- Former NFL Player Convicted for $197M Medicare Fraudon February 12, 2026 at 10:09 AM
A federal jury convicted Joel Rufus French, 47, of Amory, Mississippi, the owner of a marketing company, and former NFL player, for his role in a yearslong scheme to bilk Medicare and the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) out of nearly $200 million by selling patient information and sham doctors’ orders for orthotic braces that patients did not want or need.
French had a brief and limited NFL career after a standout college tenure at Ole Miss.He signed as an undrafted free agent with the Seattle Seahawks in 1999. A knee injury sidelined him for the entire 2000 season, leading to his release from the team. He later signed with the Green Bay Packers in 2002 but never appeared in a regular-season game (likely on the practice squad or released without playing).
According to court documents and evidence presented at trial, French worked with overseas call centers that pressured elderly Americans to provide their personal and health insurance information and agree to accept medically unnecessary orthotic braces. Some of the individuals who agreed to the braces suffered from Alzheimer’s and dementia. In certain instances, the call centers altered call recordings to make it seem like Medicare patients agreed to the braces when they did not.
French paid sham telemedicine companies to obtain signed orders from doctors and nurse practitioners who never examined, and often never even spoke to, the patients. He sold the orders to marketers and medical supply companies, which then submitted claims to Medicare. French also defrauded Medicare and CHAMPVA, the health care program for spouses and children of veterans who have or had a permanent and total service-connected disability or who died from a service-connected condition, by billing the programs for orthotic braces through eight durable medical equipment supply companies that he owned and managed, using false documents to hide his connection to the companies from Medicare.
The evidence at trial showed that French and his co-conspirators caused Medicare to be billed for braces for amputees for limbs they did not have and for deceased beneficiaries. Also during the conspiracy, French withdrew approximately $225,000 in cash from a bank in Mississippi, over $10,000 of which was placed in a bag and driven to Orlando to pay accomplices who sold him beneficiaries’ personal and insurance information.
The jury convicted French of conspiracy to commit health care fraud and wire fraud, conspiracy to commit money laundering, and conspiracy to offer, pay, solicit, and receive kickbacks. French faces a maximum penalty of 20 years in prison for conspiracy to commit health care fraud and wire fraud, 10 years in prison for conspiracy to commit money laundering, and five years in prison for conspiracy to defraud the United States. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors. A sentencing date has not been set.
“This scheme built on sham operations exploited seniors and corrupted the federal health care system. By falsifying doctors’ orders and selling patient information, the defendant sought to turn Medicare into their own personal ATM machine,” said Acting Deputy Inspector General for Investigations Scott J. Lampert of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG). “HHS-OIG will stop and catch anyone who exploits vulnerable patients to bilk federal healthcare programs and hold them accountable to the full extent of the law.”
This case was similar to Operation Brace Yourself, a major 2019 Department of Justice (DOJ) enforcement action (also called the "Telemedicine and Durable Medical Equipment Takedown") that charged dozens of individuals across multiple states for schemes involving kickbacks, bribes, sham telemedicine consultations, and fraudulent billing to Medicare for medically unnecessary braces (like back, knee, shoulder, and wrist braces). It resulted in charges related to over $1.7 billion in false claims, with significant cost avoidance for Medicare in the following years.
HHS-OIG, FBI, and VA-OIG investigated the case. Acting Assistant Chief Catherine Wagner and Trial Attorney William Hochul III of the Justice Department’s Fraud Section are prosecuting the case.
- The Workplace Overdose Reversal Kits (WORK) to Save Lives Acton February 12, 2026 at 10:08 AM
The Workplace Overdose Reversal Kits (WORK) to Save Lives Act is a bipartisan, bicameral piece of U.S. legislation aimed at addressing opioid overdoses in workplace settings by improving access to overdose reversal medications like naloxone (commonly known as Narcan). It was most recently reintroduced on February 10, 2026.
The bill directs the Secretary of Labor, through the Occupational Safety and Health Administration (OSHA), to issue non-mandatory guidance for private-sector employers on acquiring and maintaining opioid overdose reversal medications (such as naloxone kits). And offering voluntary annual training to employees on how to use such medications.
The goal is to integrate overdose response into workplace emergency preparedness plans, similar to how workplaces prepare for fires, cardiac events, or other emergencies. It emphasizes that overdose incidents can happen anywhere, including on the job, and quick access to naloxone can be lifesaving while waiting for emergency services.
Organizations like the National Safety Council (NSC) have publicly applauded the bill, noting rising workplace overdose deaths and the need for such tools. Other supporters, including overdose prevention advocates, highlight it as a practical, non-burdensome way to equip workplaces without imposing heavy new mandates on private employers (guidance is voluntary for them).
The bill was first introduced in the 118th Congress (2023-2024). Even strong bipartisan bills like this one often fail to become law due to systemic factors in Congress, rather than outright opposition such as:
- - Low Priority in a Crowded Agenda — Congress handles thousands of bills each session. Broader opioid crisis legislation (e.g., major funding packages, enforcement bills, or comprehensive reforms) often takes precedence over narrower, targeted measures like workplace-specific guidance. This bill is relatively modest (mostly non-mandatory guidance for private employers, with requirements only for federal agencies), so it doesn't generate the same urgency or media attention as bigger spending or regulatory fights.
- - Committee Bottlenecks — Labor and workplace safety bills go through committees like Education and the Workforce (House) or HELP (Senate), which have heavy workloads. Without strong leadership push, a dedicated champion on the committee, or external pressure (e.g., a major incident spotlighting the issue), bills can sit without hearings. Reports note that the 2023 versions "neither advanced out of committee," which is a classic sign of this.
- - No Major Opposition, But Also No Strong Momentum — There's little evidence of active resistance (e.g., from business groups or conservatives worried about mandates. But it hasn't built a groundswell of lobbying or public pressure to force movement. Bipartisanship helps avoid filibusters or veto threats, but it doesn't guarantee floor time.
- - Congressional Dysfunction and Timing — The 118th Congress saw gridlock on many issues due to divided government, narrow majorities, debt ceiling fights, and other priorities. Bills introduced late in a session (like this one in fall 2023) often expire without action. Reintroductions in new Congresses reset the clock, which is why it's back now.
In short, bipartisanship is a plus - it reduces partisan roadblocks - but it's not sufficient on its own. Many well-intentioned, low-controversy bills languish for years (or forever) unless they get attached to must-pass legislation, gain a powerful sponsor's priority, or ride a wave of public attention (e.g., a high-profile workplace overdose event). This one fits that pattern: sensible, supported, but not yet prioritized enough to move. Its recent reintroduction means there's still a window in the current session, especially with ongoing opioid crisis awareness.
- OSHA Clarifies Recording Workplace Injuries Related to Lithium-Ion Batterieson February 11, 2026 at 3:48 PM
The U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) has issued a letter of interpretation clarifying whether injuries resulting from the use of personal rechargeable lithium-ion batteries in the workplace should be recorded as work-related on the OSHA Forms 300, 301, and 300-A or equivalent forms.
The letter addressed a scenario in which employees bring rechargeable lithium-ion batteries from home to the workplace for use in e-cigarettes, and that are not used in any equipment or device related to employee work duties. In this scenario, the battery terminals are unprotected and the employee or employees improperly carry these batteries in their pants pocket, a fire is sparked by the batteries, and that the fire results in employee injury.
If a work-related injury caused by a lithium-ion battery meets one or more of the general recording criteria in Section 1904.7 of the Recording and Reporting Occupational Injuries and Illnesses standard, it must be recorded on the OSHA logs.
OSHA's Response: "No, section 1904.5(b)(3) of OSHA's recordkeeping regulation does not apply in this scenario, assuming that the employee was at your workplace during assigned work hours and present as a condition of employment."
However the Notice of Interpretation letter addresses recordkeeping requirements and highlights the growing need for awareness of safety risks associated with lithium-ion batteries in workplace environments. These batteries can pose safety and health risks to workers during manufacturing, usage, emergency response, disposal, and recycling. Potential risks include fires, explosions, and exposure to harmful chemicals.
Safety measures employers can take include implementing hazard controls during battery design and production; ensuring proper ventilation; storing batteries in cool, dry locations; monitoring storage areas for flammable and toxic gases; using designated recycling facilities for disposal; and providing safety showers and eyewash stations when handling battery materials.
A Letter of Interpretation is OSHA's official response to questions about how its requirements apply to specific workplace situations or hazards. They cannot create additional employer obligations. Each letter constitutes OSHA's interpretation of the requirements discussed. These letters can help stakeholders understand how to comply with Federal OSHA standards, regulations, and section 5(a)(1) of the Occupational Safety and Health Act in specific workplace situations.
