance Committee bill that the governor signed on July 6, 2026. Existing law allowed employers to deposit disability indemnity payments into prepaid card accounts only until January 1, 2027. AB 1683 extends that authorization indefinitely. CHSWC noted that the bill tracks the recommendation in its own report on prepaid card programs, approved in February. Because the bill is not an urgency measure, it takes effect January 1, 2027, the same day the prior authorization would have lapsed.
Several bills that drew attention during the session were not enacted. Senate Bill 555 would have raised the weekly earnings range used to compute permanent partial disability indemnity from the current 240 to 435 dollars to a range of 363 to 658 dollars for injuries on or after January 1, 2027. Its first Assembly committee hearing, set for June 24, was canceled at the author's request and the bill did not advance. Assembly Bill 1576, a separate SIBTF reform vehicle, and Assembly Bill 1048, which would have required explanations of review to identify the contract behind a discounted payment and required physicians to sign requests for authorization, were both held in committee on August 13. CHSWC's update lists two more as having missed legislative deadlines: Assembly Bill 2098, on leave for medical treatment during work hours, and Senate Bill 632, which would have created injury presumptions for hospital employees providing direct patient care.
The permanent disability question is likely to return. Business Insurance reported in July that the chief lobbyist for the California Coalition on Workers' Compensation told the group's conference that employers are preparing for negotiations in 2027 over permanent disability benefits, and will seek offsetting savings in areas such as cumulative trauma claims and medical-legal costs.
- Court Sets Rules for Use of Strict Liability in FEHA Caseson October 6, 2026 at 10:00 AM
A California Court of Appeal has held, in an opinion certified for publication, that an employer is not strictly liable under the Fair Employment and Housing Act (FEHA) for sexual harassment by an employee who supervises other workers but has no supervisory authority over the plaintiff. In that situation the employer answers only under the negligence standard. The court described the question as one no California appellate case had directly decided.
The plaintiff in this case, Jane Doe, returned to Wells Fargo in 2018 as a wealth advisor in its private bank division, where advisors assemble teams of specialists to serve high-net-worth clients. Eric Pagel was an investment strategist who handled portfolios for many of her clients and was one of the bank's top producers nationally. He was not her supervisor. Wells Fargo had not designated him a supervisor of anyone, and he could not hire, fire, or approve expenses or time off, although he gave input on the performance of the support associates who executed his trades and handled his scheduling.
In January 2020, Doe, Pagel and several coworkers traveled to Bakersfield for client meetings and had dinner and drinks afterward. Doe says she blacked out that night, that Pagel later came to her hotel room, and that she was too intoxicated to consent to the sex that followed. Pagel maintains that she invited him and consented. About a month later Doe told a colleague who had been on the trip that Pagel had been harassing her, without mentioning an assault. That complaint was not escalated or investigated.
On November 9, 2020, Doe reported harassment and assault to the bank's ethics hotline, to her direct supervisor and to law enforcement. Wells Fargo flagged the complaint for expedited investigation eight days later and placed Pagel on paid administrative leave. After a ten-month inquiry, the internal investigator issued a 28-page report finding the harassment and assault allegations unsubstantiated, but concluding that everyone at the dinner had violated the workplace conduct policy and that Pagel had violated the professionalism policy. Pagel received a final notice warning that further violations could lead to immediate termination.
Doe sued Wells Fargo, Pagel and three other employees in Los Angeles County Superior Court in February 2023, alleging sexual harassment under FEHA and, against the bank, failure to prevent harassment and retaliation. Wells Fargo moved for summary judgment, arguing that it could not be strictly liable because Pagel never supervised Doe, and that it could not be liable in negligence because it responded promptly and appropriately once she complained. Doe's opposition argued that strict liability attaches to harassment by any supervisor, whoever that person supervises, and did not address the negligence standard. Judge Tony L. Richardson granted the motion on both grounds and entered judgment for the bank.
In the published case of Doe v. Wells Fargo Bank, N.A., No. B344642 (October 2026), the Second Appellate District, Division Four, affirmed the judgment on Doe's appeal. Justice Tamzarian, as acting presiding justice, wrote for a unanimous panel. Only the harassment claim against Wells Fargo was before the court, because Doe's briefs did not address her other causes of action.
The court began with the statute. Government Code § 12940, subdivision (j)(1) expressly sets a negligence standard for harassment by an employee other than an agent or supervisor, and the California Supreme Court inferred from that wording, in State Dept. of Health Services v. Superior Court (2003) 31 Cal.4th 1026, that employers are strictly liable when a supervisor is the harasser. The statute never uses the words strict liability, and the panel found that its text does not plainly answer whether "supervisor" means any supervisor or the plaintiff's supervisor. Because the definition in Government Code § 12926, subdivision (t) turns on a person's authority over other employees, the court reasoned that someone with no authority over the plaintiff is, as to her, simply a coworker.
With no helpful legislative history, the court looked to the purpose of the rule. Strict liability exists because a supervisor wields employer-conferred power over the victim, which makes harassment harder to resist and report and justifies imputing the conduct to the employer. None of that is present when the harasser's authority runs only to other people. The panel also found that Doe's reading would produce arbitrary results: an employer would be strictly liable when a shop foreman harasses an executive, or when a mid-level manager harasses her own boss, but liable only in negligence when a senior non-supervisory employee harasses a junior one.
The court read Health Services as consistent with this view. That opinion spoke of "the victim's supervisor" and cautioned that the supervisor must be acting in a supervisory capacity when the harassment occurs. Later Court of Appeal decisions said the same, including Chapman v. Enos (2004) 116 Cal.App.4th 920, Atalla v. Rite Aid Corp. (2023) 89 Cal.App.5th 294, and Kruitbosch v. Bakersfield Recovery Services, Inc. (2025) 114 Cal.App.5th 200. A person who does not supervise the plaintiff at all, the panel concluded, cannot be acting as her supervisor.
Doe's contrary authorities did not persuade the court. Two Fair Employment and Housing Commission decisions from the 1980s (Dept. of Fair Employment and Housing v. Hart & Starkey, Inc., FEHC Dec. No. 84-23, and Dept. of Fair Employment and Housing v. Community Hospital of San Gabriel, FEHC Dec. No. 86-08) predated both Health Services and the statutory definition of supervisor, and the court declined to follow them. Massachusetts cases she cited involved harassers with authority over, or clearly senior to, the victim. To the extent the Illinois Supreme Court's decision in Sangamon County Sheriff's Dept. v. Illinois Human Rights Com. (2009) 233 Ill.2d 125, 908 N.E.2d 39 treats direct supervisory authority as irrelevant under an analogous statute, the panel respectfully disagreed.
The holding has stated limits. The court assumed, without deciding, that Pagel supervised the associates, so it did not resolve whether giving input on reviews and directing support staff makes someone a FEHA supervisor. It emphasized that strict liability is not confined to a plaintiff's direct boss or those above that boss in the reporting chain, since the broad statutory definition can make others the plaintiff's supervisor as well. It also did not address liability for harassment by an employer's agent, a theory Doe did not raise.
Finally, the court held that Doe forfeited her remaining theories. She did not argue on appeal that a triable issue existed on negligence, and her contention that Wells Fargo ratified Pagel's conduct was raised for the first time in her opening appellate brief. The panel declined to exercise its discretion to reach it. As a result, the opinion does not review whether the bank's handling of the February 2020 complaint or the length of its investigation met the negligence standard.
- Waiver of Right to Avoid Arbitration in Sexual Harassment Claimson October 6, 2026 at 10:00 AM
A divided California Court of Appeal has held, in an opinion certified for publication, that an employee can waive the right to avoid arbitration under the federal Ending Forced Arbitration of Sexual Assault and Sexual Harassment Act of 2021 (EFAA), 9 U.S.C. §§ 401–402. The majority found waiver where the employee knew of a sex-based harassment claim, held it back for tactical reasons while opposing arbitration on other grounds, and raised it only after the trial court had sent the case to arbitration. One justice dissented.
In this case DoorDash hired Andrew Chin in 2020. He took nine weeks of parental bonding leave in early 2023 and alleges that the company then retaliated against him: it denied him the same or a comparable position on his return, interfered with three further weeks of leave, and terminated him at the end of 2023. He also alleged that a superior repeatedly asked when he would take the rest of his leave. In February 2024 he sued in Los Angeles County Superior Court for violation of the California Family Rights Act, whistleblower retaliation, wrongful termination and unfair competition. The complaint contained no harassment claim.
