Based upon a stipulated Award of May 27, 2015 it was found that while employed on December 19, 2013 as a tower technician by Pearce Services Inc., Andres Hernandez sustained industrial injury to the left knee causing temporary disability from June 23, 2014 to July 6, 2014, permanent disability of 14%, and the need for further medical treatment. On August 13, 2015, defendant sent applicant a notice that permanent disability payments were ending because the full amount of the stipulated Award had been paid. The notice sent contained all the information required by Administrative Rule 9812(d). (Cal. Code Regs., tit. 8, § 9812, subd. (d).) Applicant apparently continued to be provided medical care for his injury on an industrial basis and underwent surgery on October 30, 2018. Defendant reinitiated temporary disability benefits commencing November 3, 2018. On November 14, 2018, defendant sent a notice of resumed temporary disability benefit payments pursuant to Administrative Rule 9812(b) (Cal. Code Regs., tit. 8, § 9812, subd. (b)). Defendant then determined that applicant was entitled to temporary disability benefits at a higher rate pursuant to Labor Code section 4661.5 and sent the appropriate notice on November 28, 2018 pursuant to Administrative Rule 9812(c) (Cal. Code Regs., tit. 8, § 9812, subd. (c).) On December 17, 2018, defendant sent applicant a notice that temporary disability benefits were ending pursuant to Labor Code section 4656(c)(2) which states that, save exceptions not applicable to the current case, temporary disability indemnity is payable only within five years of the date of injury. Defendant sent applicant a notice that complied with Administrative Rule 9812(d) (Cal. Code Regs., tit. 8, § 9812, subd. (d).) Additionally, along with the notice that temporary disability was ending, defendant sent a notice pursuant to Administrative Rule 9812(e) (Cal. Code Regs., tit. 8, § 9812, subd. (e)) that applicant’s condition was not yet permanent and stationary and that: "[I]t is too soon to tell if you will have any permanent disability from your injury. I will be checking with your doctor until your condition is permanent and stationary. At that time, your doctor will determine whether you have any permanent disability and if there will be a need for future medical care. I expect to have my information by 3/16/19. I will notify you of the status of permanent disability at that time." On February 19, 2019, Hernandez filed a Petition to Reopen alleging that he underwent surgery of his left knee in October of 2018 and that his condition had significantly worsened since the issuance of the stipulated Award. On December 23, 2019 the WCJ found that Hernandez’s Petition to Reopen was barred by the five-year statute of limitations contained in Labor Code section 5410. After filing a Petition for Reconsideration, the WCAB affirmed the WCJ's decision in the case of Hernandez v Pearce Services Inc. -ADJ9972218 (May 2025). Applicant argues that that the statute of limitations should be tolled because he was “misled” by defendant’s claims examiner into not timely filing a petition to reopen. In other contexts, the mere furnishing of benefits without an unequivocal denial in and of itself tolls the statute of limitations. For instance in McDaniel v. Workers’ Comp. Appeals Bd. (1990) 218 Cal.App.3d 1011 [55 Cal.Comp.Cases 72], the Court of Appeal held that when a defendant provides medical treatment benefits knowing of a potential claim for workers’ compensation benefits, the provision of treatment tolls the one-year limitation period of Labor Code section 5405(c) and triggers the five year period of Labor Code section 5410, running from the date of injury. Only after an explicit unequivocal denial of liability does the statute revert to one year from the denial. The WCAB noted however that "while McDaniel and similar cases find that the mere furnishing of benefits tolls the one-year statute of limitations found in Labor Code section 5405 for the initial claim of benefits, these claims still remain subject to the five-year statute found in section 5410. While the liberal rules of pleading and construction of the workers’ compensation system militate in favor of tolling of the one-year statute, once five years from the date of injury has elapsed the initial interest favoring an injured worker’s right to present their case on the merits must also be balanced against the interest in finality." "As the Supreme Court explained in Nickelsberg v. Workers’ Comp. Appeals Bd. (1991) 54 Cal.3d 288, 299 [56 Cal.Comp.Cases 476], section 5410 does 'not express a mere concern for barring stale claims. The statute[] express[es] legislative concern for certainty and finality in the determination of compensation benefit obligations.' " "Here, there was no legal obligation to inform applicant of the upcoming five-year statute, and, in any case, there was no evidence that the claims representative intentionally withheld this information. Defendant merely paid the legally required benefits and provided the legally required notices." ...