In June, the Department of Labor launched its opinion letter program, which expands the department's longstanding commitment to providing meaningful compliance assistance that helps workers, employers, and other stakeholders understand how federal labor laws apply in specific workplace situations.
The public is encouraged to use the division's new opinion letters page to explore past guidance and submit new requests. The division will exercise discretion in determining whether and how it will respond to each request, which will focus primarily on attempting to address issues of broad-based concern.
Learn more about OSHA and safety practices related to lithium-ion batteries.
Note however that California is regulated by Cal/OSHA, which operates under an OSHA-approved state plan (approved in 1973). This means Cal/OSHA has primary authority to enforce occupational safety and health standards for both private-sector and public-sector (state and local government) workplaces in the state.
Under the federal Occupational Safety and Health Act of 1970 (OSH Act), state plans like California's must be "at least as effective" as federal OSHA standards. Federal OSHA standards serve as a floor (minimum baseline): Cal/OSHA must cover all the same issues addressed by federal standards and cannot be less protective.
Cal/OSHA can (and often does) adopt more stringent or additional standards. California frequently issues rules that exceed federal requirements (e.g., stricter permissible exposure limits for chemicals, more comprehensive heat illness prevention, workplace violence prevention measures, or shorter injury reporting deadlines). In these cases, the more protective Cal/OSHA rule prevails for California employers.
Employers in California must comply with a stricter Cal/OSHA provision if there is one. Federal OSHA does not preempt or override a state plan's more stringent rules once the plan is approved.
- ACOEM Studies Office Space/Room Design for Excessive Sittingon February 11, 2026 at 3:48 PM
The phrase "sitting is the new smoking" is a popular health slogan that highlights the serious health risks of prolonged sedentary behavior (especially sitting for extended periods), comparing them to the well-established dangers of smoking cigarettes. It emphasizes how modern lifestyles - desk jobs, screen time, commuting - lead to excessive sitting, which is linked to increased risks of obesity, type 2 diabetes, cardiovascular disease, certain cancers, metabolic issues, and even premature death, independent of regular exercise.
The phrase is widely attributed to Dr. James A. Levine, an endocrinologist and professor of medicine formerly at the Mayo Clinic (now associated with initiatives like the Mayo Clinic-Arizona State University Obesity Solutions). He is credited with coining or popularizing it in the early 2010s as part of his research on non-exercise activity thermogenesis (NEAT) and the metabolic impacts of sedentary time.
A key early mention appeared in a 2014 Los Angeles Times article titled "'Get Up!' or lose hours of your life every day, scientist says," where Levine is quoted saying things like: “Sitting is more dangerous than smoking, kills more people than HIV and is more treacherous than parachuting. We are sitting ourselves to death.” This tied into his book Get Up!: Why Your Chair Is Killing You and What You Can Do About It (published around that time).
And perhaps concerns about the health hazards of excessive sitting influenced researchers to conduct a new study, published ahead of print in the Journal of Occupational and Environmental Medicine. Researchers decided to explore how workplace design influences office workers' sitting behaviors, which are linked to health risks like cardiovascular disease and reduced productivity. The research draws on affordance theory and ecological models, emphasizing that environments can "invite" sitting or standing.
Cluster analysis identified 7 office types. Workers stood longer in large shared offices with trash cans out of reach and few decorations. They stood shorter in small shared offices with screens/boards,but this was explained by lower worktime control in those offices.
Individual features were studied. Longer standing took place in offices with two workstations compared to one, or additional chairs. Shorter sitting (quicker stand-ups) with trash cans or waste paper bins within arm's reach, and small under-desk cabinets.
The study concluded that workplace design is associated with sitting patterns to some extent, but primarily indirectly - through the work tasks, goals, and collegial interactions it affords (e.g., focused desk work in offices promotes sitting; interactions in shared spaces encourage standing). Key principles: (1) Office designs as wholes may impact sitting differently than isolated features (per Gestalt theory); (2) Design influences sitting via enabled behaviors, not just physical cues.
To reduce prolonged sitting (~70-80% of work time), designs should promote task variety and interactions (e.g., shared offices, out-of-reach bins to encourage movement). However, work characteristics like time control may be more influential than design alone. This supports holistic interventions combining environmental changes with behavioral strategies.
- 8 Carriers Targeted for Advance Premium Tax Credit Fraud Probeon February 10, 2026 at 1:40 PM
The U.S. Government Accountability Office (GAO) released a report in December 2025 highlighting significant vulnerabilities and instances of fraud in the Advance Premium Tax Credit (APTC) Program, which provides subsidies to reduce health insurance premiums under the Affordable Care Act (ACA, or Obamacare). Key findings on the scale of improper payments and fraud include:
- - Overall Program Scale and Unreconciled Payments: The Centers for Medicare & Medicaid Services (CMS) estimated $124 billion in APTC payments for 19.5 million enrollees in plan year 2024. A preliminary analysis identified over $21 billion in unreconciled APTC (representing 32% of APTC for enrollees who provided Social Security Numbers in plan year 2023), which could indicate overpayments or fraud but is not yet fully verified.
- - Payments to Deceased Individuals: CMS disbursed over $94 million in APTC for households where Social Security Numbers matched Social Security Administration death data in plan year 2023. Over 58,000 such SSNs (0.42% of those receiving APTC) were flagged, with CMS failing to conduct periodic reviews for all enrollees.
- - Identity Theft and SSN Misuse: More than 29,000 SSNs (0.21%) in plan year 2023 and nearly 66,000 (0.37%) in plan year 2024 had over 365 days of coverage, suggesting potential identity theft or errors. GAO's covert testing revealed weak controls, with all four fictitious applications in 2024 and 18 of 20 in 2025 receiving subsidized coverage despite invalid SSNs, fictitious documentation, and unverified income or citizenship. This resulted in about $2,350 in monthly APTC for late-2024 tests and over $10,000 monthly for active 2025 fictitious enrollees.
- - Unauthorized Enrollment Changes: At least 30,000 applications (0.4%) in plan year 2023 and 160,000 (1.5%) in plan year 2024 showed signs of unauthorized changes by agents or brokers, such as multiple brokers editing the same application on the same day. CMS received 275,000 complaints about unauthorized enrollments or plan switches from January to August 2024, with some leading to indictments for falsified applications.
The report notes that fraud is exacerbated by incentives for brokers (paid per enrollment) to enroll ineligible individuals, potentially leading to consumer harm like loss of provider access, higher costs, or subsidy repayments. GAO recommended CMS update its outdated 2018 fraud risk assessment, strengthen controls (e.g., SSN verification and death data reviews), and develop an antifraud strategy. Estimates from external analyses, such as one by the Paragon Health Institute, suggest federal spending on ineligible enrollees could exceed $20 billion in 2024.
On December 15, 2025, House Judiciary Committee Republicans sent letters (described in some contexts as demands under subpoena authority) to the CEOs of eight major health insurance companies as part of an oversight probe into ACA subsidy fraud, triggered by the GAO report.
The House Judiciary Committee sent letters to Blue Shield of California, Centene Corporation, CVS Health, Elevance Health, Kaiser Permanente, Oscar Health Inc. and GuideWell, demanding detailed information on their enrollment services.
These companies are involved in offering ACA marketplace plans, facilitating enrollments through brokers or agents, and receiving APTC subsidies on behalf of enrollees. The probe focuses on their role in potentially enabling or overlooking fraud, such as through broker incentives that encourage improper enrollments. The committee requested documents on enrollment numbers, unused benefits, internal fraud communications, and anti-fraud staff.
Some of the fraud comes from brokers, who are paid by insurance companies for each enrollment and are, therefore, incentivized to enroll as many people as possible - whether eligible or not. Brokers have targeted individuals with deceptive advertisements and pressured enrollees to lie about their incomes to obtain Obamacare subsidies. Evidence suggests that many individuals do not even know they are signing up for health insurance or agreeing to switch plans.
Last year, a federal judge blocked a regulation issued by the Trump Administration to fight Obamacare subsidy fraud, claiming it violated the Administrative Procedure Act.
- LCO Resolves Farm Workers' Wage-and-Hour Case for $6Mon February 10, 2026 at 1:40 PM
The California Labor Commissioner’s Office (LCO) has secured a $6,175,000 settlement with Santa Maria-based Alco Harvesting LLC dba Bonipak Produce Inc. and related entities for widespread wage-and-hour violations that affected more than 10,000 farmworkers, including H-2A workers living in employer-provided housing during the COVID-19 pandemic.