DoorDash moved to compel arbitration under an agreement covering any dispute arising from Chin's employment. Chin's written opposition argued only that no valid agreement existed. It did not mention sexual harassment, an amended complaint, or the EFAA. At the May 28, 2024 hearing, after a tentative ruling against him, his counsel said that if arbitration were ordered Chin would ask for leave to add a sexual harassment claim to avoid arbitration under federal law. The court ordered the whole action to arbitration, stayed the suit, and declined to allow an amendment at that time. Chin's writ petition was denied. In it he stated that he had left the harassment claim out of his complaint "for strategic purposes."
Chin filed an arbitration demand in August 2024 and amended it in December 2024 to add a sex-based harassment claim under the Fair Employment and Housing Act (FEHA). He alleged that DoorDash encouraged women to take full parental leave while discouraging men through intimidation, ridicule and insults. The only specific incident alleged was the superior's repeated questioning already described in the 2024 complaint. He then asked the arbitrator to return the matter to court under the EFAA, missed a ten-day window the arbitrator gave him to petition the superior court, and in April 2025 filed a second lawsuit pleading the harassment claim and seeking a declaration that the arbitration agreement was invalid as to both suits.
Three motions were heard in July 2025: Chin's motion to consolidate the two suits, his motion to invalidate the arbitration agreement under the EFAA, and DoorDash's motion to compel arbitration of the second suit. Judge Jon R. Takasugi said he was "not happy with the way this has gone" but believed the law required a ruling for Chin. He found that Chin had plausibly pleaded a sex-based harassment claim and had not waived the EFAA by asserting that claim in arbitration. He granted both of Chin's motions, denied DoorDash's, and so undid the earlier order compelling arbitration. The court did not address DoorDash's argument that Chin's conduct before that earlier order amounted to waiver. DoorDash appealed.
In the published case of Chin v. DoorDash, Inc., No. B348844 (October 2026), the Second Appellate District, Division Eight, reversed all three orders and remanded with instructions to grant DoorDash's motion to compel arbitration. Justice Scherb wrote the majority opinion, joined by Justice Viramontes. Acting Presiding Justice Wiley dissented and would have affirmed. DoorDash was awarded its costs on appeal.
The majority started from the statutory text. The EFAA does not void arbitration agreements automatically. It applies at the election of the person alleging harassment, and nothing in it displaces the ordinary rule that statutory rights can be waived. Chin did not argue otherwise. Reviewing an undisputed record de novo, the court assumed that waiver had to be shown by clear and convincing evidence.
Waiver is the intentional relinquishment of a known right, and the majority explained that it can be implied from deliberate, tactical litigation conduct as well as from express words. It relied on California authority that grounds for resisting arbitration must be raised in court before the arbitration goes forward, citing Moncharsh v. Heily & Blase (1992) 3 Cal.4th 1 and Cummings v. Future Nissan (2005) 128 Cal.App.4th 321. A party who knows of such a ground and keeps it in reserve loses it.
Applying those principles, the majority found waiver on four points. Chin knew of the harassment claim in 2024, since the one specific incident he later relied on was already in his first complaint. He withheld it by his own account for strategic reasons, and conceded at oral argument that the fair inference was a plan to defeat the agreement entirely before turning to the EFAA. He opposed arbitration vigorously without invoking the statute, and his reference to "federal law" at the hearing came too late and explained nothing. He then waited almost a year to file the second suit. The majority also noted the cost of sending the parties back and forth between court and arbitration.
The majority treated the Ninth Circuit's recent decision in Ding v. Structure Therapeutics, Inc. (9th Cir., Aug. 19, 2026, No. 25-1532) as supporting its result. Ding confirmed that EFAA rights may be waived under ordinary principles, but found no waiver where the plaintiff discovered her harassment claim during arbitration and invoked the statute as soon as she faced a motion to compel. The majority distinguished Quilala v. Securitas Security Services USA, Inc. (2025) 117 Cal.App.5th 75, where the complaint already pleaded harassment and the trial court raised the EFAA itself.
Chin's remaining arguments were rejected. He could not avoid waiver by pointing out that no harassment claim had been pleaded before arbitration began, because withholding the claim was the deliberate choice that produced the waiver. His contention that trial counsel believed an amendment was barred once the motion to compel was filed had no support in the record. The court also declined to read the EFAA as a right to move between forums at will. Because the EFAA applies to an entire case, the waiver reached both the claims Chin pleaded and the one he withheld. The majority did not decide whether his allegations stated a harassment claim sufficient to trigger the statute.
In dissent, Justice Wiley agreed that the delay and expense were regrettable and said he would be sympathetic to sanctions requiring plaintiff's counsel to reimburse the fees wasted. But he concluded that Chin never purposely gave up a court forum, since escaping arbitration was his aim throughout. In his words, "It looks more like a blunder," and a miscalculation is not a waiver.
- WCIRB Reports Combined Ratio Hits 127%, Highest in 20+ Yearson October 13, 2026 at 9:22 AM
California’s workers’ compensation insurers are on track for their worst underwriting year in more than two decades. The projected combined ratio for accident year 2025 now stands at 127%, meaning insurers are expected to pay out about $1.27 in losses and expenses for every premium dollar earned, according to the Workers’ Compensation Insurance Rating Bureau of California’s (WCIRB) Quarterly Experience Report, valued as of June 30, 2026, and released October 8, 2026.
The WCIRB says the 2025 figure is the second straight year above 120% (accident year 2024 came in at 125%) and the fifth consecutive year above 110%. The bureau notes that the last multi-year stretch with combined ratios above 100% came before the Senate Bill 863 reforms of 2012. By comparison, the ratio bottomed out at 78% in accident year 2016.
The report repeatedly points to cumulative trauma (CT) claims as a principal driver of the deterioration. Citing its June 2026 study, Emerging Patterns of Cumulative Trauma Claims, the WCIRB says CT claims grew from roughly 18% of indemnity claims in 2022 to more than 25%, with the increase concentrated in litigated claims, claims filed after termination, and claims showing little early medical treatment. Indemnity claim frequency rose 7.6% and 8.3% in the two accident-year periods following 2022, slowed to 0.7%, and then climbed another 3.6% in the first half of 2026. Excluding CT claims, the bureau describes recent frequency changes as more modest.
The projected loss and allocated loss adjustment expense (ALAE) ratio for accident year 2025 is 95%, essentially flat with 94% for 2024 but well above the 53% low recorded in 2016. The WCIRB attributes the climb mainly to higher average medical costs, higher ALAE, and rising claim frequency, particularly among CT claims.
Average ALAE per indemnity claim (excluding medical cost containment program costs) jumped 11% to $13,860 for accident year 2025, the fourth straight annual increase, based on data valued as of December 31, 2025. The bureau links the growth partly to CT claims, which are frequently litigated, and to a growing number of injured workers outside Los Angeles being represented by Los Angeles-based law firms.
Medical-legal costs are rising even faster. Indexed to 2014, average medical-legal costs per claim reached 170 in service year 2025, up from 121 in 2022, driven by both greater utilization and higher average payments per service, especially for medical record review. The WCIRB says CT claims use more medical-legal services, including psychological and psychiatric evaluations, and that the increases have been sharper in Southern California. Overall medical paid per claim rose 5% in the most recent service year, following a 10% gain the year before, with average paid per transaction up 4% and transactions per claim up 1%.
Other severity measures were flatter. Projected total loss and ALAE severity for 2025 is $81,460, nearly identical to 2024 and more than 30% above 2016. Indemnity severity slipped slightly to $30,611 but remains 29% above 2016, a rise the bureau ties largely to wage inflation. Medical severity per indemnity claim fell 3% to $34,560. The WCIRB cautions that these recent figures may understate eventual costs: CT claims tend to develop slowly, and roughly a quarter show no medical payments at 18 months.
Only 32% of open indemnity claims closed within the following year for the period ending June 30, 2026, down from a peak of 38% in 2019. The bureau says the decline since 2023 likely reflects more CT claims, heavier use of medical-legal services, and increased litigation, all of which can drag out the claims process.
On the revenue side, statewide written premium has held at roughly $15.7 billion to $15.9 billion annually since 2022. Premium written in the first half of 2026 totaled $8.6 billion, 5% ahead of the same period in 2025, which the WCIRB says points to growth for the full year. The industry average charged rate fell for more than a decade to a low of $1.63 per $100 of payroll in 2025; the preliminary estimate for the first half of 2026 is $1.64, suggesting the long decline may be ending. The report notes that the Insurance Commissioner approved average advisory pure premium rate increases of 8.7% effective September 1, 2025, and 6.6% effective September 1, 2026.