The Travelers Companies, Inc., one of the country’s largest workers compensation insurers, just published its 2025 Injury Impact Report, which compared workers compensation data from the five years leading up to the COVID-19 pandemic with the next five years. The analysis of more than 2.6 million claims submitted during that time found that while the number of workplace injuries overall continues to decline, the costs associated with them are climbing. “Over the past decade, we’ve seen three trends intensify: increasing retirement ages, ongoing employee turnover and longer injury recovery times,” said Rich Ives, Senior Vice President of Business Insurance Claim at Travelers. “Our aim with this report is to provide employers with insights on these dynamics that are contributing to growing claim severity so they can better navigate these workforce challenges, protect their employees and keep their businesses running.” The report found that the frequency of workplace injuries overall has declined over the past decade. Travelers examined 1.2 million workers compensation claims received during the past five years, down from 1.4 million from 2015 through 2019. There were many shifts in the workplace over the last 10 years, including continued job churn during and after the pandemic. This created a steady stream of new employees, who are among the most vulnerable to injury. The report found that employees in their first year on the job accounted for approximately 36% of injuries and 34% of overall claim costs during the last five years. This is an increase from the prior five years, when 34% of injuries and 32% of overall claim costs were attributed to new employees. The U.S. Bureau of Labor Statistics projects that by 2033, approximately 24% of employees will be age 55 or older – up from 15% in 2003. Travelers has seen the volume of claims involving older employees rise in line with this shift. During the past five years, employees aged 50 or older made up 41% of the injured employee population, and those 60 and above represented 16%. This is up from 39% and 13%, respectively, when compared with data from 2015 through 2019. This trend is significant because older employees – while typically injured less frequently than their younger counterparts – tend to require longer recovery times and have more costly claims. From 2020 through 2024, employees missed an average of 80 workdays per injury – an increase of more than seven days when compared with the previous five-year period. Injured employees aged 60 and above were out of work due to workplace injuries for nearly 97 days, almost 17 more days than the overall average and an increase of 14 days from pre-pandemic years. With proper precautions, many workplace injuries can be prevented. Travelers Workforce Advantage® is the company’s comprehensive approach to helping businesses manage employee safety by focusing on three key areas: - - Onboarding and training employees to establish safe work practices. - - Creating a culture of safety by supporting and engaging employees. - - Managing workplace accidents and injuries through the Travelers Corridor of Care® post-injury management process. “By examining claim data, which includes information such as injury frequency, severity and causes, we can provide guidance to employers across multiple industries to anticipate future risks and implement preventive strategies,” said Chris Hayes, Assistant Vice President of Workers Compensation and Transportation, Risk Control, at Travelers. “Taking these steps can help employees feel valued and supported, which is key to maintaining a motivated, safe and healthy workforce.” Additional findings from the 2025 Injury Impact Report can be found at Travelers.com/InjuryImpactReport. For best practices on creating safer workspaces, visit the Workplace Safety Resources page on the company’s website ...

The Presiding Judge of the Los Angeles Office of the WCAB issued a notice early this week that he "just received word from our DIR safety and security detail that the WCAB Los Angeles District Office will be closed the remainder of this week due to the civil unrest that has been occurring for the last five days." The announcement went on to say that in person hearings will proceed using the Court Call platform. This office of the WCAB is located in the downtown Los Angeles area in close proximity to the federal buildings which are the center of attention of civil unrest related to protests over recent Immigration and Customs Enforcement (ICE) activity in the County and City of Los Angeles. ICE is a federal law enforcement agency under the U.S. Department of Homeland Security. Its primary mission is to enforce immigration laws and customs regulations in the United States. On November 19, 2024, the Los Angeles City Council unanimously passed a sanctuary city ordinance (13-0 vote, with two council members absent) that prohibits the use of city resources, property, or personnel for federal immigration enforcement. This ordinance codifies protections for immigrants into municipal law, including barring city employees from inquiring about or sharing information on immigration status and prohibiting cooperation with federal immigration agents unless required by state law. It was signed into effect by Mayor Karen Bass and went into effect within 10 days due to an urgency clause. A revised version of the ordinance, approved on December 4, 2024, included exceptions for cases involving individuals convicted of serious felony crimes, allowing limited cooperation with federal authorities in such instances. The County of Los Angeles has not formally declared itself a "sanctuary county" through a specific ordinance or resolution, unlike the City of Los Angeles. However, it is listed by the Department of Homeland Security (DHS) as a "sanctuary jurisdiction" due to policies that limit cooperation with federal immigration enforcement. These policies align with California’s Senate Bill 54 (SB 54), the California Values Act of 2017, which restricts local and state agencies from cooperating with Immigration and Customs Enforcement (ICE) on immigration enforcement for individuals who have committed misdemeanors. The current Los Angeles protests, which began on June 6, 2025, have included demands for the release of ICE detainees held in downtown Los Angeles, particularly at the Metropolitan Detention Center and the Edward R. Roybal Federal Building. Hundreds of protesters have rallied outside these federal facilities, condemning the ICE raids that resulted in at least 44 arrests across the city on June 6. Demonstrators, including community organizers and families of detainees, have specifically called for the release of those detained, such as Service Employees International Union (SEIU) California President David Huerta, who was arrested during the raids. Protests have involved blocking entrances to federal buildings and clashing with law enforcement, leading to the deployment of tear gas, flash-bang grenades, and less-lethal munitions by federal agents and the Los Angeles Police Department (LAPD). Now a political turf war has been launched after President Trump issued a Memorandum on June 7, 2025 “call[ing] into Federal service members and units of the National Guard.” Secretary of Defense Hegseth, in turn, issued a Memorandum (DOD Order) that same day to the Adjutant General of California, ordering 2,000 California National Guard members into federal service. And on June 9, 2025, Secretary Hegseth issued another Memorandum (June 9 DOD Order) ordering an additional 2,000 California National Guard members into federal service. This federal activity was based upon presidential authority created by federal law 10 U.S.C. §12406 which provides in part that whenever "(2) there is a rebellion or danger of a rebellion against the authority of the Government of the United States; or (3) the President is unable with the regular forces to execute the laws of the United States;" .... "the President may call into Federal service members and units of the National Guard of any State in such numbers as he considers necessary to repel the invasion, suppress the rebacllion, or execute those laws. Orders for these purposes shall be issued through the governors of the States.." In response, on June 9th Governor Newsome filed case 3:25-cv-04870 in United States District Court for the Northern District of California alleging that 10 U.S.C. §12406 does not authorize President Trump to call the National Guard into Federal service unless the "State requests or consents to federal control." In this case the lawsuit asserts that Governor Gavin Newsom did not request or consent to the federal control of the State National Guard. Concurrently he filed an Ex-Parte Motion for a Temporary Restraining Order against Pete Hegseth, in his official capacity as Secretary of the Department of Defense, and the United States Department of Defense from taking any of the actions described in Plaintiffs’ contemporaneously-filed Proposed Order and Order to Show Cause. According the the Docket, responses to the request for a TRO are due by 6/11/2025, and replies are due by 6/12/2025. The Motion Hearing is set for 6/12/2025 at 1:30 PM in San Francisco, Courtroom 06, 17th Floor, and by videoconference (Zoom Webinar) before Judge Charles R. Breyer. All counsel, members of the public, and media may access the webinar information at https://www.cand.uscourts.gov/crb. Zoom guidance and setup can be found at https://www.cand.uscourts.gov/zoom/ ...