The LCO opened this investigation in 2020 after receiving information that a farmworker living in employer-provided housing had died from COVID-19. It discovered that Alco Harvesting failed to provide workers with the legally required written notice of available paid sick leave and COVID-19 supplemental paid sick leave. Without this information, workers could not effectively use these protections.
During the early days of the pandemic, workers who did not know how much paid sick leave they had were effectively prevented from staying home when sick, increasing the risk of COVID-19 transmissions. In some cases, H-2A workers believed to have COVID-19 were quarantined in crowded employer-provided motel rooms. The investigation also found other labor law violations, including unpaid transportation time, overtime and minimum wage.
The LCO filed this lawsuit on July 16, 2021, in Santa Barbara Superior Court against Alco Harvesting LLC dba Bonipak Produce Inc., and related entities. The court consolidated the LCO’s lawsuit with a separate action filed by the California Rural Legal Assistance (CRLA) on behalf of H-2A workers, along with several related lawsuits filed by other plaintiffs. Additional details about the defendants and the terms of the settlement are outlined in the court order.
As the case progressed, the Central Coast Alliance United for a Sustainable Economy (CAUSE) and CRLA referred additional H-2A workers to LCO investigators and supported outreach efforts. These organizations helped ensure workplace conditions were documented and violations were reported. CRLA and the PAGA plaintiffs consolidated with the LCO’s lawsuit also helped identify additional wage-and-hour violations, expanding the relief available to workers.
Of the total settlement, $4.2 million will be distributed directly to affected farmworkers, including approximately $1.5 million for paid sick leave and minimum wage violations. Remaining funds will be used to pay wages and other damages, penalties and interest to workers, counsel fees and expenses, individual plaintiff claims, and administrator expenses.
The settlement also includes non-monetary relief, such as required postings and additional notices to H-2A workers about paid sick leave, and ongoing compliance and reporting requirements.
CAUSE and CRLA are part of the California Workplace Outreach Project launched in 2020 to help address workplace concerns related to COVID-19.
- Exclusive Remedy Applies to Cal/OSHA Rule Violationson February 9, 2026 at 11:38 AM
Alejandro Razo was employed by the Orange County Public Works. His job involved cleaning debris from various locations. On one occasion, Razo's supervisor instructed him to use a "Vactor Truck" equipped with a hose and nozzle for spraying highly pressurized water. The County had allegedly modified the nozzle by welding closed its backward-facing spray ports, which increased the water pressure from the remaining ports and created an unsafe condition. Despite warnings from the equipment distributor that the modified nozzle was unsafe and should not be used, Razo's supervisor directed him to disregard safety concerns and proceed. While using the nozzle, there was a sudden "big blast," causing the hose and nozzle to kick back forcefully, striking Razo in the head. This resulted in severe injuries. The County had also been cited by Cal/OSHA for various safety violations related to injuries or equipment issues, which Razo alleged demonstrated willful and criminal disregard for employee safety.
Razo filed a lawsuit in 2022 against the County, alleging negligence. The County demurred to each amended complaint, primarily arguing that Razo's claims were barred by the exclusivity of the Workers' Compensation Act. For the third amended complaint, the County again demurred, emphasizing both workers' compensation exclusivity and that the new causes of action exceeded the scope of the granted leave to amend.
In May 2024, the trial court sustained the demurrer without leave to amend. It ruled that the amendments exceeded the scope because they introduced entirely new claims instead of fixing the prior negligence and respondeat superior issues. Additionally, it held that the claims remained barred by workers' compensation exclusivity, as Razo could not evade the system by relabeling his causes of action. In July 2024, the court dismissed the action against the County and entered judgment in its favor.
The California Court of Appeal affirmed the trial court's judgment in full in the unpublished case of Razo v. County of Orange -G064631 (February 2026). It upheld the sustaining of the demurrer without leave to amend and the dismissal of Razo's action.
The appellate court assumed, for the sake of argument, that the third amended complaint did not exceed the scope of leave to amend, but still concluded that the claims were barred by workers' compensation exclusivity as a matter of law. Razo did not invoke any statutory exceptions to exclusivity. Instead, he argued the County's conduct - willfully and criminally creating an ultrahazardous risk by modifying equipment and directing its use - fell outside the compensation bargain, as it was not a "normal part of the employment relationship."
The court rejected this, noting that Razo's injury occurred while performing assigned duties with employer-provided equipment. Even accepting allegations of intentional, egregious, or "criminal" misconduct (such as violating safety regulations and ignoring warnings), such conduct remains within exclusivity if connected to normal employment functions like providing tools and directing tasks.
Citing precedents like Shoemaker v. Myers 52 Cal.3d 1 (1990) and Cole v. Fair Oaks Fire Protection Dist. 43 Cal.3d 148 (1987), the court emphasized that exclusivity applies despite intentional or outrageous employer actions, and knowing disregard of safety standards (e.g., Cal/OSHA violations) does not remove claims from the system, as seen in cases like Gunnell v. Metrocolor Laboratories, Inc. 92 Cal.App.4th 710 (2001) and Johns-Manville Products Corp. v. Superior Court 27 Cal.3d 465 (1980).
The court distinguished Razo's cited cases. For instance, in Lee v. West Kern Water Dist. 5 Cal.App.5th 606 (2016), a mock robbery orchestrated by the employer created a triable issue because it bore no relation to workplace operations, unlike here where the conduct involved routine equipment decisions. In Johns-Manville, exclusivity did not bar claims for aggravated injuries from fraudulent concealment of a disease, but Razo's injury arose directly from ordinary duties, not a separate aggravation. Razo's public policy violation argument also failed, as the exception applies only to conduct violating fundamental policies independent of workplace safety (e.g., retaliatory discharge), not Cal/OSHA or safety statute breaches.
Finally, the court found no abuse of discretion in denying further leave to amend. Razo bore the burden to show how amendments could cure the defects but offered only vague proposals (e.g., reasserting negligence or adding that another employee was injured with the same equipment), which would still fall within the compensation bargain as restatements of unsafe equipment use. No plausible theory could remove the conduct from exclusivity.
- Congress Extends Telehealth & Hospital-at-Home Waiverson February 9, 2026 at 11:38 AM
Congress approved extensions to Medicare telehealth flexibilities and the Acute Hospital Care at Home waivers as part of the Consolidated Appropriations Act, 2026 (H.R. 7148), which President Trump signed into law on February 3, 2026. This followed a brief partial government shutdown that caused a temporary lapse in these provisions starting January 31, 2026, but the extensions are retroactive, restoring continuity.
The five-bill minibus brings an end to the three-day government shutdown and reinstates key telehealth flexibilities for multiple years. This legislative package includes several critical telehealth provisions, including:
- - Extension of Medicare telehealth flexibilities through December 31, 2027
- - Five-year extension of the Acute Hospital Care at Home Program through September 30, 2030
- - Extension of in-home cardiopulmonary rehabilitation flexibilities through January 1, 2028
- - A requirement that HHS issue guidance within one year on furnishing telehealth services to individuals with limited English proficiency
- - Inclusion of virtual diabetes suppliers in the Medicare Diabetes Prevention Program through December 31, 2029
In the landscape of U.S. healthcare policy, Medicare's framework for telehealth services - defined as the provision of medical care through telecommunications technologies such as video conferencing or telephone consultations - has historically been constrained to mitigate risks of overuse and ensure quality. Prior to the COVID-19 pandemic, eligibility was limited to patients in rural locales, required physical presence at designated originating sites like clinics or hospitals, and mandated real-time audio-video interactions, excluding home-based services and restricting reimbursement to a narrow cadre of providers. This conservative stance mirrored an era of nascent technology adoption and fiscal prudence.
The onset of the pandemic in 2020 catalyzed a paradigm shift. Enacted through emergency legislation including the Coronavirus Preparedness and Response Supplemental Appropriations Act and the CARES Act in March 2020, Medicare introduced sweeping telehealth flexibilities. These reforms eliminated geographic restrictions, enabling nationwide access from patients' homes; incorporated audio-only modalities for those with limited broadband; broadened the scope of reimbursable practitioners to encompass therapists, counselors, and allied health professionals; and covered an expanded array of services, from mental health evaluations to chronic disease management.
Concurrently, the Centers for Medicare & Medicaid Services (CMS) initiated the Acute Hospital Care at Home waivers in November 2020, authorizing select hospitals to administer inpatient-acute care - encompassing intravenous therapies, respiratory support, and post-operative monitoring - in patients' residences, subject to rigorous protocols including daily in-person assessments and continuous virtual oversight. These measures addressed acute capacity strains and infection control imperatives during peak crisis periods.