Finally, the WCIRB’s projected ultimate losses remain below what insurers have reported, but the gap has narrowed sharply, from about $16 billion in evaluation years 2017 and 2018 to roughly $2 billion for 2025. The bureau stresses that this comparison does not, by itself, indicate whether insurer reserves are adequate.
The WCIRB flags several limitations. The figures reflect insured employers only and may not represent the experience of self-insured employers. Results are statewide aggregates; individual insurers can differ significantly. Many figures are projections based on data as of June 30, 2026 (some exhibits use December 31, 2025, or June 7, 2026, data), and some rely on partial-period or preliminary data that may change as information matures. COVID-19 claims are included in some exhibits and excluded from others to preserve comparability with pre-pandemic years. - Healthcare AI Pays Off in Claims and Billing, Not Yet at the Bedsideon October 13, 2026 at 9:22 AM
Healthcare organizations say artificial intelligence is paying for itself fastest in the back office — billing, claims processing and other administrative work — while AI at the bedside is still struggling to earn clinicians’ trust, according to The 2026 Healthcare AI ROI Scorecard, published September 30, 2026, by venture capital firm Bessemer Venture Partners. The report is based on a survey, conducted with Bain & Company, of 226 executives at health insurers (payers), healthcare providers and pharmaceutical companies, covering 65 AI use cases. It follows Bessemer’s 2025 Healthcare AI Adoption Index, which surveyed more than 400 executives using a similar framework.
The headline finding is speed. Respondents had budgeted for AI investments to pay back in roughly 24 months, but report realizing returns in about 12, at an average of 3.5 times cost, with results beating expectations in roughly 40 percent of use cases. Fifty-four percent reported material return on investment inside the first year. Ranked by reported return, provider revenue cycle work led at 4.0 times cost, followed by payer claims and pharmaceutical preclinical discovery at 3.4 times, payer provider-network functions at 3.3 times, member engagement at 3.2 times, provider front-office work at 3.1 times, provider clinical uses at 2.9 times, pharmaceutical commercial uses at 2.6 times and clinical drug development at 2.3 times.
The gap between administrative and clinical AI shows up most clearly in how much work organizations have handed over to autonomous systems. Two-thirds of provider revenue cycle respondents now run semi- or fully autonomous AI agents, as do 62 percent of payers in member engagement, compared with just 4 percent in provider clinical work. The fastest-growing use cases were all administrative: payer contracting management rose from 19 percent to 37 percent adoption, provider credentialing and enrollment from 35 percent to 56 percent, provider contracting from 40 percent to 60 percent and prior authorization from 32 percent to 46 percent. Still, the share of use cases in full production barely moved over the year, and for payers it held flat at 6 percent.
The survey also points to workforce effects. Half of the organizations surveyed said they have already reduced headcount as a direct result of AI or plan to within six months, with cuts averaging 8 to 13 percent of the affected functions. Among payers reporting reductions, 71 percent named claims processing and 68 percent named member services; among providers, 73 percent named revenue cycle and medical billing. Bessemer estimates, as a rough calculation of its own, that this implies about $100 billion in labor-spend disruption across roughly $1 trillion in annual healthcare administrative spending. The authors also argue that healthcare is short of workers in many of these same functions, citing an American Medical Association estimate of a roughly 30 percent medical coder shortage, and suggest that nurses now staffing prior authorization and utilization review could be redeployed to care management rather than simply eliminated.
For the claims side of the business, the report highlights how much AI is being aimed at the same disputes from both directions. Providers ranked denial and appeals management as their top pain point (78 percent) and prior authorization second (61 percent), while payers placed appeals management in their top three (42 percent). Bessemer characterizes the result as “AI-to-AI combat” on mirrored workflows, and argues the larger savings would come from eliminating duplicative processes altogether through aligned incentives and faster payment — something it says AI alone cannot deliver. For scale, it points to a 2021 JAMA Viewpoint, Administrative Simplification and the Potential for Saving a Quarter-Trillion Dollars in Health Care, which estimated roughly $265 billion in potential annual administrative savings (Bessemer cites the figure as $260 billion).
Clinical AI faces steeper obstacles. Only 46 percent of respondents said they trust AI-generated tools to support clinical decision-making, and 77 percent said clinicians override AI suggestions more than half the time. Fifty-eight percent said the treating clinician bears primary accountability for AI-influenced decisions, half cited medico-legal exposure as the main barrier to scaling beyond proof of concept, and 36 percent of providers have delayed or canceled a clinical AI deployment over regulatory and compliance uncertainty. Payment is another hurdle: about 48 percent of payers said they are unwilling to reimburse fully autonomous AI care, versus about 5 percent who object to AI-assisted care in which a clinician reviews and confirms the output. Roughly 44 percent of payers expressed willingness to create payment pathways in narrower areas such as primary and preventive care, diagnostic support and medication management. Bessemer frames the stakes against workforce shortages, citing the Association of American Medical Colleges’ projection in The Complexities of Physician Supply and Demand: Projections From 2021 to 2036 of a shortfall of up to 86,000 physicians by 2036, including 20,200 to 40,400 in primary care.
Buyers are also changing how they purchase AI. Forty-two percent have completed or are running a vendor consolidation, 72 percent now have an AI governance committee, and respondents named regulatory and compliance uncertainty as the top reason deployments are delayed or canceled. More than half of next year’s incremental AI spending is earmarked for scaling proven use cases (35 percent) and integrating them into existing workflows (20 percent). Internal development has faded: 61 percent of organizations said half or fewer of their internally built AI tools are still maintained and in use.
For insurers, claims administrators and employers, the findings suggest that AI-driven automation of claims processing, prior authorization and utilization review is moving from pilots into routine operations, with real staffing consequences, while the unresolved questions around clinical AI — who is liable when a clinician follows or overrides an AI recommendation, and whether payers will pay for AI-delivered care — remain open. The survey covers group health payers, providers and pharmaceutical companies; it does not address workers’ compensation or property-casualty claims specifically.
Several caveats apply. The return figures are self-reported by respondents and reflect deployments that Bessemer says are roughly two years old; the firm presents them as a floor rather than a ceiling, but they have not been independently audited. The published article does not detail how respondents were selected or the survey’s margin of error. Bessemer is a venture investor in healthcare AI companies, and the report names portfolio companies, including Abridge and SmarterDx, among the market’s winners; the firm’s own disclaimer notes that companies discussed may be current or former portfolio companies. Characterizations of trends and opportunities in the report reflect Bessemer’s analysis and investment perspective rather than independent findings. - No Medi-Cal Clawback of Unused Managed Care Payments From Estateson October 12, 2026 at 12:18 PM
This is a published opinion of the California Court of Appeal, that concerns Medi-Cal estate recovery, the program families and elder law attorneys often call the Medi-Cal “clawback,” under which the state files a claim against a deceased member’s estate to recover what Medi-Cal paid for the member’s care. The case addresses one slice of that clawback: for members in managed care, the Department had been claiming the full monthly payments it sent to the health plan, even when the plan spent far less on the member’s actual care. The dispute that was litigated as a class action.
Medi-Cal clawback is an issue for workers' compensation and personal injury attorneys who settle large cases for clients who concurrently receive means tested social benefits such as Medi-Cal. One strategy is the use of a Special Needs Trust funded by an annuity purchased by the settlement proceeds. The following case adds to the legal precedent that may have some relevance to strategies to protect a litigant's estate from inappropriate clawbacks by social services consistent with law applicable to such cases.
Medi-Cal is California’s Medicaid program, administered by the Department of Health Care Services. When certain Medi-Cal members die, state law requires the Department to seek reimbursement from their estates. Welfare and Institutions Code § 14009.5 sets the recovery amount as the payments for the health care services the member received. Under managed care, however, the Department does not pay for each service. It pays the member’s health plan a fixed monthly “capitation” amount, whether or not the member uses any services.
Theodosia Phillip received Medi-Cal benefits while living in a nursing facility from 2010 until her death in 2015. The Department paid her managed care plan, CenCal Health, $261,957.40 in capitation over that period. The plan, in turn, paid about $106,672.71 for the services she actually received. After her death, the Department sought $407,774.41 from her estate: the full capitation amount, plus $5,852.30 in Medicare Part B premiums and $139,964.71 in interest.
The estate’s trustee disputed the claim, and the Department sued. Theodosia’s beneficiaries, Hardie and Jennifer Phillip, cross-complained on behalf of a certified class of Medi-Cal members’ estates from which the Department had sought to recover capitation in excess of the services received. The class included members who died both before and after January 1, 2017. They asserted quasi-contract and declaratory relief claims and petitioned for a writ of mandate.