Only one out of every 21 California workers’ compensation COVID-19 claims from accident years (AY) 2020-2022 involved medical treatment beyond 90 days from the injury date, but that small number of “Long COVID” cases consumed 82.1% of the treatment payments on COVID claims and 73.7% of all COVID claim payments according to a new California Workers’ Compensation Institute (CWCI) study. While the number of new COVID claims in California workers’ compensation has gone from a flood shortly after Governor Newsom declared a COVID-19 state of emergency in March 2020 to a trickle over the last year, the new study comes amid growing concern about a potential COVID surge after the CDC adopted new guidelines that may make it more difficult to obtain COVID-19 vaccines just as the summer travel season hits and the new NB.18.1 COVID variant has been detected in multiple locations around the U.S. The study, based on a review of 126,397 insured and self-insured COVID-19 claims found that most were relatively inexpensive due to little to no medical intervention (only 14.6% involved medical treatment), but 4.7% – or nearly 6,000 of them – were Long COVID claims that involved long-term medical conditions that impeded or prevented the claimants from returning to their jobs and resulted in significant costs. Medical payments for the COVID-19 claims in the study sample totaled $128.4 million, with Long COVID claims accounting for $105.5 million, or 82.1%; while total payments on the COVID-19 claims, including medical treatment, indemnity costs, and expenses, were $350.6 million, with Long COVID claims consuming $258.3 million, or 73.7%. Overall, average medical payments were 105 times higher on Long COVID cases than on shorter duration COVID claims, and average indemnity payments were 37 times higher. Long COVID claim payments were significantly higher regardless of the body part involved, though the difference was most pronounced for injuries involving the lungs, multiple body parts, and “other” body parts. The top 10 diagnostic categories for Long COVID claims encompassed a wide range of organ systems, including respiratory (17.8%); circulatory (9.0%); nervous (8.7%); connective, soft tissue and bone disorders (5.2%); endocrine systems (4.9%); as well as mental health (4.4%), and digestive conditions (3.4%). Together the top 10 diagnostic categories associated with the Long COVID claims in the study sample accounted for 80.3% of all the diagnoses on these claims, highlighting the multisystem nature of Long COVID. The Institute has included more details and graphics from the study in a report, Long COVID-19 Claim Characteristics and Treatment in California Workers’ Compensation. CWCI members and subscribers can log on to www.cwci.org to access the report under the Research tab on the home page, others can purchase a copy from CWCI’s online Store ...

Monroe Operations, LLC, doing business as Newport Healthcare is a nationwide behavioral healthcare company which provides therapy for individuals with mental health issues. It has residential treatment facilities across the country including in California, Utah, Minnesota, Connecticut, and Washington. Prior to starting her employment at Newport Healthcare, Karla Velarde worked as a customer service agent for Air Tahiti. However, she was laid off in March 2020 due to the COVID-19 pandemic. She was unemployed for nine months until Newport Healthcare agreed to hire her as a care coordinator. Newport Healthcare required Velarde to attend an orientation scheduled for her first day of work. Upon arriving at Newport Healthcare’s office, Velarde was escorted to a large conference room where she waited until an HR manager arrived. The HR manager presented Velarde with “a stack of [31] documents and told [her she] was required to complete the forms before [she] could start working.” The HR manager told her, ‘“we gotta get through [these to] get you onboard. We’ll try to get through them as fast as possible.”’ Velarde “felt pressured to fill out the forms quickly, since [the HR manager] was waiting for [her] . . . .” One of the documents was an arbitration agreement, which Velarde refused to sign because she “did not understand what it was.” Velarde told the HR manager that because she did not understand what it was, she did not feel comfortable signing it. The HR manager told her, “‘if there are ever any issues, [the arbitration agreement] will allow us to resolve them for you.”’ Velarde asked if she needed to sign the agreement in order to start working. The HR manager responded, ‘“Yes. This will help us resolve any issues without having to pay lawyers.”’ Velarde executed the agreement because she “knew that [she] had to sign it to begin working . . . .” Newport Healthcare later terminated Velarde’s employment. Velarde filed a lawsuit alleging, among other things, discrimination, retaliation, and violation of whistleblower protections against Newport Healthcare and its director of residential services, Amanda Seymour. Defendants filed a motion to compel arbitration which the trial court denied. The trial court ruled Newport Healthcare pressured Velarde to sign the agreement, which she did not want to do, and the agreement unlawfully prohibited Velarde from seeking judicial review of an arbitration award. On appeal, Appellants take issue with the trial court interpreting the agreement in a manner which bars judicial review of an arbitration award. The Court of Appeal affirmed the trial court denial of the motion to compel arbitration in the published case of Velarde v. Monroe Operations, CA4/3 - G063626 - (June 2025). “Procedural unconscionability ‘addresses the circumstances of contract negotiation and formation, focusing on oppression or surprise due to unequal bargaining power.’” (Ramirez v. Charter Communications, Inc. (2024) 16 Cal.5th 478, 492.) “This element is generally established by showing the agreement is a contract of adhesion, i.e., a ‘standardized contract which, imposed and drafted by the party of superior bargaining strength, relegates to the subscribing party only the opportunity to adhere to the contract or reject it.’” (Ibid.) “Substantive unconscionability looks beyond the circumstances of contract formation and considers ‘the fairness of an agreement’s actual terms’ [citation], focusing on whether the contract will create unfair or one-sided results [citation].” (Ramirez, supra, 16 Cal.5th at p. 493.) Substantively “[u]nconscionable terms “‘impair the integrity of the bargaining process or otherwise contravene the public interest or public policy”’ or attempt to impermissibly alter fundamental legal duties. [Citation.] They may include fine-print terms, unreasonably or unexpectedly harsh terms regarding price or other central aspects of the transaction, and terms that undermine the nondrafting party’s reasonable expectations.” (OTO, L.L.C. v. Kho (2019) 8 Cal.5th 111, 130 (OTO).) After a review of the record, the Court of Appeal noted that there "was extensive evidence of procedural unconscionability, with an adhesive contract, buried in a stack of 31 documents to be signed as quickly as possible while a human resources (HR) manager waited, before Velarde could start work that same day. "Most problematically, in response to Velarde’s statements that she was uncomfortable signing the arbitration agreement as she did not understand it, false representations were made by Newport Healthcare’s HR manager to Velarde about the nature and terms of the agreement." "These representations, which specifically and directly contradicted the written terms of the agreement, rendered aspects of the agreement substantively unconscionable. These procedural and substantively unconscionable aspects, taken together, render the agreement unenforceable." ...