As the public health emergency concluded on May 11, 2023, the enduring value of these innovations became evident. Empirical data highlighted enhanced patient access, reduced operational costs, and elevated satisfaction metrics, prompting congressional extensions. The Consolidated Appropriations Act of 2023 prolonged telehealth flexibilities until December 31, 2024, while hospital-at-home waivers received incremental renewals: a two-year extension in 2022, followed by 90-day and subsequent bridges to September 30, 2025. Industry stakeholders, including the American Medical Association and American Telemedicine Association, advocated vigorously for permanence, citing demographic trends such as population aging and persistent rural-urban disparities in care delivery.
- Employees Can Sue for Even Technical ICRAA Disclosure Violationson February 5, 2026 at 10:38 AM
In June 2018, Tina Parsonage applied for a sales associate position at Wal-Mart. She accepted a conditional offer of employment, subject to passing a background check. As part of the process, she electronically acknowledged a "Background Report Disclosure" and signed a "Background Report Authorization" form. The disclosure document was 14 pages long, with the California-specific section starting on page 9.
This section informed her that Wal-Mart would obtain an investigative consumer report, which could include details about her character, reputation, personal characteristics, and mode of living. However, instead of identifying a single investigative consumer reporting agency, it listed six possible agencies, along with their addresses, websites, and phone numbers. It instructed her to call Wal-Mart Global Security to determine which one was used. The document also summarized relevant provisions of the Investigative Consumer Reporting Agencies Act (ICRAA, Civ. Code § 1786 et seq.), but Parsonage later alleged it violated ICRAA by not being a standalone disclosure, failing to clearly identify the specific agency, omitting a checkbox to request a copy of the report, and lacking proper certification to the agency.
Wal-Mart obtained the report from First Advantage Background Services Corp., one of the listed agencies, and mailed Parsonage a copy with a cover letter identifying the agency. Despite the alleged violations, Parsonage passed the check and began employment on June 15, 2018. In September 2021, she filed a lawsuit against Wal-Mart in San Diego Superior Court, asserting a single cause of action for ICRAA violations.
She claimed the disclosure was not clear and conspicuous, not standalone, and otherwise noncompliant. Parsonage sought statutory damages of $10,000 per violation (or actual damages if greater), attorney fees, costs, and punitive damages. She did not initially allege specific harm but later claimed the report contained inaccuracies (e.g., misstating offenses as involving a commercial vehicle, which could imply work-related misconduct), depriving her of the chance to correct them easily and potentially risking future job denials.
Wal-Mart moved for summary judgment solely on the ground that Parsonage lacked standing under ICRAA, arguing her claims involved mere "technical violations" without any concrete injury or harm, such as an adverse employment action. The trial court agreed, granting summary judgment in Wal-Mart's favor. It reasoned that Parsonage suffered no injury because she was hired, received the report she authorized, and faced no adverse consequences from any inaccuracies. The court dismissed her concerns about potential lost opportunities as speculative and unmaterialized, emphasizing the absence of harm to her interest in a fair and accurate report.
The Court of Appeal reversed the trial court's judgment in the published case of Parsonage v. Wal-Mart Associates -D083831 (February 2026). It directed the trial court to vacate its order granting summary judgment to Wal-Mart, allowing Parsonage's claim to proceed.
The appellate court held that ICRAA confers standing based solely on a violation of its requirements, without needing to show concrete injury or actual damages beyond the statutory breach. This conclusion stemmed from the statute's plain language in Civil Code § 1786.50, which makes an employer or agency liable for failing to comply with any ICRAA provision regarding an investigative consumer report, allowing recovery of "[a]ny actual damages... or... ten thousand dollars ($10,000), whichever sum is greater." The court interpreted this as authorizing the $10,000 sum as a remedy for the violation itself, emphasizing that California law - unlike federal Article III requirements - permits the Legislature to grant standing for statutory violations absent concrete harm, treating such breaches as invasions of legally protected interests.
The court distinguished California standing from federal "injury-in-fact" mandates, noting that ICRAA's legislative history supports this view: enacted in 1975 to address shortcomings in the federal Fair Credit Reporting Act (FCRA) and prior state laws, ICRAA aimed to ensure stringent notice, consent, and accuracy in consumer reports for employment purposes, protecting privacy and enabling corrections. Amendments increasing the minimum recovery from $300 to $10,000 were intended to incentivize compliance and deter violations, not to compensate for proven harm. Comparisons to sister statutes like the Consumer Credit Reporting Agencies Act (CCRAA) and FCRA highlighted ICRAA's unique structure, which omits qualifiers like "damages as a result of" and focuses on noncompliance.
The court rejected Wal-Mart's reliance on cases like Limon v. Circle K Stores Inc 84 Cal.App.5th 671 (2022) 300 Cal.Rptr.3d 572, and Muha v. Experian Information Solutions Inc.,106 Cal.App.5th 199 (2024) 326 Cal. Rptr. 3d 622 which required injury for FCRA/ICRAA standing in state court under a "beneficial interest" test (akin to federal injury-in-fact). It found this test inapplicable beyond writ of mandate contexts and inconsistent with ICRAA's deterrent purpose. Since Parsonage alleged violations (e.g., non-standalone disclosure obscuring the agency), she had standing; Wal-Mart's motion addressed only standing, not merits, warranting reversal.
- FTC v Express Scripts Litigation Settlement Should Lower Drug Priceson February 5, 2026 at 10:38 AM
The Federal Trade Commission secured what it claims is "a landmark settlement" with one of the nation’s largest pharmacy benefit managers (“PBMs”), Express Scripts, Inc., and its affiliated entities (collectively “ESI”). The settlement requires ESI to adopt fundamental changes to its business practices that increase transparency, are expected to drive down patients’ out-of-pocket costs for drugs like insulin by up to $7 billion over 10 years, bring millions of dollars in new revenue to community pharmacies each year, and advance key healthcare priorities.
The FTC’s settlement resolves the Commission’s lawsuit against ESI, which alleges that ESI artificially inflated the list price of insulin drugs by using anticompetitive and unfair rebating practices, and impaired patients’ access to lower list price products, ultimately shifting the cost of high insulin list prices to vulnerable patients.
https://news.workcompacademy.com/2026/Parsonage-v-Wal-Mart-Associates-D083831.PDF. The complaint alleges that this system pushed insulin manufacturers, among others, to compete for preferred formulary coverage based on the size of rebates off the list price rather than net price, which ultimately benefitted the PBMs, including ESI, which keep a portion of the inflated rebates. According to the FTC’s complaint, the inflated list prices hurt patients whose out-of-pocket payments like copays and coinsurance are tied to the list price of the drug.
ESI, under the FTC’s proposed consent order, has agreed to:
- - Stop preferring on its standard formularies high wholesale acquisition cost versions of a drug over identical low wholesale acquisition cost versions;
- - Provide a standard offering to its plan sponsors that ensures that members’ out-of-pocket expenses will be based on the drug’s net cost, rather than its artificially inflated list price;
- - Provide covered access to TrumpRx as part of its standard offering upon relevant legal and regulatory changes;
- - Provide full access to its Patient Assurance Program’s insulin benefits to all members when a plan sponsor adopts a formulary that includes an insulin product covered by the Patient Assurance Program unless the plan sponsor opts out in writing;
- - Provide a standard offering to all plan sponsors that allows the plan sponsor to transition off rebate guarantees and spread pricing;
- - Delink drug manufacturers’ compensation to ESI from list prices as part of its standard offering;
- - Increase transparency for plan sponsors, including with mandatory, drug-level reporting, providing data to permit compliance with the Transparency in Coverage regulations, and disclosing payments to brokers representing plan sponsors;
- - Transition its standard offering to retail community pharmacies to a more transparent and fairer model based on the actual acquisition cost for a drug product plus a dispensing fee and additional compensation for non-dispensing services;
- - Promote the standard offerings to plan sponsors and retail community pharmacies; and
- - Reshore its group purchasing organization Ascent from Switzerland to the United States, which will bring back to the United States more than $750 billion in purchasing activity over the duration of the order.
The Commission vote to accept the consent agreement for public comment was 1-0, with Commissioner Meador recused.
The public will have 30 days to submit comments on the proposed consent agreement package. Instructions for filing comments appear on the docket. Once processed, they will be posted on Regulations.gov.