The trial court ruled that recovering this “excess capitation” violated both state and federal law, and that its ruling applied retroactively. It entered judgment for the Department only for the capitation reflecting what the plan actually paid for Theodosia’s care, plus prejudgment interest. It also issued a declaratory judgment for the class and a writ of mandate directing the Department to reform its estate recovery practices, stop collecting excess capitation, and reprocess certain class members’ claims. The Department appealed.
In the published case of Phillip v. Baass, No. B341853 (October 2026) the Court of Appeal affirmed the judgment and awarded the Phillips their costs on appeal. Michelle Baass is named as the Department’s Director. The court held that the Department may recover only the portion of capitation that corresponds to services the member actually received.
The court began with the plain language of Welfare and Institutions Code § 14009.5, considering both its pre-2017 version and the version that applies to members who died on or after January 1, 2017. “Health care services” are defined by reference to specific enumerated benefits, and capitation is not among them. Applying the last antecedent rule, the court read the word “received” as modifying “services,” not “payments.” Recovery is therefore tied to services actually received, not to everything the Department paid out. The 2016 amendments, effective for deaths on or after January 1, 2017, narrowed recovery further, to services that federal law requires states to recover.
The court found support in Pottgieser v. Kizer (9th Cir. 1990) 906 F.2d 1319. There, the Ninth Circuit held that California could not collect from a decedent’s estate the Medicare Part B premiums the state had paid on her behalf, because the “medical assistance” subject to recovery covers the cost of services, not premiums. The court rejected the Department’s reliance on In re Estate of Ecklund (Minn. 2025) 20 N.W.3d 351, in which the Minnesota Supreme Court allowed recovery of capitation. In that case, Minnesota sought only the portion of capitation tied to long-term care services, not the whole payment, and the decision did not address California law.
Even if the statute were ambiguous, the court said, the legislative history does not mention excess capitation, and the amendments over time narrowed recovery rather than expanding it.
The court then invalidated the Department’s regulation. California Code of Regulations, title 22, § 50961 provides that the Department’s estate claim includes “payments to managed care plans.” Because that language enlarges the scope of the statute, the regulation is void under Government Code § 11342.2, which bars regulations that conflict with or expand the statutes they implement.
Federal law did not change the result. The federal estate recovery statute, 42 U.S.C. § 1396p(b), requires recovery only for specified categories, chiefly nursing facility services, home and community-based services, and related hospital and prescription drug services. Excess capitation is not among them, and federal law does not require states to recover it. The court gave no weight to the federal State Medicaid Manual, describing it as informal guidance without the force of law that cannot override the statute. The Department also could not rely on the Manual or its regulation to sidestep California’s Administrative Procedure Act.
Finally, the court rejected the Department’s policy arguments, including its warning of serious consequences if excess capitation could not be recovered. If the Legislature wanted that money recovered, the court said, it would have said so; the Department’s concerns belong with the Legislature, not the courts. - EEOC Seeks End to 2012 Criminal Records Employer Guidanceon October 12, 2026 at 12:18 PM
The U.S. Equal Employment Opportunity Commission (EEOC) has taken the first formal step toward withdrawing its 2012 guidance on how employers may use arrest and conviction records in hiring and other employment decisions. On October 6, 2026, the White House Office of Management and Budget’s Office of Information and Regulatory Affairs (OIRA) logged receipt of a draft final rule from the EEOC titled “Rescission of Enforcement Guidance on the Consideration of Arrest and Conviction Records in Employment Decisions Under Title VII of the Civil Rights Act,” according to Littler Mendelson, Ogletree Deakins in The National Law Review, and Bloomberg Law.
The text of the draft has not been released. Under the federal regulatory review process, OIRA publicly lists a rule’s title, agency, stage, and date of receipt when it begins review, but the document itself generally does not become public until the agency publishes it in the Federal Register. What is known comes from that listing and from practitioner commentary.
First, the action is a complete rescission. The title indicates the EEOC intends to withdraw the 2012 guidance, not revise it. Ogletree’s attorneys wrote that, based on past practice, it is very possible the agency will rescind the guidance without issuing any replacement.
Second, it is styled as a final rule, not a proposed rule. That means no public comment period is expected. Littler’s attorneys noted that if OIRA clears the draft, the EEOC is expected to publish it and repeal the guidance effective on publication, though the timing is unclear.
Third, nothing about the rescission changes the underlying statute. Title VII of the Civil Rights Act of 1964, and the case law interpreting it, remain in place. The guidance was the EEOC’s interpretation of that law, not law itself.
The 2012 Enforcement Guidance, adopted under the Obama administration, consolidated and updated EEOC policy statements dating to 1987 and 1990. It explained that an employer’s use of criminal history can violate Title VII in two ways. The first is disparate treatment: treating applicants differently because of race or national origin, for example by excusing a record for one applicant but not another. The second is disparate impact: applying a neutral screen that disproportionately excludes protected groups and is not justified by the job. The guidance relied on national data showing higher arrest and incarceration rates for Black and Hispanic individuals to support the view that criminal record screens can have a disparate impact.
To defend a screen against a disparate impact claim, an employer must show it is job related and consistent with business necessity. The guidance said the most common way to do that was a targeted screen considering the three “Green factors”: the nature and gravity of the offense, the time elapsed since the offense or completion of sentence, and the nature of the job. It encouraged employers to follow up with an individualized assessment giving the applicant a chance to explain. The guidance also took the position that an arrest alone does not show that criminal conduct occurred, and it discouraged blanket exclusions of anyone with a record. It recognized that federal laws requiring the exclusion of people with certain convictions are a defense to a Title VII claim.
The guidance drew criticism from the start. Texas sued in 2013, arguing it had the right to refuse to hire convicted felons for state jobs. On August 6, 2019, the Fifth Circuit ruled in Texas v. EEOC that the guidance was a substantive rule the EEOC lacked authority to issue. The court barred the EEOC and the Attorney General from treating it as binding against Texas. Business groups argued more broadly that the guidance discouraged legitimate safety screening and exposed employers to liability for following state no-hire laws.
Supporters of the guidance saw it as an important tool for people re-entering the workforce after involvement with the criminal justice system. They argued that blanket exclusions shut a large share of the population out of work and fall hardest on Black and Hispanic workers, and that individualized review lets employers manage real risks without screening out people whose records have nothing to do with the job.
The current effort to withdraw the guidance is part of a broader federal retreat from disparate impact enforcement. As described by Quarles & Brady, President Trump signed Executive Order 14281, “Restoring Equality of Opportunity and Meritocracy,” on April 23, 2025. It directed federal agencies to deprioritize enforcement of disparate impact liability, specifically naming Title VII. EEOC leadership reportedly directed staff to close nearly all pending charges based solely on disparate impact by September 30, 2025. On June 9, 2026, the Department of Justice issued a formal opinion concluding that the EEOC’s existing interpretations of disparate impact liability are unconstitutional and that selection tools such as background checks should be treated as presumptively job related. The EEOC, chaired by Andrea Lucas, voted on June 30, 2026, to rescind its affirmative action guidelines.
Critics of that shift have pushed back. An EEOC administrative judge told HR Dive that the presidential directive was illegal, and the publication noted that a federal judge dismissed a 2025 lawsuit challenging the EEOC’s nonenforcement of disparate impact claims.
Practitioners across the commentary agree on several points. Disparate impact liability remains part of Title VII. The Supreme Court recognized it in Griggs v. Duke Power Co. (1971), and Congress wrote it into the statute in the Civil Rights Act of 1991. The EEOC can decline to pursue such claims, but applicants can still file charges, obtain right-to-sue notices, and bring private lawsuits, including class actions.
The Green factors come from case law, not the guidance. Courts have applied the Eighth Circuit’s framework for decades, and the Third Circuit in El v. SEPTA (2007) required employers to show that a criminal record policy accurately separates applicants who pose an unacceptable risk from those who do not. Quarles & Brady expects courts to keep weighing offense severity, recency, and job relevance, while noting that employers will likely cite the Justice Department’s opinion and that some courts may find it persuasive.
Disparate treatment claims are unaffected. The EEOC is expected to continue investigating uneven application of background check policies across racial or national origin groups. Arrest-only exclusions and blanket bans remain the riskiest practices, because an arrest is not proof of misconduct and courts have long been skeptical of across-the-board exclusions.
The federal Fair Credit Reporting Act’s notice and adverse action requirements, and the growing body of state and local “ban the box” and fair chance laws, are not affected by the rescission. That is especially significant in California. The California Fair Chance Act generally bars employers with five or more employees from asking about conviction history before a conditional job offer. It also requires an individualized assessment, and specific written notices, before an offer is withdrawn based on a conviction. The California Civil Rights Department continues to enforce the law actively, as reflected in its June 2026 settlement with the City of Signal Hill over a rescinded job offer. Ogletree’s attorneys noted that several state agencies have signaled they are prepared to fill the gap left by federal disparate impact enforcement.