A federal grand jury returned a six-count indictment charging Jessa Zayas, 34, of Santa Clarita, with health care fraud and aggravated identity theft for submitting millions of dollars in of fraudulent claims for hospice care to Medicare. Hospice is a type of care and support for terminally ill patients. Medicare is a federal health insurance program that covers certain hospice expenses. Generally, a patient must be certified as being terminally ill to qualify for hospice care payments under Medicare. According to court records, Zayas was the CEO and owner of Healing Hands Hospice and Humane Love Hospice, which are based in Van Nuys, while also working another full-time job. Zayas caused Healing Hands and Humane Love to fraudulently bill Medicare for hospice care supposedly provided to over 100 people who were not in fact terminally ill. Zayas knew these individuals were not terminally ill as was represented to Medicare, and that they therefore were ineligible for the Medicare hospice payments. The total amount of fraudulent Medicare billings caused by Zayas from June 2023 through May 2025 was at least $2,500,000. Zayas and others obtained personal Medicare information for the supposed hospice patients by going to retirement homes in Fresno and Kern Counties. To avoid detection, they made these visits after hours when most of the retirement residences’ managers were gone for the day. Zayas and others knocked on the patients’ doors and asked them for their information so that they could enroll them in hospice. Zayas then caused the Medicare claims to be submitted with false representations about terminal illness and submitted forged doctor’s certifications when Medicare asked for supporting documentation. The Medicare payments were deposited into banks accounts that Zayas controlled. The FBI and HHS OIG arrested Zayas and executed a search warrant at her home last week. Among other evidence, the FBI seized $77,000 in cash that Zayas had hidden in boxes underneath her bed. This case is the product of an investigation by the FBI and HHS OIG. Assistant United States Attorneys Joseph Barton and Brittany Gunter are prosecuting the case. If convicted, Zayas faces a maximum term of 10 years in prison and a $250,000 fine for the health care fraud charge. She also faces an additional mandatory two years in prison for the aggravated identity theft charge, consecutive to any other sentence. Any sentence, however, would be determined at the discretion of the court after consideration of any applicable statutory factors and the Federal Sentencing Guidelines, which take into account a number of variables. The charges are only allegations. Zayas is presumed innocent until and unless proven guilty beyond a reasonable doubt ...

Marlean Ames, a heterosexual woman employed by the Ohio Department of Youth Services, applied for a management position in 2019 but was denied in favor of a lesbian candidate. She was subsequently demoted from her program administrator role to a lower-paying secretarial position, which was then filled by a gay man. Ames filed a lawsuit under Title VII, alleging discrimination based on her sexual orientation. The District Court granted summary judgment to the agency, citing Sixth Circuit precedent requiring majority-group plaintiffs (like heterosexuals) to show "background circumstances" indicating discrimination against the majority. The Sixth Circuit affirmed, reinforcing a circuit split on whether majority-group plaintiffs face a higher evidentiary burden under the McDonnell Douglas framework. In the unanimous decision in Ames v Ohio Department of Youth Services - 23-1039 - (June 2025), the United State Supreme Court vacated the Sixth Circuit’s judgment and remanded the case, holding that Title VII does not impose a heightened evidentiary standard on majority-group plaintiffs. The "background circumstances" rule, which required majority-group plaintiffs to provide additional evidence suggesting that the employer discriminates against the majority, was deemed inconsistent with Title VII’s text and Supreme Court precedents. Ohio conceded that Title VII imposes the same standard for all plaintiffs but argued the "background circumstances" rule was not a heightened burden. The Court rejected this, noting the Sixth Circuit explicitly applied a higher standard to Ames because of her heterosexual status. The Court emphasized that Title VII prohibits discrimination against "any individual" based on protected characteristics (race, color, religion, sex, or national origin), without distinguishing between majority and minority groups. The statute’s focus is on individual protection, not group status (citing Bostock v. Clayton County 140 S.Ct. 1731 (2020) 590 U.S. 644). Prior cases, such as Griggs v. Duke Power Co. 401 U.S. 424 (1971) and McDonald v. Santa Fe Trail Transportation Co., 427 U.S. 273 (1976) confirm that Title VII applies equally to all individuals, regardless of majority or minority status. The "background circumstances" rule violated this principle by imposing a higher burden on majority-group plaintiffs. The Court reiterated that the McDonnell Douglas framework is a flexible, burden-shifting tool to evaluate disparate-treatment claims based on circumstantial evidence. The prima facie burden is not onerous, and the Sixth Circuit’s additional requirement for majority-group plaintiffs was an inflexible and improper deviation. Justice Thomas agreed with the majority but wrote separately to criticize judge-made doctrines like the "background circumstances" rule and the McDonnell Douglas framework itself. He argued that the "background circumstances" rule lacks textual basis in Title VII, distorts the statute by imposing unequal burdens, and is unworkable due to the difficulty of defining "majority" status (e.g., by race, sex, or religion) in varying contexts. Thomas expressed skepticism about the McDonnell Douglas framework’s applicability at the summary judgment stage, noting its lack of textual grounding, incompatibility with Federal Rule of Civil Procedure 56, failure to capture all ways to prove discrimination (e.g., mixed-motive cases), and tendency to cause judicial confusion. He suggested the Court reconsider its use in a future case. The decision eliminates a circuit split, clarifying that Title VII’s protections apply uniformly to all plaintiffs, regardless of majority or minority status, and reinforces the statute’s focus on individual discrimination. It also signals potential future scrutiny of the McDonnell Douglas framework itself ...