- Former NFL Player Convicted for $197M Medicare Fraudon February 12, 2026 at 10:09 AM
A federal jury convicted Joel Rufus French, 47, of Amory, Mississippi, the owner of a marketing company, and former NFL player, for his role in a yearslong scheme to bilk Medicare and the Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) out of nearly $200 million by selling patient information and sham doctors’ orders for orthotic braces that patients did not want or need.
French had a brief and limited NFL career after a standout college tenure at Ole Miss.He signed as an undrafted free agent with the Seattle Seahawks in 1999. A knee injury sidelined him for the entire 2000 season, leading to his release from the team. He later signed with the Green Bay Packers in 2002 but never appeared in a regular-season game (likely on the practice squad or released without playing).
According to court documents and evidence presented at trial, French worked with overseas call centers that pressured elderly Americans to provide their personal and health insurance information and agree to accept medically unnecessary orthotic braces. Some of the individuals who agreed to the braces suffered from Alzheimer’s and dementia. In certain instances, the call centers altered call recordings to make it seem like Medicare patients agreed to the braces when they did not.
French paid sham telemedicine companies to obtain signed orders from doctors and nurse practitioners who never examined, and often never even spoke to, the patients. He sold the orders to marketers and medical supply companies, which then submitted claims to Medicare. French also defrauded Medicare and CHAMPVA, the health care program for spouses and children of veterans who have or had a permanent and total service-connected disability or who died from a service-connected condition, by billing the programs for orthotic braces through eight durable medical equipment supply companies that he owned and managed, using false documents to hide his connection to the companies from Medicare.
The evidence at trial showed that French and his co-conspirators caused Medicare to be billed for braces for amputees for limbs they did not have and for deceased beneficiaries. Also during the conspiracy, French withdrew approximately $225,000 in cash from a bank in Mississippi, over $10,000 of which was placed in a bag and driven to Orlando to pay accomplices who sold him beneficiaries’ personal and insurance information.
The jury convicted French of conspiracy to commit health care fraud and wire fraud, conspiracy to commit money laundering, and conspiracy to offer, pay, solicit, and receive kickbacks. French faces a maximum penalty of 20 years in prison for conspiracy to commit health care fraud and wire fraud, 10 years in prison for conspiracy to commit money laundering, and five years in prison for conspiracy to defraud the United States. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors. A sentencing date has not been set.
“This scheme built on sham operations exploited seniors and corrupted the federal health care system. By falsifying doctors’ orders and selling patient information, the defendant sought to turn Medicare into their own personal ATM machine,” said Acting Deputy Inspector General for Investigations Scott J. Lampert of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG). “HHS-OIG will stop and catch anyone who exploits vulnerable patients to bilk federal healthcare programs and hold them accountable to the full extent of the law.”
This case was similar to Operation Brace Yourself, a major 2019 Department of Justice (DOJ) enforcement action (also called the "Telemedicine and Durable Medical Equipment Takedown") that charged dozens of individuals across multiple states for schemes involving kickbacks, bribes, sham telemedicine consultations, and fraudulent billing to Medicare for medically unnecessary braces (like back, knee, shoulder, and wrist braces). It resulted in charges related to over $1.7 billion in false claims, with significant cost avoidance for Medicare in the following years.
HHS-OIG, FBI, and VA-OIG investigated the case. Acting Assistant Chief Catherine Wagner and Trial Attorney William Hochul III of the Justice Department’s Fraud Section are prosecuting the case. - The Workplace Overdose Reversal Kits (WORK) to Save Lives Acton February 12, 2026 at 10:08 AM
The Workplace Overdose Reversal Kits (WORK) to Save Lives Act is a bipartisan, bicameral piece of U.S. legislation aimed at addressing opioid overdoses in workplace settings by improving access to overdose reversal medications like naloxone (commonly known as Narcan). It was most recently reintroduced on February 10, 2026.
The bill directs the Secretary of Labor, through the Occupational Safety and Health Administration (OSHA), to issue non-mandatory guidance for private-sector employers on acquiring and maintaining opioid overdose reversal medications (such as naloxone kits). And offering voluntary annual training to employees on how to use such medications.
The goal is to integrate overdose response into workplace emergency preparedness plans, similar to how workplaces prepare for fires, cardiac events, or other emergencies. It emphasizes that overdose incidents can happen anywhere, including on the job, and quick access to naloxone can be lifesaving while waiting for emergency services.
Organizations like the National Safety Council (NSC) have publicly applauded the bill, noting rising workplace overdose deaths and the need for such tools. Other supporters, including overdose prevention advocates, highlight it as a practical, non-burdensome way to equip workplaces without imposing heavy new mandates on private employers (guidance is voluntary for them).
The bill was first introduced in the 118th Congress (2023-2024). Even strong bipartisan bills like this one often fail to become law due to systemic factors in Congress, rather than outright opposition such as:
- - Low Priority in a Crowded Agenda — Congress handles thousands of bills each session. Broader opioid crisis legislation (e.g., major funding packages, enforcement bills, or comprehensive reforms) often takes precedence over narrower, targeted measures like workplace-specific guidance. This bill is relatively modest (mostly non-mandatory guidance for private employers, with requirements only for federal agencies), so it doesn't generate the same urgency or media attention as bigger spending or regulatory fights.
- - Committee Bottlenecks — Labor and workplace safety bills go through committees like Education and the Workforce (House) or HELP (Senate), which have heavy workloads. Without strong leadership push, a dedicated champion on the committee, or external pressure (e.g., a major incident spotlighting the issue), bills can sit without hearings. Reports note that the 2023 versions "neither advanced out of committee," which is a classic sign of this.
- - No Major Opposition, But Also No Strong Momentum — There's little evidence of active resistance (e.g., from business groups or conservatives worried about mandates. But it hasn't built a groundswell of lobbying or public pressure to force movement. Bipartisanship helps avoid filibusters or veto threats, but it doesn't guarantee floor time.
- - Congressional Dysfunction and Timing — The 118th Congress saw gridlock on many issues due to divided government, narrow majorities, debt ceiling fights, and other priorities. Bills introduced late in a session (like this one in fall 2023) often expire without action. Reintroductions in new Congresses reset the clock, which is why it's back now.
In short, bipartisanship is a plus - it reduces partisan roadblocks - but it's not sufficient on its own. Many well-intentioned, low-controversy bills languish for years (or forever) unless they get attached to must-pass legislation, gain a powerful sponsor's priority, or ride a wave of public attention (e.g., a high-profile workplace overdose event). This one fits that pattern: sensible, supported, but not yet prioritized enough to move. Its recent reintroduction means there's still a window in the current session, especially with ongoing opioid crisis awareness. - OSHA Clarifies Recording Workplace Injuries Related to Lithium-Ion Batterieson February 11, 2026 at 3:48 PM
The U.S. Department of Labor's Occupational Safety and Health Administration (OSHA) has issued a letter of interpretation clarifying whether injuries resulting from the use of personal rechargeable lithium-ion batteries in the workplace should be recorded as work-related on the OSHA Forms 300, 301, and 300-A or equivalent forms.
The letter addressed a scenario in which employees bring rechargeable lithium-ion batteries from home to the workplace for use in e-cigarettes, and that are not used in any equipment or device related to employee work duties. In this scenario, the battery terminals are unprotected and the employee or employees improperly carry these batteries in their pants pocket, a fire is sparked by the batteries, and that the fire results in employee injury.
If a work-related injury caused by a lithium-ion battery meets one or more of the general recording criteria in Section 1904.7 of the Recording and Reporting Occupational Injuries and Illnesses standard, it must be recorded on the OSHA logs.
OSHA's Response: "No, section 1904.5(b)(3) of OSHA's recordkeeping regulation does not apply in this scenario, assuming that the employee was at your workplace during assigned work hours and present as a condition of employment."
However the Notice of Interpretation letter addresses recordkeeping requirements and highlights the growing need for awareness of safety risks associated with lithium-ion batteries in workplace environments. These batteries can pose safety and health risks to workers during manufacturing, usage, emergency response, disposal, and recycling. Potential risks include fires, explosions, and exposure to harmful chemicals.
Safety measures employers can take include implementing hazard controls during battery design and production; ensuring proper ventilation; storing batteries in cool, dry locations; monitoring storage areas for flammable and toxic gases; using designated recycling facilities for disposal; and providing safety showers and eyewash stations when handling battery materials.