There is no set deadline for OIRA to finish its review. Once the rule is published, the 2012 guidance is expected to be withdrawn immediately. Employers that built their screening programs around the guidance are generally being advised not to dismantle them, because the same practices remain the best defense under Title VII case law and are required by many state and local laws. - From "Job Killers" to "Cost Drivers" - CalChamber's Legislative Reportson October 8, 2026 at 7:22 AM
The California Chamber of Commerce reported on October 7, 2026 that its 2026 Affordability Agenda produced strong results for business. Of 31 bills it labeled "Cost Drivers" this year, only one was signed into law. The year-end report is the second under a framework that has taken the place of the chamber's best-known advocacy tool, the annual "Job Killer" list, which CalChamber last published as a standalone list in 2024.
For more than 25 years, the Job Killer label was CalChamber's way of marking the legislation it considered most damaging to employment and economic growth in California. The list began in 1997 with 57 bills, according to a May 2024 Capitol Weekly analysis, which counted 844 bills tagged through 2023, of which 64 became law. CalChamber has described the record as more than 93 percent of tagged bills halted. The final list, for 2024, contained 18 bills. In its October 2024 wrap-up, CalChamber reported that only one of them reached the governor: SB 399, which restricts mandatory employer meetings on political and religious matters. It was signed.
The same Capitol Weekly analysis noted that the list had shrunk to its smallest size in more than two decades and questioned how much it still mattered. An unnamed longtime Capitol lobbyist told the publication the label counts mainly when a bill needs Republican votes, which is rarely the case under a Democratic supermajority. California Business Roundtable President Rob Lapsley, a former chamber political director, defended the list as a way to focus on bills with the broadest impact on employers. Then-Senator Steve Glazer, whose digital advertising tax bill carried the tag, said it made the chamber's advocacy "a lot less effective" on narrowly drafted measures.
The shift came in April 2025, when CalChamber announced its first Affordability Agenda. The new framework sorts legislation into two groups: Cost Drivers, which CalChamber says raise costs for businesses and consumers, and Cost Cutters, which it says lower them. The initial 2025 release identified 10 Cost Drivers and three Cost Cutters. CalChamber said the Job Killer list had served it well, but that a focus on jobs alone was no longer enough. President and CEO Jennifer Barrera said that "California businesses and consumers alike are focused on the affordability of everyday life," and pointed to the 2024 election as showing that affordability was a leading concern for voters.
The timing tracked a broader change in Sacramento. After Democrats lost legislative seats and voters rejected several progressive ballot measures in November 2024, Assembly Speaker Robert Rivas urged lawmakers to frame their bills around affordability, CalMatters reported in February 2025. A CalChamber executive vice president welcomed the focus in that report and called for bills that reduce costs and regulation for businesses and customers.
CalChamber has not formally announced the end of the Job Killer list. Its Job Killer page still links to lists from 2021 through 2024 alongside the current Affordability Agenda, and CalChamber describes the agenda as building on the Job Killer lists while also weighing regulatory burdens and incentives for economic growth. In practice, the Affordability Agenda has been its headline bill-tracking tool for the past two sessions. CalChamber said in March 2026 that all but one of its 2025 Cost Drivers failed to move forward.
The 2026 agenda launched in March with nine Cost Drivers and two Cost Cutters, and grew over the session to 31 Cost Drivers and six Cost Cutters. Barrera said at the launch that no bill should come up for a vote this year "without taking stock of its impact." The Cost Drivers ranged across air quality, antitrust, climate liability, energy, health care, privacy, taxation and employment. Bills restricting artificial intelligence and automated decision systems in the workplace made up the largest group of employment measures.
According to CalChamber's year-end report, only two Cost Drivers reached Governor Gavin Newsom. He signed AB 2646 by Assemblymember Maggy Krell, which sets an industry-specific minimum wage of 19.75 dollars an hour for H-2A agricultural workers and comparable domestic workers in the same county. CalChamber says the law will raise farm labor costs and, eventually, food prices. He vetoed AB 2575 by Assemblymember Liz Ortega, which would have imposed disclosure and liability rules on the use of AI in health care facilities. Two Cost Cutters also reached the governor. He signed AB 1693 by Assemblymember Rick Zbur, which streamlines permitting for retail tenant improvements by letting licensed architects or engineers certify code compliance and setting deadlines for local action. He vetoed AB 2124 by Assemblymember Blanca Pacheco, which would have required independent review of the effect of energy legislation on utility ratepayers, citing existing analytical resources and the lack of budget funding.
The headline tally does not capture every bill the chamber fought. During the session CalChamber removed the Cost Driver tag from several bills after amendments while continuing to oppose some of them and urging vetoes. Three of those were signed on September 30 as part of a package of workplace AI and surveillance laws, according to KQED and the governor's office. SB 947 by Senator Jerry McNerney bars employers from relying solely on an automated system to discipline or fire workers. SB 951 by Senator Eloise GÓmez Reyes requires notice when technology displaces workers in a layoff, relocation or termination. AB 1331 by Assemblymember Mark GonzÁlez Elhawary restricts certain workplace surveillance. California Federation of Labor Unions President Lorena Gonzalez praised the package as putting "guardrails on AI at work." KQED reported that CalChamber did not respond to a request for comment. Other Cost Drivers died before reaching the governor, including AB 2564 on litigation exposure for discount offers and AB 1018 on impact assessments for automated decision systems.
For the workers' compensation community, the 2026 list included one claims measure. CalChamber tagged SB 632 by Senator Jesse ArreguÍn, which would have created presumptions of industrial injury for hospital employees providing direct patient care, and the bill did not advance. The year's significant comp changes, including the Subsequent Injuries Benefits Trust Fund reforms in SB 171, came instead through the state budget process and were not part of the agenda.
The "Cost Driver" and "Cost Cutter" labels and the descriptions of each bill's effects are CalChamber's own advocacy positions. Supporters of the bills generally regard them as worker, consumer or public health protections, and the chamber's tallies count only bills that still carried its tags at the end of the session. Readers should consult CalChamber's Affordability Agenda bill list and the individual bills for complete details and final status. - Blue Cross Says AI Coding Added $942 Million to Hospital Billson October 8, 2026 at 7:22 AM
Workers' compensation carriers and self-insured employers pay hospital bills under fee schedules built on the same diagnosis codes that group health insurers use, so a dispute now playing out between the nation's largest insurer federation and the hospital industry deserves close attention from claims and bill review professionals. On September 24, 2026, the Blue Cross Blue Shield Association (BCBSA) released a claims analysis concluding that hospitals' growing use of artificial intelligence to document and code inpatient stays has made patients look sicker on paper without any matching change in the care they received. As Fierce Healthcare reported, the association put the price of that shift at an estimated $942 million in added costs to Blue plans over 2024 and 2025, measured against a 2023 baseline.
To follow the argument, it helps to understand how a hospital stay is priced. Most inpatient admissions are paid as a single lump sum determined by a diagnosis-related group, or DRG. Each DRG family typically comes in tiers. The same operation pays one amount for an uncomplicated patient, more if the record lists a "complication or comorbidity," and more still if it lists a "major" one. A single secondary diagnosis, such as anemia from blood loss, a low sodium level, or malnutrition, can move a stay up a tier and add thousands of dollars to the payment even though the surgery itself is unchanged.
That is where the new software comes in. AI revenue cycle tools scan physician notes, laboratory results and other chart entries for conditions that qualify as secondary diagnoses, and ambient "scribe" products listen to patient encounters and draft the clinical note. Hospitals say these tools capture conditions that busy clinicians always treated but did not always write down. Insurers say they are finding billable diagnoses that made no difference to the patient's care.
BCBSA's analysis, a short white paper covering claims from the first quarter of 2023 through the end of 2025, found that the share of inpatient cases billed to Blue plans as medically complex rose from 37 percent to 40 percent. About 70 percent of the increase came from more than 55,000 additional cases in which a secondary diagnosis pushed the claim into a higher-paying DRG. Those cases accounted for $653 million of the total, or roughly $11,000 per case. The paper used major bowel surgery as its example: claims in the highest severity tier climbed to 22.7 percent while uncomplicated cases fell from 36.6 percent to 32.8 percent.