Philip Yen, M.D. has agreed to pay the United States $125,000 to resolve allegations that he failed to comply with federal statutory requirements related to his role as the Drug Enforcement Administration registrant at Sutter Imaging Capitol Pavilion, Acting U.S. Attorney Michele Beckwith announced today. Dr. Yen is a radiologist employed by Sutter Medical Group. From 2018 to 2024, he was the DEA registrant at Capitol Pavilion, which is located at 2725 Capitol Avenue, next to Sutter Medical Center, in Sacramento. As the registrant, Dr. Yen was required by the Controlled Substances Act to keep detailed records related to Capitol Pavilion’s receipt and dispensing of controlled substances, to ensure that controlled substances including opioids and other addictive and dangerous drugs were maintained, recorded, and documented properly in order to prevent their diversion. An inspection conducted in 2022 of controlled substance records at Capitol Pavilion identified multiple recordkeeping violations at the facility. Other evidence developed that Dr. Yen was not adequately trained regarding the role and responsibilities of a DEA registrant, and that Sutter staff was aware of the risk of diversion of controlled substances from Capitol Pavilion. In addition to paying civil monetary penalties, Dr. Yen has agreed to complete comprehensive training on his obligations under the CSA as a registrant, including recordkeeping requirements and effective controls against theft and diversion. “Healthcare facilities and their employees are entrusted to handle dangerous drugs with care,” said Acting US Attorney Beckwith. “Compliance with the CSA and its recordkeeping requirements is critical to preventing diversion and protecting the public.” “Controlled substance recordkeeping requirements are an essential line of defense against prescription drug diversion. Every dose must be accounted for to prevent misuse and save lives,” said DEA Special Agent in Charge Bob P. Beris. “The DEA will continue to pursue healthcare providers who are not in compliance with mandatory regulations.” The investigation was conducted by the DEA Tactical Diversion Squad. Assistant U.S. Attorney Emilia P. E. Morris handled the case for the United States. The claims resolved by this settlement are allegations only, and there has been no determination of liability ...

Hector Gutierrez began working as a school janitor and maintenance worker in August 2011 at Inglewood Middle School Academy. The school operated under the control of Inner City Education Foundation (ICEF). On February 14, 2012, at the end of the school day, Gutierrez walked to the school’s front office, where school employees had gathered and were laughing. The principal angrily approached plaintiff and, “out of nowhere,” violently kicked him in the groin, causing plaintiff to bend over in “agony.” Several employees saw the incident and laughed. Plaintiff suffered severe pain and emotional distress and has been unable to work since the injury. His last day of work due to the injury was June 29, 2012. Later, Gutierrez filed three separate worker’s compensation claims with the Workers’ Compensation Appeals Board. Two of those claims - one with an injury date of February 14, 2022, and another filed January 12, 2023 - related to injuries he allegedly sustained from the kick to the groin. As to the January 2023 claim, Gutierrez alleged, “In retrospect beginning 3 weeks or so later after the kick applicant believes depression and other factors caused by the assault unbeknownst to him has caused him to become morbidly obese.” On January 10, 2023, Gutierrez (in pro. per.) sued ICEF for general negligence, intentional tort, and sexual assault and battery based on injuries he allegedly sustained from the principal’s kick to his groin almost 11 years earlier. ICEF demurred on the following grounds: (1) the Worker’s Compensation Appeals Board had exclusive jurisdiction over plaintiff’s injury claims; (2) worker’s compensation was plaintiff’s exclusive remedy; and (3) plaintiff’s claims were time barred. Plaintiff did not file an opposition. On April 18, 2023, the court sustained ICEF’s demurrer with leave to amend. Plaintiff filed his FAC on May 9, 2023. He again pleaded the same causes of action, except for “intentional tort,” and added causes of action - without the court’s permission - for negligent and intentional infliction of emotional distress, as well “malice.” ICEF demurred on the same grounds as before and argued the new causes of action were time-barred, insufficiently pleaded, or weren’t causes of action at all. The court sustained ICEF’s demurrer without leave to amend. The court found plaintiff’s claims were barred by the statute of limitations and the FAC’s allegations were insufficient to state a cause of action. The court also noted plaintiff failed to allege sufficient facts to support an exception to worker’s compensation exclusivity. After judgment had been entered, on September 27, 2023, plaintiff moved for reconsideration. Plaintiff accused ICEF’s attorneys of fraud and of having “bamboozled” the court into believing counsel had agreed to give plaintiff more time to respond to discovery, not to a continuance of the demurrer hearing. Plaintiff argued “[d]efendants” violated his due process rights. The court denied plaintiff’s motion for reconsideration. Plaintiff appealed the judgment of dismissal on the grounds he was denied his federal constitutional rights to due process and of access to the courts under the Fourteenth and First Amendments, respectively. The Court of Appeal affirmed the trial court in the unpublished case of Gutierrez v Inner City Education Foundation CA2/3 - B333337 - (June 2025) The Court of Appeal noted it reviewed the record and found no error. "The record shows plaintiff received adequate, effective, and meaningful access to the court. After ICEF demurred to plaintiff’s initial complaint, he had an opportunity to file his FAC. At plaintiff’s request, the court continued the hearing on ICEF’s demurrer to the FAC from July to August 2023 due to plaintiff’s medical emergency. Before ruling on ICEF’s demurrer, the court considered the written response plaintiff filed, even though he filed the response late and did not appear at the hearing. (Code Civ. Proc., § 1005, subd. (b) [opposition papers must be filed nine court days before the hearing].)8 Indeed, the court explained in detail plaintiff’s position in its ruling." "Nor did plaintiff demonstrate he did not receive due process under the Fourteenth Amendment." ... "Accordingly, plaintiff has failed to meet his burden on appeal to demonstrate the court erred in sustaining ICEF’s demurrer to his FAC or that it abused its discretion in denying plaintiff leave to amend the FAC." ...