A Letter of Interpretation is OSHA's official response to questions about how its requirements apply to specific workplace situations or hazards. They cannot create additional employer obligations. Each letter constitutes OSHA's interpretation of the requirements discussed. These letters can help stakeholders understand how to comply with Federal OSHA standards, regulations, and section 5(a)(1) of the Occupational Safety and Health Act in specific workplace situations.
In June, the Department of Labor launched its opinion letter program, which expands the department's longstanding commitment to providing meaningful compliance assistance that helps workers, employers, and other stakeholders understand how federal labor laws apply in specific workplace situations.
The public is encouraged to use the division's new opinion letters page to explore past guidance and submit new requests. The division will exercise discretion in determining whether and how it will respond to each request, which will focus primarily on attempting to address issues of broad-based concern.
Learn more about OSHA and safety practices related to lithium-ion batteries.
Note however that California is regulated by Cal/OSHA, which operates under an OSHA-approved state plan (approved in 1973). This means Cal/OSHA has primary authority to enforce occupational safety and health standards for both private-sector and public-sector (state and local government) workplaces in the state.
Under the federal Occupational Safety and Health Act of 1970 (OSH Act), state plans like California's must be "at least as effective" as federal OSHA standards. Federal OSHA standards serve as a floor (minimum baseline): Cal/OSHA must cover all the same issues addressed by federal standards and cannot be less protective.
Cal/OSHA can (and often does) adopt more stringent or additional standards. California frequently issues rules that exceed federal requirements (e.g., stricter permissible exposure limits for chemicals, more comprehensive heat illness prevention, workplace violence prevention measures, or shorter injury reporting deadlines). In these cases, the more protective Cal/OSHA rule prevails for California employers.
Employers in California must comply with a stricter Cal/OSHA provision if there is one. Federal OSHA does not preempt or override a state plan's more stringent rules once the plan is approved. - ACOEM Studies Office Space/Room Design for Excessive Sittingon February 11, 2026 at 3:48 PM
The phrase "sitting is the new smoking" is a popular health slogan that highlights the serious health risks of prolonged sedentary behavior (especially sitting for extended periods), comparing them to the well-established dangers of smoking cigarettes. It emphasizes how modern lifestyles - desk jobs, screen time, commuting - lead to excessive sitting, which is linked to increased risks of obesity, type 2 diabetes, cardiovascular disease, certain cancers, metabolic issues, and even premature death, independent of regular exercise.
The phrase is widely attributed to Dr. James A. Levine, an endocrinologist and professor of medicine formerly at the Mayo Clinic (now associated with initiatives like the Mayo Clinic-Arizona State University Obesity Solutions). He is credited with coining or popularizing it in the early 2010s as part of his research on non-exercise activity thermogenesis (NEAT) and the metabolic impacts of sedentary time.
A key early mention appeared in a 2014 Los Angeles Times article titled "'Get Up!' or lose hours of your life every day, scientist says," where Levine is quoted saying things like: “Sitting is more dangerous than smoking, kills more people than HIV and is more treacherous than parachuting. We are sitting ourselves to death.” This tied into his book Get Up!: Why Your Chair Is Killing You and What You Can Do About It (published around that time).
And perhaps concerns about the health hazards of excessive sitting influenced researchers to conduct a new study, published ahead of print in the Journal of Occupational and Environmental Medicine. Researchers decided to explore how workplace design influences office workers' sitting behaviors, which are linked to health risks like cardiovascular disease and reduced productivity. The research draws on affordance theory and ecological models, emphasizing that environments can "invite" sitting or standing.
Cluster analysis identified 7 office types. Workers stood longer in large shared offices with trash cans out of reach and few decorations. They stood shorter in small shared offices with screens/boards,but this was explained by lower worktime control in those offices.
Individual features were studied. Longer standing took place in offices with two workstations compared to one, or additional chairs. Shorter sitting (quicker stand-ups) with trash cans or waste paper bins within arm's reach, and small under-desk cabinets.
The study concluded that workplace design is associated with sitting patterns to some extent, but primarily indirectly - through the work tasks, goals, and collegial interactions it affords (e.g., focused desk work in offices promotes sitting; interactions in shared spaces encourage standing). Key principles: (1) Office designs as wholes may impact sitting differently than isolated features (per Gestalt theory); (2) Design influences sitting via enabled behaviors, not just physical cues.
To reduce prolonged sitting (~70-80% of work time), designs should promote task variety and interactions (e.g., shared offices, out-of-reach bins to encourage movement). However, work characteristics like time control may be more influential than design alone. This supports holistic interventions combining environmental changes with behavioral strategies. - 8 Carriers Targeted for Advance Premium Tax Credit Fraud Probeon February 10, 2026 at 1:40 PM
The U.S. Government Accountability Office (GAO) released a report in December 2025 highlighting significant vulnerabilities and instances of fraud in the Advance Premium Tax Credit (APTC) Program, which provides subsidies to reduce health insurance premiums under the Affordable Care Act (ACA, or Obamacare). Key findings on the scale of improper payments and fraud include:
- - Overall Program Scale and Unreconciled Payments: The Centers for Medicare & Medicaid Services (CMS) estimated $124 billion in APTC payments for 19.5 million enrollees in plan year 2024. A preliminary analysis identified over $21 billion in unreconciled APTC (representing 32% of APTC for enrollees who provided Social Security Numbers in plan year 2023), which could indicate overpayments or fraud but is not yet fully verified.
- - Payments to Deceased Individuals: CMS disbursed over $94 million in APTC for households where Social Security Numbers matched Social Security Administration death data in plan year 2023. Over 58,000 such SSNs (0.42% of those receiving APTC) were flagged, with CMS failing to conduct periodic reviews for all enrollees.
- - Identity Theft and SSN Misuse: More than 29,000 SSNs (0.21%) in plan year 2023 and nearly 66,000 (0.37%) in plan year 2024 had over 365 days of coverage, suggesting potential identity theft or errors. GAO's covert testing revealed weak controls, with all four fictitious applications in 2024 and 18 of 20 in 2025 receiving subsidized coverage despite invalid SSNs, fictitious documentation, and unverified income or citizenship. This resulted in about $2,350 in monthly APTC for late-2024 tests and over $10,000 monthly for active 2025 fictitious enrollees.
- - Unauthorized Enrollment Changes: At least 30,000 applications (0.4%) in plan year 2023 and 160,000 (1.5%) in plan year 2024 showed signs of unauthorized changes by agents or brokers, such as multiple brokers editing the same application on the same day. CMS received 275,000 complaints about unauthorized enrollments or plan switches from January to August 2024, with some leading to indictments for falsified applications.
The report notes that fraud is exacerbated by incentives for brokers (paid per enrollment) to enroll ineligible individuals, potentially leading to consumer harm like loss of provider access, higher costs, or subsidy repayments. GAO recommended CMS update its outdated 2018 fraud risk assessment, strengthen controls (e.g., SSN verification and death data reviews), and develop an antifraud strategy. Estimates from external analyses, such as one by the Paragon Health Institute, suggest federal spending on ineligible enrollees could exceed $20 billion in 2024.
On December 15, 2025, House Judiciary Committee Republicans sent letters (described in some contexts as demands under subpoena authority) to the CEOs of eight major health insurance companies as part of an oversight probe into ACA subsidy fraud, triggered by the GAO report.
The House Judiciary Committee sent letters to Blue Shield of California, Centene Corporation, CVS Health, Elevance Health, Kaiser Permanente, Oscar Health Inc. and GuideWell, demanding detailed information on their enrollment services.
These companies are involved in offering ACA marketplace plans, facilitating enrollments through brokers or agents, and receiving APTC subsidies on behalf of enrollees. The probe focuses on their role in potentially enabling or overlooking fraud, such as through broker incentives that encourage improper enrollments. The committee requested documents on enrollment numbers, unused benefits, internal fraud communications, and anti-fraud staff.
Some of the fraud comes from brokers, who are paid by insurance companies for each enrollment and are, therefore, incentivized to enroll as many people as possible - whether eligible or not. Brokers have targeted individuals with deceptive advertisements and pressured enrollees to lie about their incomes to obtain Obamacare subsidies. Evidence suggests that many individuals do not even know they are signing up for health insurance or agreeing to switch plans.
Last year, a federal judge blocked a regulation issued by the Trump Administration to fight Obamacare subsidy fraud, claiming it violated the Administrative Procedure Act. - LCO Resolves Farm Workers' Wage-and-Hour Case for $6Mon February 10, 2026 at 1:40 PM
The California Labor Commissioner’s Office (LCO) has secured a $6,175,000 settlement with Santa Maria-based Alco Harvesting LLC dba Bonipak Produce Inc. and related entities for widespread wage-and-hour violations that affected more than 10,000 farmworkers, including H-2A workers living in employer-provided housing during the COVID-19 pandemic.