The association's central evidence is what it calls a disconnect between coding and treatment. Hospitals in the top quarter for growth in complex coding showed similar or lower rates of intensive care use, transfusion, reoperation and length of stay than their peers. For acute blood loss anemia, which BCBSA describes as a common "bump" code, the hospitals that diagnosed it most often actually transfused those patients less often, 16.9 percent compared with 19.3 percent elsewhere. Luke Chalker, the association's senior vice president of product and data science, told reporters the data showed "no change in corresponding care for a more complex patient." The September paper follows a March 2026 BCBSA and Blue Health Intelligence study that attributed about one-fifth of a 9 percent rise in per-member inpatient costs to coding intensity.
Hospitals reject the conclusion. In an October 5 response, the American Hospital Association said patients today are older and more clinically complex and that AI tools help providers record their conditions accurately. "The question is whether the patient's medical record supports those diagnoses," two AHA policy executives wrote, noting that BCBSA reviewed claims rather than charts and did not identify which claims actually involved AI. The AHA made similar points in an August fact sheet, and in a statement to CNBC it criticized insurers for raising coding concerns while relying on their own automated downcoding and denial systems.
The study's limits are real, and BCBSA concedes the main one. It relied on claims data, not medical records, so it cannot show that any particular diagnosis was unsupported. The link to AI rests on timing and on survey figures showing that most hospital systems now use AI somewhere in the revenue cycle, not on claims traced to specific software. The white paper is not peer reviewed, it names no hospitals, and it arrived during a period of difficult contract negotiations between plans and hospital systems. Independent researchers had nonetheless raised the same concern before the insurers did. A January 2026 viewpoint in JAMA Health Forum warned that ambient scribes marketed for their ability to capture more and more severe diagnoses could drive spending upward, and an April report from the Peterson Health Technology Institute described a payer-provider AI "arms race" that raises billing intensity without fixing underlying inefficiency.
For workers' compensation payers the relevance is direct, even though the study examined commercial health claims and its examples were bowel surgery and, earlier, maternity care. California's Official Medical Fee Schedule prices inpatient hospital stays using Medicare's DRG system with a multiplier, as do the fee schedules of many other states. The DRG families that dominate comp inpatient spending, including spinal fusion, major joint replacement and fracture repair, are tiered by complications and comorbidities in the same way. Acute blood loss anemia, the code BCBSA singled out, is one of the diagnoses most frequently recorded after orthopedic surgery. A hospital that deploys AI coding software applies it to every payer's claims, not just those of Blue plans.
That raises several practical points. First, bill review programs that validate only the fee schedule calculation will not catch severity drift, because a correctly priced DRG can still rest on a secondary diagnosis the record does not support. Clinical validation, which compares the coded diagnoses against the treatment actually delivered, is the test BCBSA applied in aggregate and the one payers can apply claim by claim. Second, any objection must still be made within the deadlines and explanation-of-review requirements of Labor Code § 4603.2, and unresolved payment disputes proceed through second review and independent bill review. Third, the issue cuts both ways. Applicants' attorneys and providers will point out that more complete documentation of comorbidities is legitimate and may bear on apportionment, causation and future medical needs, while defense counsel may question whether a newly charted secondary condition was ever clinically significant.
Payers should also expect scrutiny of their own automation. According to an Orthopedics This Week commentary, Indiana now bars health plans from using an automated tool as the sole basis for downcoding a claim without reviewing the medical record, and lawmakers in California and several other states introduced downcoding bills this year. Those measures are aimed at health plans, but they signal where regulators are heading.
BCBSA says further analyses are coming, including outpatient care and additional DRGs, and orthopedic and spine procedures are obvious candidates. The broader cost pressure is not in dispute. CNBC reported that benefits consultant Marsh projects employer health costs per employee will rise 8.2 percent in 2027. Whether AI-assisted coding represents accurate documentation finally catching up with reality or technology-enabled upcoding is a question the claims data alone cannot answer. For comp payers, the prudent step is to find out whether their bill review vendor tracks DRG severity mix over time and tests secondary diagnoses against the treatment record. - Psychologist's License Probation for WC Fraud Conviction Upheldon October 7, 2026 at 12:14 PM
Morella Bombardini has been licensed as a psychologist in California since 2011. On November 4, 2018 she was convicted in Los Angeles County, on a plea of no contest, of a misdemeanor violation of Insurance Code § 1871.4, subdivision (a)(1), the workers' compensation fraud statute. She was ordered to perform community service and pay more than 11,000 dollars in restitution to her employer. The conviction was dismissed in 2019 under Penal Code § 1203.4.
The opinion gives only a limited account of the underlying offense. The claim arose from her work as a psychologist at Kaiser Permanente and involved carpal tunnel syndrome. The criminal complaint originally alleged three felony counts, and the court's minute order placed the incident on or about July 11, 2014. The Board found that she made a fraudulent workers' compensation claim in connection with that employment, but the opinion does not say which statement or representation was false. Bombardini testified that she left Kaiser because she was in severe pain and filed the claim to obtain physical therapy for her hands. She also referred to an accusation that she had lied in a deposition about carpal tunnel syndrome, and said she wanted to show that she did have the condition. The Board treated the conviction as a crime substantially related to the practice of psychology because it involved fiscal dishonesty.
The Board of Psychology brought a disciplinary accusation based on the conviction. It also alleged that she had obtained her license by fraud by failing to disclose a 1984 conviction for writing checks with insufficient funds, but that charge was dismissed because the Board had known of the 1984 conviction before it licensed her. After a hearing held remotely in 2020, at which Bombardini represented herself, the Board placed her license on probation for five years, effective April 23, 2021. The conditions included a practice monitor, an ethics examination, coursework, quarterly reports and reimbursement of investigation costs. She did not seek judicial review within the 30 days allowed by Government Code § 11523.
Bombardini moved to Maryland in 2021 and to Oregon in 2022, which tolled the probation, and returned to California in 2023. In July 2023 she petitioned the Board for early termination of probation. At the administrative hearing she maintained that she had never intended to commit fraud and that she had in fact suffered from carpal tunnel syndrome. The Board denied the petition in a decision effective May 23, 2024. It found she had not shown rehabilitation by clear and convincing evidence because she continued to deny her criminal conduct, claimed she was being unfairly punished, and described herself as a victim of circumstances.
Bombardini filed a petition for writ of administrative mandate under Code of Civil Procedure § 1094.5 in Sacramento County Superior Court, challenging both the 2021 probation order and the 2024 denial. Judge Jennifer K. Rockwell denied the petition in its entirety. The court ruled that the challenge to the 2021 decision was untimely and, applying the substantial evidence test, that the 2024 decision was supported by the evidence. Bombardini appealed.
In the partially published case of Bombardini v. Board of Psychology, No. C104172 (October 2026), the Third Appellate District affirmed the judgment denying the writ petition. The opinion is certified for publication except for parts II, III and IV of the Discussion, so only part I, on the standard of review, may be cited as precedent.
In the published portion, the court addressed which test a trial court applies when a licensee seeks review of a board's refusal to lift probation early. The answer depends on whether the decision affects what the cases call a "fundamental vested right." A person who already holds a professional license has such a right to continue practicing, so a decision revoking, suspending or restricting the license receives independent judgment review, in which the trial court reweighs the evidence. The court cited Hughes v. Board of Architectural Examiners (1998) 17 Cal.4th 763 for that principle.
Decisions on applications for a license are treated differently. There, courts have largely deferred to the agency's expertise and ask only whether substantial evidence in the whole record supports its findings, as explained in Bixby v. Pierno (1971) 4 Cal.3d 130. The same deferential review applies to a person seeking reinstatement of a revoked license, who has no greater rights than a first-time applicant under Flanzer v. Board of Dental Examiners (1990) 220 Cal.App.3d 1392.
The court placed a petition for early termination of probation in the second category. Bombardini was not defending her license against new discipline. She was asking the Board to remove restrictions that were already final, which the court considered closer to an application for an unrestricted license. Whether a probationer can safely return to unsupervised practice is, like initial qualification, a judgment that calls on the board's expertise. The trial court therefore applied the correct test.