The owner and operator of two West Covina hospices was arrested on a 14-count federal grand jury indictment alleging she filed more than $4.8 million in false and fraudulent claims to Medicare – which paid more than $3.8 million on those claims – for medically unnecessary services for people not terminally ill and for paying kickbacks to marketers to procure patients. Normita Sierra, 71, a.k.a. “Normie,” of West Covina, is charged with nine counts of health care fraud, one count of conspiracy, and four counts of illegal remuneration for health care referrals. Also arrested was Rowena Elegado, 55, a.k.a. “Weng,” also of West Covina, who is charged with one count of conspiracy, and four counts of illegal remuneration for health care referrals. Both defendants are expected to make their initial appearances and be arraigned in United States District Court in downtown Los Angeles. According to the indictment, Sierra owned and operated Golden Meadows Hospice Inc., and D’Alexandria Hospice Inc., which billed Medicare for hospice services for patients who were not terminally ill during a scheme that lasted from September 2018 to October 2022. Sierra and Elegado allegedly worked together to pay marketers to recruit patients to the hospices, knowing that most of those patients had not been referred by their primary care physicians for such services. Those kickbacks, often referred to internally using the code words “girl scout cookies,” amounted to as much as $1,300 per patient, per month that the patient stayed on hospice service. Others involved in the scheme included Carl Bernardo, 53, of Chino, who pleaded guilty in September 2024 to one count of receiving kickbacks in connection with a federal health care program and is scheduled to be sentenced on October 23. Relyndo Salcedo, 60, of Fontana, a nurse practitioner involved in the scheme, pleaded guilty on May 22 to one count of health care fraud and is scheduled for sentencing on November 20. Salcedo, a nurse practitioner, conducted initial assessments for the hospice and found many of the patients ineligible for hospice. But, under pressure from Sierra, who made the ultimate enrollment decisions even though she wasn’t a medical professional, and marketers such as Bernardo, Salcedo exaggerated and falsified the patients’ conditions to make them seem terminally ill. Hospice physicians then relied on Salcedo’s records to certify the patients as hospice appropriate. Once enrolled, those patients – who were not in fact terminally ill – rarely died, and instead were often discharged at around six months at Sierra’s direction, sometimes to her home health company or the other hospice company. During the scheme, Golden Meadows submitted at least approximately $3,870,642 in fraudulent claims, on which Medicare paid approximately $2,912,187. D’Alexandria submitted approximately $945,647 in fraudulent claims, on which Medicare paid approximately $894,199. An indictment contains allegations that a defendant has committed a crime. Every defendant is presumed innocent until and unless proved guilty beyond a reasonable doubt. If convicted of the charges, Sierra would face a statutory maximum sentence of 10 years in federal prison for each health care fraud count. Sierra and Elegado would face up to five years in federal prison for the conspiracy count and up to 10 years in federal prison for each illegal kickback count. The United States Department of Health and Human Services Office of the Inspector General and the FBI investigated this matter. Assistant United States Attorney Kristen A. Williams of the Major Frauds Section is prosecuting this case ...