The LCO opened this investigation in 2020 after receiving information that a farmworker living in employer-provided housing had died from COVID-19. It discovered that Alco Harvesting failed to provide workers with the legally required written notice of available paid sick leave and COVID-19 supplemental paid sick leave. Without this information, workers could not effectively use these protections.
During the early days of the pandemic, workers who did not know how much paid sick leave they had were effectively prevented from staying home when sick, increasing the risk of COVID-19 transmissions. In some cases, H-2A workers believed to have COVID-19 were quarantined in crowded employer-provided motel rooms. The investigation also found other labor law violations, including unpaid transportation time, overtime and minimum wage.
The LCO filed this lawsuit on July 16, 2021, in Santa Barbara Superior Court against Alco Harvesting LLC dba Bonipak Produce Inc., and related entities. The court consolidated the LCO’s lawsuit with a separate action filed by the California Rural Legal Assistance (CRLA) on behalf of H-2A workers, along with several related lawsuits filed by other plaintiffs. Additional details about the defendants and the terms of the settlement are outlined in the court order.
As the case progressed, the Central Coast Alliance United for a Sustainable Economy (CAUSE) and CRLA referred additional H-2A workers to LCO investigators and supported outreach efforts. These organizations helped ensure workplace conditions were documented and violations were reported. CRLA and the PAGA plaintiffs consolidated with the LCO’s lawsuit also helped identify additional wage-and-hour violations, expanding the relief available to workers.
Of the total settlement, $4.2 million will be distributed directly to affected farmworkers, including approximately $1.5 million for paid sick leave and minimum wage violations. Remaining funds will be used to pay wages and other damages, penalties and interest to workers, counsel fees and expenses, individual plaintiff claims, and administrator expenses.
The settlement also includes non-monetary relief, such as required postings and additional notices to H-2A workers about paid sick leave, and ongoing compliance and reporting requirements.
CAUSE and CRLA are part of the California Workplace Outreach Project launched in 2020 to help address workplace concerns related to COVID-19. - Exclusive Remedy Applies to Cal/OSHA Rule Violationson February 9, 2026 at 11:38 AM
Alejandro Razo was employed by the Orange County Public Works. His job involved cleaning debris from various locations. On one occasion, Razo's supervisor instructed him to use a "Vactor Truck" equipped with a hose and nozzle for spraying highly pressurized water. The County had allegedly modified the nozzle by welding closed its backward-facing spray ports, which increased the water pressure from the remaining ports and created an unsafe condition. Despite warnings from the equipment distributor that the modified nozzle was unsafe and should not be used, Razo's supervisor directed him to disregard safety concerns and proceed. While using the nozzle, there was a sudden "big blast," causing the hose and nozzle to kick back forcefully, striking Razo in the head. This resulted in severe injuries. The County had also been cited by Cal/OSHA for various safety violations related to injuries or equipment issues, which Razo alleged demonstrated willful and criminal disregard for employee safety.
Razo filed a lawsuit in 2022 against the County, alleging negligence. The County demurred to each amended complaint, primarily arguing that Razo's claims were barred by the exclusivity of the Workers' Compensation Act. For the third amended complaint, the County again demurred, emphasizing both workers' compensation exclusivity and that the new causes of action exceeded the scope of the granted leave to amend.
In May 2024, the trial court sustained the demurrer without leave to amend. It ruled that the amendments exceeded the scope because they introduced entirely new claims instead of fixing the prior negligence and respondeat superior issues. Additionally, it held that the claims remained barred by workers' compensation exclusivity, as Razo could not evade the system by relabeling his causes of action. In July 2024, the court dismissed the action against the County and entered judgment in its favor.
The California Court of Appeal affirmed the trial court's judgment in full in the unpublished case of Razo v. County of Orange -G064631 (February 2026). It upheld the sustaining of the demurrer without leave to amend and the dismissal of Razo's action.
The appellate court assumed, for the sake of argument, that the third amended complaint did not exceed the scope of leave to amend, but still concluded that the claims were barred by workers' compensation exclusivity as a matter of law. Razo did not invoke any statutory exceptions to exclusivity. Instead, he argued the County's conduct - willfully and criminally creating an ultrahazardous risk by modifying equipment and directing its use - fell outside the compensation bargain, as it was not a "normal part of the employment relationship."
The court rejected this, noting that Razo's injury occurred while performing assigned duties with employer-provided equipment. Even accepting allegations of intentional, egregious, or "criminal" misconduct (such as violating safety regulations and ignoring warnings), such conduct remains within exclusivity if connected to normal employment functions like providing tools and directing tasks.
Citing precedents like Shoemaker v. Myers 52 Cal.3d 1 (1990) and Cole v. Fair Oaks Fire Protection Dist. 43 Cal.3d 148 (1987), the court emphasized that exclusivity applies despite intentional or outrageous employer actions, and knowing disregard of safety standards (e.g., Cal/OSHA violations) does not remove claims from the system, as seen in cases like Gunnell v. Metrocolor Laboratories, Inc. 92 Cal.App.4th 710 (2001) and Johns-Manville Products Corp. v. Superior Court 27 Cal.3d 465 (1980).
The court distinguished Razo's cited cases. For instance, in Lee v. West Kern Water Dist. 5 Cal.App.5th 606 (2016), a mock robbery orchestrated by the employer created a triable issue because it bore no relation to workplace operations, unlike here where the conduct involved routine equipment decisions. In Johns-Manville, exclusivity did not bar claims for aggravated injuries from fraudulent concealment of a disease, but Razo's injury arose directly from ordinary duties, not a separate aggravation. Razo's public policy violation argument also failed, as the exception applies only to conduct violating fundamental policies independent of workplace safety (e.g., retaliatory discharge), not Cal/OSHA or safety statute breaches.
Finally, the court found no abuse of discretion in denying further leave to amend. Razo bore the burden to show how amendments could cure the defects but offered only vague proposals (e.g., reasserting negligence or adding that another employee was injured with the same equipment), which would still fall within the compensation bargain as restatements of unsafe equipment use. No plausible theory could remove the conduct from exclusivity. - Congress Extends Telehealth & Hospital-at-Home Waiverson February 9, 2026 at 11:38 AM
Congress approved extensions to Medicare telehealth flexibilities and the Acute Hospital Care at Home waivers as part of the Consolidated Appropriations Act, 2026 (H.R. 7148), which President Trump signed into law on February 3, 2026. This followed a brief partial government shutdown that caused a temporary lapse in these provisions starting January 31, 2026, but the extensions are retroactive, restoring continuity.
The five-bill minibus brings an end to the three-day government shutdown and reinstates key telehealth flexibilities for multiple years. This legislative package includes several critical telehealth provisions, including:
- - Extension of Medicare telehealth flexibilities through December 31, 2027
- - Five-year extension of the Acute Hospital Care at Home Program through September 30, 2030
- - Extension of in-home cardiopulmonary rehabilitation flexibilities through January 1, 2028
- - A requirement that HHS issue guidance within one year on furnishing telehealth services to individuals with limited English proficiency
- - Inclusion of virtual diabetes suppliers in the Medicare Diabetes Prevention Program through December 31, 2029
In the landscape of U.S. healthcare policy, Medicare's framework for telehealth services - defined as the provision of medical care through telecommunications technologies such as video conferencing or telephone consultations - has historically been constrained to mitigate risks of overuse and ensure quality. Prior to the COVID-19 pandemic, eligibility was limited to patients in rural locales, required physical presence at designated originating sites like clinics or hospitals, and mandated real-time audio-video interactions, excluding home-based services and restricting reimbursement to a narrow cadre of providers. This conservative stance mirrored an era of nascent technology adoption and fiscal prudence.
The onset of the pandemic in 2020 catalyzed a paradigm shift. Enacted through emergency legislation including the Coronavirus Preparedness and Response Supplemental Appropriations Act and the CARES Act in March 2020, Medicare introduced sweeping telehealth flexibilities. These reforms eliminated geographic restrictions, enabling nationwide access from patients' homes; incorporated audio-only modalities for those with limited broadband; broadened the scope of reimbursable practitioners to encompass therapists, counselors, and allied health professionals; and covered an expanded array of services, from mental health evaluations to chronic disease management.