On the merits, the court found substantial evidence for the Board's conclusion that rehabilitation had not been shown. The Board's disciplinary guidelines look both to the licensee's state of mind, meaning appreciation of the gravity of the misconduct and remorse, and to a course of conduct showing the public would be safe. Citing Seide v. Committee of Bar Examiners (1989) 49 Cal.3d 933, the court said that acknowledging wrongdoing is an essential step toward rehabilitation. Bombardini's statements that she never intended fraud, that she was being treated as a criminal, and that her attorneys had advised the no contest plea supported the Board's finding that she had not accepted responsibility. Compliance with probation terms carried little weight, because good conduct is expected of someone under supervision. Supporting letters were discounted because they predated the conviction or came from authors who did not appear to know the full facts. - SIBTF Overhaul Leads Short List of 2026 Legislative Changeson October 7, 2026 at 12:14 PM
California's 2026 legislative session produced two enacted workers' compensation measures that claims administrators, employers and practitioners will carry into 2027: a budget trailer bill that rewrites eligibility for the Subsequent Injuries Benefits Trust Fund (SIBTF) and makes the current reconsideration deadline permanent, and a short bill that keeps prepaid card indemnity payments available indefinitely. Several other closely watched proposals, including a permanent disability rate increase, did not reach the governor. The governor's deadline to act on bills passed this year was September 30.
This report was compiled from the chaptered bill digests, the governor's signing announcements and legislative tracking by the Commission on Health and Safety and Workers' Compensation (CHSWC). The California Workers' Compensation Institute has issued its own summary of the 2026 session as a Bulletin, which is available to CWCI members and subscribers through its Bulletins page.
The centerpiece is Senate Bill 171, a labor budget trailer bill approved by Governor Gavin Newsom on July 13, 2026 and chaptered as Chapter 83, Statutes of 2026. As a budget measure it took effect immediately. The Legislative Counsel's digest explains that case law had treated a prior condition as "labor disabling" if it could have supported an award had it been industrial, without requiring any showing of lost earnings. SB 171 replaces that approach with a statutory definition: the impairment must have caused a loss of earnings, interfered with the employee's work in their occupation, or otherwise had a demonstrable impact on the ability to work.
The bill also changes how the preexisting disability is proved. Its existence at the time of the later industrial injury must be shown by substantial evidence drawn from medical records, testimony and other evidence that already existed before that injury. In determining whether the subsequent injury meets the statutory threshold, the bill excludes any adjustment for future earning capacity or the corresponding adjustment factor. It sets a filing deadline for SIBTF claims of five years from the date of the subsequent injury or six months from the resolution of permanent disability in the underlying claim, whichever is later.
How the new rules apply to the existing backlog was the most contested question. The digest states that claims filed on or before July 1, 2020, and claims that had reached a specified procedural status on or before June 1, 2026, are exempt from the changes, and that those provisions become inoperative on July 1, 2031 and are repealed on January 1, 2032.
SB 171 makes administrative changes to the fund as well. The Director of Industrial Relations, as trustee of the SIBTF, replaces the State Compensation Insurance Fund as the entity that pays awards, and State Fund's authority to reimburse itself for related costs is deleted. A Senate Republican Caucus summary of the enacted budget reports 13 million dollars and 57 positions to work down backlogged SIBTF claims. That is in line with the 12.7 million dollars and 57 positions the administration requested in January, a request that CHSWC's June legislative update said would grow to 36.5 million dollars and 177 positions by fiscal year 2030-31.
The reforms respond to rapid growth in the program. A July 2025 report by the Legislative Analyst's Office found a backlog of more than 25,000 claims and estimated lifetime benefit costs of 2 billion to 3 billion dollars for each annual cohort of claims, costs that are funded through assessments on employers.
The second major workers' compensation provision in SB 171 concerns petitions for reconsideration under Labor Code § 5909. Since 2024, a petition has been deemed denied unless the Workers' Compensation Appeals Board acts within 60 days of the date the trial judge transmits the case to the Board. That rule was scheduled to expire on July 1, 2026, when the clock would again have started on the date the petition was filed. SB 171 removes the sunset, so the transmission-based deadline is now permanent.
Two further provisions affect payers directly. Workers' compensation surcharges and assessments must now be paid by electronic funds transfer, and the bill imposes a 10 percent penalty on late or unpaid amounts and on payments not made electronically, with the penalties deposited in the Workers' Compensation Administration Revolving Fund. The bill also removes the Administrative Director of the Division of Workers' Compensation from a statutory salary schedule.
The other enacted measure is Assembly Bill 1683, an Assembly Insurance Committee bill that the governor signed on July 6, 2026. Existing law allowed employers to deposit disability indemnity payments into prepaid card accounts only until January 1, 2027. AB 1683 extends that authorization indefinitely. CHSWC noted that the bill tracks the recommendation in its own report on prepaid card programs, approved in February. Because the bill is not an urgency measure, it takes effect January 1, 2027, the same day the prior authorization would have lapsed.
Several bills that drew attention during the session were not enacted. Senate Bill 555 would have raised the weekly earnings range used to compute permanent partial disability indemnity from the current 240 to 435 dollars to a range of 363 to 658 dollars for injuries on or after January 1, 2027. Its first Assembly committee hearing, set for June 24, was canceled at the author's request and the bill did not advance. Assembly Bill 1576, a separate SIBTF reform vehicle, and Assembly Bill 1048, which would have required explanations of review to identify the contract behind a discounted payment and required physicians to sign requests for authorization, were both held in committee on August 13. CHSWC's update lists two more as having missed legislative deadlines: Assembly Bill 2098, on leave for medical treatment during work hours, and Senate Bill 632, which would have created injury presumptions for hospital employees providing direct patient care.
The permanent disability question is likely to return. Business Insurance reported in July that the chief lobbyist for the California Coalition on Workers' Compensation told the group's conference that employers are preparing for negotiations in 2027 over permanent disability benefits, and will seek offsetting savings in areas such as cumulative trauma claims and medical-legal costs. - Court Sets Rules for Use of Strict Liability in FEHA Caseson October 6, 2026 at 10:00 AM
A California Court of Appeal has held, in an opinion certified for publication, that an employer is not strictly liable under the Fair Employment and Housing Act (FEHA) for sexual harassment by an employee who supervises other workers but has no supervisory authority over the plaintiff. In that situation the employer answers only under the negligence standard. The court described the question as one no California appellate case had directly decided.
The plaintiff in this case, Jane Doe, returned to Wells Fargo in 2018 as a wealth advisor in its private bank division, where advisors assemble teams of specialists to serve high-net-worth clients. Eric Pagel was an investment strategist who handled portfolios for many of her clients and was one of the bank's top producers nationally. He was not her supervisor. Wells Fargo had not designated him a supervisor of anyone, and he could not hire, fire, or approve expenses or time off, although he gave input on the performance of the support associates who executed his trades and handled his scheduling.
In January 2020, Doe, Pagel and several coworkers traveled to Bakersfield for client meetings and had dinner and drinks afterward. Doe says she blacked out that night, that Pagel later came to her hotel room, and that she was too intoxicated to consent to the sex that followed. Pagel maintains that she invited him and consented. About a month later Doe told a colleague who had been on the trip that Pagel had been harassing her, without mentioning an assault. That complaint was not escalated or investigated.
On November 9, 2020, Doe reported harassment and assault to the bank's ethics hotline, to her direct supervisor and to law enforcement. Wells Fargo flagged the complaint for expedited investigation eight days later and placed Pagel on paid administrative leave. After a ten-month inquiry, the internal investigator issued a 28-page report finding the harassment and assault allegations unsubstantiated, but concluding that everyone at the dinner had violated the workplace conduct policy and that Pagel had violated the professionalism policy. Pagel received a final notice warning that further violations could lead to immediate termination.
Doe sued Wells Fargo, Pagel and three other employees in Los Angeles County Superior Court in February 2023, alleging sexual harassment under FEHA and, against the bank, failure to prevent harassment and retaliation. Wells Fargo moved for summary judgment, arguing that it could not be strictly liable because Pagel never supervised Doe, and that it could not be liable in negligence because it responded promptly and appropriately once she complained. Doe's opposition argued that strict liability attaches to harassment by any supervisor, whoever that person supervises, and did not address the negligence standard. Judge Tony L. Richardson granted the motion on both grounds and entered judgment for the bank.
In the published case of Doe v. Wells Fargo Bank, N.A., No. B344642 (October 2026), the Second Appellate District, Division Four, affirmed the judgment on Doe's appeal. Justice Tamzarian, as acting presiding justice, wrote for a unanimous panel. Only the harassment claim against Wells Fargo was before the court, because Doe's briefs did not address her other causes of action.
The court began with the statute. Government Code § 12940, subdivision (j)(1) expressly sets a negligence standard for harassment by an employee other than an agent or supervisor, and the California Supreme Court inferred from that wording, in State Dept. of Health Services v. Superior Court (2003) 31 Cal.4th 1026, that employers are strictly liable when a supervisor is the harasser. The statute never uses the words strict liability, and the panel found that its text does not plainly answer whether "supervisor" means any supervisor or the plaintiff's supervisor. Because the definition in Government Code § 12926, subdivision (t) turns on a person's authority over other employees, the court reasoned that someone with no authority over the plaintiff is, as to her, simply a coworker.