Disbarred plaintiffs’ personal injury attorney Thomas Vincent Girardi was sentenced to 87 months in federal prison for leading a years-long scheme in which he embezzled tens of millions of dollars of settlement money that belonged to his clients, some of whom awaited payment for treatment of severe physical injuries. Girardi, 86, formerly of Pasadena and who now resides in Seal Beach, was sentenced by United States District Judge Josephine L. Staton also ordered Girardi to pay a $35,000 fine and $2,310,247 in restitution. Judge Staton ordered Girardi to surrender to federal authorities no later than July 17. Girardi was found guilty by a jury in August 2024 of four counts of wire fraud. A once-powerful figure in California’s legal community, Girardi ran the now-defunct downtown Los Angeles law firm Girardi Keese. For years, Girardi misappropriated and embezzled millions of dollars from client trust accounts at his law firm. The scheme involved defendant Girardi stealing millions of dollars in client settlement funds and failing to pay Girardi Keese clients – some of whom had suffered serious injuries in accidents – the money they were owed. In carrying out his criminal conduct, from October 2010 to late 2020, Girardi operated Girardi Keese like a Ponzi-scheme by providing a litany of lies for failure to pay clients and directing law firm employees, including co-defendant and former Girardi Keese CFO Christopher Kazuo Kamon, to make incremental payments of newly obtained settlement funds to previously defrauded clients or using the new funds to pay other unrelated expenditures. Girardi sent lulling communications to the defrauded clients that, among other things, falsely denied that the settlement proceeds had been paid and falsely claimed that Girardi Keese could not pay the settlement proceeds to clients until certain purported requirements had been met. These bogus requirements included addressing supposed tax obligations, settling bankruptcy claims, obtaining supposedly necessary authorizations from judges, and satisfying other debts. Girardi also diverted tens of millions of dollars from his law firm’s operating account to pay illegitimate expenses, including more than $25 million to pay the expenses of EJ Global, a company formed by his wife related to her entertainment career, as well as spent millions of dollars of Girardi Keese funds on private jet travel, jewelry, luxury cars, and exclusive golf and social clubs. At the end of 2020, as Girardi and his law firm faced mounting legal problems related to his years-long theft of client funds, Girardi Keese was forced into involuntary bankruptcy. The State Bar of California disbarred Girardi in July 2022. Relatedly, co-defendant Kamon, 51, formerly of Encino and Palos Verdes and who was residing in The Bahamas at the time of his November 2022 arrest on a federal criminal complaint, pleaded guilty in October 2024 to two counts of wire fraud. Kamon, the long-time head of the accounting department at Girardi Keese, aided and abetted Girardi’s fraud scheme and embezzled millions of dollars from Girardi Keese itself for his own benefit. On April 11, Kamon was sentenced to 121 months in custody and ordered to pay $8,903,324 in restitution. Kamon has been in federal custody since November 2022. Kamon has agreed to plead guilty to federal fraud charges in Chicago where he is charged along with former Girardi Keese lawyer David R. Lira, Girardi’s son-in-law. Trial in that case is scheduled to start on July 14. Girardi was dismissed from the Chicago case because of his conviction and sentencing in this case. IRS Criminal Investigation and the FBI investigated this matter. The Office of the United States Trustee provided assistance.Assistant United States Attorney Scott Paetty of the Major Frauds Section prosecuted this case ...

A class action lawsuit was filed by Sandy Bell and Martin Gama against Home Depot U.S.A. in 2012 in California state court. The lawsuit alleged that Home Depot violated California labor laws by designing its workday to evade overtime obligations, specifically for employees working overnight shifts. The plaintiffs claimed Home Depot structured its workday (defined as 12 a.m. to 11:59 p.m.) to avoid paying proper overtime wages for shifts crossing midnight. California law requires overtime pay (1.5 times the regular rate) for hours worked beyond 8 in a single workday or 40 in a workweek, and double time for hours exceeding 12 in a workday. By splitting overnight shifts across two calendar days, Home Depot allegedly avoided paying overtime for hours worked past midnight, even if part of a single shift. The case is cited as Bell v. Home Depot U.S.A., Inc., No. 2:12-cv-02499-JAM-CKD, originally filed in Sacramento County Superior Court and later moved to federal court. It was consolidated with Henry v. Home Depot U.S.A., Inc., Case No. 3:14-cv-04858. The class currently includes 20,000 individual Class Members who worked more than eight hours and past midnight. The Bell portion of this action covers the following certified class: All persons who worked for Home Depot in California as a non- exempt, hourly-paid supervisor during the period from August 14, 2009 through June 1, 2016, who worked at least one overnight shift that crossed midnight of more than eight hours, and who, as a result, was not paid overtime for the hours worked over eight hours during such overnight shift. The Henry portion of the action covers the following certified class: All persons employed by Home Depot in hourly or non-exempt positions in California during the period from September 18, 2010 through May 3, 2016, who worked a shift past midnight in which the total aggregate number of hours for that shift exceeded eight hours. After several rounds of summary judgment, the claims remaining for both the Bell and Henry classes were violations of California Labor Code sections 203 and 226, as well as claims under the UCL and FLSA, and PAGA claims. Plaintiffs’ claims were predicated on allegations that they did not receive adequate compensation for overnight overtime shifts. Judge Tigar emphasized that Home Depot’s liability hinged on whether its workday designation had a legitimate business purpose or was intended to evade overtime pay. The court noted Home Depot’s detailed employee records in its Kronos time-tracking system could help determine class membership and assess claims. Plaintiffs have now filed an unopposed motion in which they request preliminary approval of the class and PAGA settlements, approval of the Class Notice, and appointment of the Settlement Administrator. Under the terms of the Settlement Agreement, the parties have agreed to settle Plaintiffs’ claims for a Gross Settlement Amount of $3,350,000. This is a non-reversionary settlement in which no portion of the Settlement can revert to Defendant. After review of the factors outlined in Federal Rule of Civil Procedure 23, Plaintiffs’ unopposed Motion for Preliminary Approval of Settlement was granted. The Bell v. Home Depot case is distinct from other Home Depot wage and hour lawsuits, such as Utne v. Home Depot U.S.A., Inc., which addressed off-the-clock work and rounding practices and settled for $72.5 million in 2023, covering over 272,000 employees since March 2012. The Bell case is explicitly excluded from the Utne settlement’s scope. California’s labor laws are among the strictest in the U.S., requiring precise compliance with overtime, meal, and rest break provisions. The Bell case highlights how workday definitions can impact overtime calculations, a tactic plaintiffs argued was exploitative ...