Concurrently, the Centers for Medicare & Medicaid Services (CMS) initiated the Acute Hospital Care at Home waivers in November 2020, authorizing select hospitals to administer inpatient-acute care - encompassing intravenous therapies, respiratory support, and post-operative monitoring - in patients' residences, subject to rigorous protocols including daily in-person assessments and continuous virtual oversight. These measures addressed acute capacity strains and infection control imperatives during peak crisis periods.
As the public health emergency concluded on May 11, 2023, the enduring value of these innovations became evident. Empirical data highlighted enhanced patient access, reduced operational costs, and elevated satisfaction metrics, prompting congressional extensions. The Consolidated Appropriations Act of 2023 prolonged telehealth flexibilities until December 31, 2024, while hospital-at-home waivers received incremental renewals: a two-year extension in 2022, followed by 90-day and subsequent bridges to September 30, 2025. Industry stakeholders, including the American Medical Association and American Telemedicine Association, advocated vigorously for permanence, citing demographic trends such as population aging and persistent rural-urban disparities in care delivery. - Employees Can Sue for Even Technical ICRAA Disclosure Violationson February 5, 2026 at 10:38 AM
In June 2018, Tina Parsonage applied for a sales associate position at Wal-Mart. She accepted a conditional offer of employment, subject to passing a background check. As part of the process, she electronically acknowledged a "Background Report Disclosure" and signed a "Background Report Authorization" form. The disclosure document was 14 pages long, with the California-specific section starting on page 9.
This section informed her that Wal-Mart would obtain an investigative consumer report, which could include details about her character, reputation, personal characteristics, and mode of living. However, instead of identifying a single investigative consumer reporting agency, it listed six possible agencies, along with their addresses, websites, and phone numbers. It instructed her to call Wal-Mart Global Security to determine which one was used. The document also summarized relevant provisions of the Investigative Consumer Reporting Agencies Act (ICRAA, Civ. Code § 1786 et seq.), but Parsonage later alleged it violated ICRAA by not being a standalone disclosure, failing to clearly identify the specific agency, omitting a checkbox to request a copy of the report, and lacking proper certification to the agency.
Wal-Mart obtained the report from First Advantage Background Services Corp., one of the listed agencies, and mailed Parsonage a copy with a cover letter identifying the agency. Despite the alleged violations, Parsonage passed the check and began employment on June 15, 2018. In September 2021, she filed a lawsuit against Wal-Mart in San Diego Superior Court, asserting a single cause of action for ICRAA violations.
She claimed the disclosure was not clear and conspicuous, not standalone, and otherwise noncompliant. Parsonage sought statutory damages of $10,000 per violation (or actual damages if greater), attorney fees, costs, and punitive damages. She did not initially allege specific harm but later claimed the report contained inaccuracies (e.g., misstating offenses as involving a commercial vehicle, which could imply work-related misconduct), depriving her of the chance to correct them easily and potentially risking future job denials.
Wal-Mart moved for summary judgment solely on the ground that Parsonage lacked standing under ICRAA, arguing her claims involved mere "technical violations" without any concrete injury or harm, such as an adverse employment action. The trial court agreed, granting summary judgment in Wal-Mart's favor. It reasoned that Parsonage suffered no injury because she was hired, received the report she authorized, and faced no adverse consequences from any inaccuracies. The court dismissed her concerns about potential lost opportunities as speculative and unmaterialized, emphasizing the absence of harm to her interest in a fair and accurate report.
The Court of Appeal reversed the trial court's judgment in the published case of Parsonage v. Wal-Mart Associates -D083831 (February 2026). It directed the trial court to vacate its order granting summary judgment to Wal-Mart, allowing Parsonage's claim to proceed.
The appellate court held that ICRAA confers standing based solely on a violation of its requirements, without needing to show concrete injury or actual damages beyond the statutory breach. This conclusion stemmed from the statute's plain language in Civil Code § 1786.50, which makes an employer or agency liable for failing to comply with any ICRAA provision regarding an investigative consumer report, allowing recovery of "[a]ny actual damages... or... ten thousand dollars ($10,000), whichever sum is greater." The court interpreted this as authorizing the $10,000 sum as a remedy for the violation itself, emphasizing that California law - unlike federal Article III requirements - permits the Legislature to grant standing for statutory violations absent concrete harm, treating such breaches as invasions of legally protected interests.
The court distinguished California standing from federal "injury-in-fact" mandates, noting that ICRAA's legislative history supports this view: enacted in 1975 to address shortcomings in the federal Fair Credit Reporting Act (FCRA) and prior state laws, ICRAA aimed to ensure stringent notice, consent, and accuracy in consumer reports for employment purposes, protecting privacy and enabling corrections. Amendments increasing the minimum recovery from $300 to $10,000 were intended to incentivize compliance and deter violations, not to compensate for proven harm. Comparisons to sister statutes like the Consumer Credit Reporting Agencies Act (CCRAA) and FCRA highlighted ICRAA's unique structure, which omits qualifiers like "damages as a result of" and focuses on noncompliance.
The court rejected Wal-Mart's reliance on cases like Limon v. Circle K Stores Inc 84 Cal.App.5th 671 (2022) 300 Cal.Rptr.3d 572, and Muha v. Experian Information Solutions Inc.,106 Cal.App.5th 199 (2024) 326 Cal. Rptr. 3d 622 which required injury for FCRA/ICRAA standing in state court under a "beneficial interest" test (akin to federal injury-in-fact). It found this test inapplicable beyond writ of mandate contexts and inconsistent with ICRAA's deterrent purpose. Since Parsonage alleged violations (e.g., non-standalone disclosure obscuring the agency), she had standing; Wal-Mart's motion addressed only standing, not merits, warranting reversal.
- FTC v Express Scripts Litigation Settlement Should Lower Drug Priceson February 5, 2026 at 10:38 AM
The Federal Trade Commission secured what it claims is "a landmark settlement" with one of the nation’s largest pharmacy benefit managers (“PBMs”), Express Scripts, Inc., and its affiliated entities (collectively “ESI”). The settlement requires ESI to adopt fundamental changes to its business practices that increase transparency, are expected to drive down patients’ out-of-pocket costs for drugs like insulin by up to $7 billion over 10 years, bring millions of dollars in new revenue to community pharmacies each year, and advance key healthcare priorities.
The FTC’s settlement resolves the Commission’s lawsuit against ESI, which alleges that ESI artificially inflated the list price of insulin drugs by using anticompetitive and unfair rebating practices, and impaired patients’ access to lower list price products, ultimately shifting the cost of high insulin list prices to vulnerable patients.
https://news.workcompacademy.com/2026/Parsonage-v-Wal-Mart-Associates-D083831.PDF. The complaint alleges that this system pushed insulin manufacturers, among others, to compete for preferred formulary coverage based on the size of rebates off the list price rather than net price, which ultimately benefitted the PBMs, including ESI, which keep a portion of the inflated rebates. According to the FTC’s complaint, the inflated list prices hurt patients whose out-of-pocket payments like copays and coinsurance are tied to the list price of the drug.
ESI, under the FTC’s proposed consent order, has agreed to:
- - Stop preferring on its standard formularies high wholesale acquisition cost versions of a drug over identical low wholesale acquisition cost versions;
- - Provide a standard offering to its plan sponsors that ensures that members’ out-of-pocket expenses will be based on the drug’s net cost, rather than its artificially inflated list price;
- - Provide covered access to TrumpRx as part of its standard offering upon relevant legal and regulatory changes;
- - Provide full access to its Patient Assurance Program’s insulin benefits to all members when a plan sponsor adopts a formulary that includes an insulin product covered by the Patient Assurance Program unless the plan sponsor opts out in writing;
- - Provide a standard offering to all plan sponsors that allows the plan sponsor to transition off rebate guarantees and spread pricing;
- - Delink drug manufacturers’ compensation to ESI from list prices as part of its standard offering;
- - Increase transparency for plan sponsors, including with mandatory, drug-level reporting, providing data to permit compliance with the Transparency in Coverage regulations, and disclosing payments to brokers representing plan sponsors;
- - Transition its standard offering to retail community pharmacies to a more transparent and fairer model based on the actual acquisition cost for a drug product plus a dispensing fee and additional compensation for non-dispensing services;
- - Promote the standard offerings to plan sponsors and retail community pharmacies; and
- - Reshore its group purchasing organization Ascent from Switzerland to the United States, which will bring back to the United States more than $750 billion in purchasing activity over the duration of the order.
The Commission vote to accept the consent agreement for public comment was 1-0, with Commissioner Meador recused.
The public will have 30 days to submit comments on the proposed consent agreement package. Instructions for filing comments appear on the docket. Once processed, they will be posted on Regulations.gov.