With no helpful legislative history, the court looked to the purpose of the rule. Strict liability exists because a supervisor wields employer-conferred power over the victim, which makes harassment harder to resist and report and justifies imputing the conduct to the employer. None of that is present when the harasser's authority runs only to other people. The panel also found that Doe's reading would produce arbitrary results: an employer would be strictly liable when a shop foreman harasses an executive, or when a mid-level manager harasses her own boss, but liable only in negligence when a senior non-supervisory employee harasses a junior one.
The court read Health Services as consistent with this view. That opinion spoke of "the victim's supervisor" and cautioned that the supervisor must be acting in a supervisory capacity when the harassment occurs. Later Court of Appeal decisions said the same, including Chapman v. Enos (2004) 116 Cal.App.4th 920, Atalla v. Rite Aid Corp. (2023) 89 Cal.App.5th 294, and Kruitbosch v. Bakersfield Recovery Services, Inc. (2025) 114 Cal.App.5th 200. A person who does not supervise the plaintiff at all, the panel concluded, cannot be acting as her supervisor.
Doe's contrary authorities did not persuade the court. Two Fair Employment and Housing Commission decisions from the 1980s (Dept. of Fair Employment and Housing v. Hart & Starkey, Inc., FEHC Dec. No. 84-23, and Dept. of Fair Employment and Housing v. Community Hospital of San Gabriel, FEHC Dec. No. 86-08) predated both Health Services and the statutory definition of supervisor, and the court declined to follow them. Massachusetts cases she cited involved harassers with authority over, or clearly senior to, the victim. To the extent the Illinois Supreme Court's decision in Sangamon County Sheriff's Dept. v. Illinois Human Rights Com. (2009) 233 Ill.2d 125, 908 N.E.2d 39 treats direct supervisory authority as irrelevant under an analogous statute, the panel respectfully disagreed.
The holding has stated limits. The court assumed, without deciding, that Pagel supervised the associates, so it did not resolve whether giving input on reviews and directing support staff makes someone a FEHA supervisor. It emphasized that strict liability is not confined to a plaintiff's direct boss or those above that boss in the reporting chain, since the broad statutory definition can make others the plaintiff's supervisor as well. It also did not address liability for harassment by an employer's agent, a theory Doe did not raise.
Finally, the court held that Doe forfeited her remaining theories. She did not argue on appeal that a triable issue existed on negligence, and her contention that Wells Fargo ratified Pagel's conduct was raised for the first time in her opening appellate brief. The panel declined to exercise its discretion to reach it. As a result, the opinion does not review whether the bank's handling of the February 2020 complaint or the length of its investigation met the negligence standard. - Waiver of Right to Avoid Arbitration in Sexual Harassment Claimson October 6, 2026 at 10:00 AM
A divided California Court of Appeal has held, in an opinion certified for publication, that an employee can waive the right to avoid arbitration under the federal Ending Forced Arbitration of Sexual Assault and Sexual Harassment Act of 2021 (EFAA), 9 U.S.C. §§ 401–402. The majority found waiver where the employee knew of a sex-based harassment claim, held it back for tactical reasons while opposing arbitration on other grounds, and raised it only after the trial court had sent the case to arbitration. One justice dissented.
In this case DoorDash hired Andrew Chin in 2020. He took nine weeks of parental bonding leave in early 2023 and alleges that the company then retaliated against him: it denied him the same or a comparable position on his return, interfered with three further weeks of leave, and terminated him at the end of 2023. He also alleged that a superior repeatedly asked when he would take the rest of his leave. In February 2024 he sued in Los Angeles County Superior Court for violation of the California Family Rights Act, whistleblower retaliation, wrongful termination and unfair competition. The complaint contained no harassment claim.
DoorDash moved to compel arbitration under an agreement covering any dispute arising from Chin's employment. Chin's written opposition argued only that no valid agreement existed. It did not mention sexual harassment, an amended complaint, or the EFAA. At the May 28, 2024 hearing, after a tentative ruling against him, his counsel said that if arbitration were ordered Chin would ask for leave to add a sexual harassment claim to avoid arbitration under federal law. The court ordered the whole action to arbitration, stayed the suit, and declined to allow an amendment at that time. Chin's writ petition was denied. In it he stated that he had left the harassment claim out of his complaint "for strategic purposes."
Chin filed an arbitration demand in August 2024 and amended it in December 2024 to add a sex-based harassment claim under the Fair Employment and Housing Act (FEHA). He alleged that DoorDash encouraged women to take full parental leave while discouraging men through intimidation, ridicule and insults. The only specific incident alleged was the superior's repeated questioning already described in the 2024 complaint. He then asked the arbitrator to return the matter to court under the EFAA, missed a ten-day window the arbitrator gave him to petition the superior court, and in April 2025 filed a second lawsuit pleading the harassment claim and seeking a declaration that the arbitration agreement was invalid as to both suits.
Three motions were heard in July 2025: Chin's motion to consolidate the two suits, his motion to invalidate the arbitration agreement under the EFAA, and DoorDash's motion to compel arbitration of the second suit. Judge Jon R. Takasugi said he was "not happy with the way this has gone" but believed the law required a ruling for Chin. He found that Chin had plausibly pleaded a sex-based harassment claim and had not waived the EFAA by asserting that claim in arbitration. He granted both of Chin's motions, denied DoorDash's, and so undid the earlier order compelling arbitration. The court did not address DoorDash's argument that Chin's conduct before that earlier order amounted to waiver. DoorDash appealed.
In the published case of Chin v. DoorDash, Inc., No. B348844 (October 2026), the Second Appellate District, Division Eight, reversed all three orders and remanded with instructions to grant DoorDash's motion to compel arbitration. Justice Scherb wrote the majority opinion, joined by Justice Viramontes. Acting Presiding Justice Wiley dissented and would have affirmed. DoorDash was awarded its costs on appeal.
The majority started from the statutory text. The EFAA does not void arbitration agreements automatically. It applies at the election of the person alleging harassment, and nothing in it displaces the ordinary rule that statutory rights can be waived. Chin did not argue otherwise. Reviewing an undisputed record de novo, the court assumed that waiver had to be shown by clear and convincing evidence.
Waiver is the intentional relinquishment of a known right, and the majority explained that it can be implied from deliberate, tactical litigation conduct as well as from express words. It relied on California authority that grounds for resisting arbitration must be raised in court before the arbitration goes forward, citing Moncharsh v. Heily & Blase (1992) 3 Cal.4th 1 and Cummings v. Future Nissan (2005) 128 Cal.App.4th 321. A party who knows of such a ground and keeps it in reserve loses it.
Applying those principles, the majority found waiver on four points. Chin knew of the harassment claim in 2024, since the one specific incident he later relied on was already in his first complaint. He withheld it by his own account for strategic reasons, and conceded at oral argument that the fair inference was a plan to defeat the agreement entirely before turning to the EFAA. He opposed arbitration vigorously without invoking the statute, and his reference to "federal law" at the hearing came too late and explained nothing. He then waited almost a year to file the second suit. The majority also noted the cost of sending the parties back and forth between court and arbitration.
The majority treated the Ninth Circuit's recent decision in Ding v. Structure Therapeutics, Inc. (9th Cir., Aug. 19, 2026, No. 25-1532) as supporting its result. Ding confirmed that EFAA rights may be waived under ordinary principles, but found no waiver where the plaintiff discovered her harassment claim during arbitration and invoked the statute as soon as she faced a motion to compel. The majority distinguished Quilala v. Securitas Security Services USA, Inc. (2025) 117 Cal.App.5th 75, where the complaint already pleaded harassment and the trial court raised the EFAA itself.
Chin's remaining arguments were rejected. He could not avoid waiver by pointing out that no harassment claim had been pleaded before arbitration began, because withholding the claim was the deliberate choice that produced the waiver. His contention that trial counsel believed an amendment was barred once the motion to compel was filed had no support in the record. The court also declined to read the EFAA as a right to move between forums at will. Because the EFAA applies to an entire case, the waiver reached both the claims Chin pleaded and the one he withheld. The majority did not decide whether his allegations stated a harassment claim sufficient to trigger the statute.
In dissent, Justice Wiley agreed that the delay and expense were regrettable and said he would be sympathetic to sanctions requiring plaintiff's counsel to reimburse the fees wasted. But he concluded that Chin never purposely gave up a court forum, since escaping arbitration was his aim throughout. In his words, "It looks more like a blunder," and a miscalculation is not a waiver.