In 2017, Michael Cash worked as a captain in the Los Angeles County Fire Department and also served as a training captain for the Department’s training academies. When plaintiff complained to the Department’s battalion chief of training that the chief should have terminated a female recruit for failing a test that ordinarily results in automatic termination from a training academy, plaintiff was removed as a training captain in future academies. Cash thereafter sued the County of Los Angeles (the County), alleging that his removal constituted (1) retaliation for reporting gender discrimination in violation of the Fair Employment and Housing Act (FEHA) (Gov. Code, § 12940 et seq.), (2) a failure to take reasonable steps to prevent such etaliation in violation of FEHA, and (3) retaliation for whistleblowing in violation of Labor Code section 1102.5.1 The matter proceeded to a 20-day jury trial in the spring of 2023. The jury found for plaintiff on all three claims and awarded him $450,000. The County filed a motion for judgment notwithstanding the verdict (JNOV) or, alternatively, for a new trial. After a round of briefing, which included an opposition from plaintiff that included 28 exhibits encompassing 385 pages, the trial court denied the motion. In August 2023, plaintiff filed a motion requesting $705,730 in attorney fees. In support of that motion, plaintiff’s attorney declared that the law firm’s hourly rates were (1) $600 for partners, (2) $400 for associates, and (3) $150 for paralegals; however, the invoices submitted in support of the $705,730 total reflected a higher hourly rate of $500 for associates and $200 for paralegals. In October 2023, plaintiff filed a supplemental request, seeking an additional $29,580 in attorney fees related to (1) additional hours opposing the County’s post-trial motions, (2) filing the motion for attorney fees, and (3) opposing the County’s motion to tax costs. This brought plaintiff’s request to a total of $735,310. Following a hearing, the trial court awarded plaintiff $455,546 in attorney fees. The court started from plaintiff’s originally proffered lodestar of $705,730, declining to include plaintiff’s supplemental request in the lodestar calculation. From that amount, the court deducted $54,950 to reflect the lower billing rates for associates and paralegals set forth in plaintiff’s attorney’s declaration. The court deducted a further $195,234—that is, an “across-the-board percentage cut” of 30 percent from the adjusted $650,780 lodestar - because the court’s “review of the billing records” indicated that “there has been unreasonable padding” because “[s]ome of the work appeared to have been duplicative” and because plaintiff’s attorneys unnecessarily prolonged trial with unnecessary prefatory statements during witness questioning. That resulted in the adjusted lodestar fee award of $455,546. The court declined to further reduce the award based on the County’s other arguments. Also in August 2023, plaintiff filed a memorandum of costs seeking $132,445.32. The County moved to tax those costs, challenging several items including $4,300 associated with one of plaintiff’s expert witnesses, Donald Lassig (Lassig). Following a hearing, the trial court denied much of the County’s motion, but did tax $4,300 in plaintiff’s costs associated with Lassig. Plaintiff timely appealed the attorney fees and costs orders. The Court of Appeal affirmed the reduced attorney fee award for the plaintiff in the published portion of the case in Cash v. County of Los Angeles CA2/5 - B336980 - (May 2025),and in the unpublished portion of this opinion also affirmed the trial court’s denial of a motion to tax the plaintiff’s costs. "Until recently, appellate courts in California uniformly “review[ed] attorney fee awards on an abuse of discretion standard” (Laffitte v. Robert Half Internat. Inc. (2016) 1 Cal.5th 480, 488 (Laffitte)), and would infer findings and defer to a trial court’s “general observation that an attorney overlitigated a case” or otherwise overcharged for fees (Karton v. Ari Design & Construction, Inc. (2021) 61 Cal.App.5th 734, 744; California Common Cause v. Duffy (1987) 200 Cal.App.3d 730, 754-755 (Duffy))." "Recently, however, a handful of California courts have employed “heightened scrutiny” - imported from federal cases interpreting a federal civil rights statute (namely, 42 U.S.C. § 1988) - and on that basis have demanded that a trial court articulate “case-specific reasons for [any] percentage reduction,” including a “clear[]” “expla[nation of] its reasons for choosing the particular negative multiplier [or percentage] that it chose.” (Warren v. Kia Motors America, Inc. (2018) 30 Cal.App.5th 24, 37, 41 (Warren); Snoeck v. ExakTime Innovations, Inc. (2023) 96 Cal.App.5th 908, 921 (Snoeck); see Kerkeles v. City of San Jose (2015) 243 Cal.App.4th 88, 101-104 (Kerkeles))." "Other courts have declined to employ this importation of federal law (Morris v. Hyundai Motor America (2019) 41 Cal.App.5th 24, 37 & fn. 6 (Morris)), and we join them in doing so." "Importing the federal standard exceeds the federal courts’ rationale for employing heightened scrutiny of specific fee awards and is inconsistent with our State’s longstanding policy that “[t]he ‘experienced trial judge is the best judge of the value of professional services rendered in [their] court.’” (Serrano v. Priest (1977) 20 Cal.3d 25, 49 (Serrano).)" ...

In a move to expand access and advance care in some of Northern California’s most remote and rural communities, Sutter Health is making two strategic investments to expand primary care and behavioral health services in Del Norte and Lake counties. These enhancements are part of Sutter’s systemwide, not-for-profit commitment to help bridge gaps and deliver high-quality, innovative care closer to where patients live. Sutter Coast Hospital just broke ground this June on its new Emergency Psychiatric Assessment, Treatment and Healing, or EmPATH, unit. The unit leverages a nationally recognized care model designed to provide a more supportive and calming environment for individuals experiencing acute psychiatric crises. The unit aims to stabilize patients in a more appropriate setting, reducing unnecessary inpatient stays. The EmPATH unit, set to open in early 2026, will also improve wait times within the hospital’s emergency department. Sutter has also closed escrow on a 18,000 square-foot building across the street from the hospital that will expand access to primary care, urgent care and rehabilitation services. Construction is set to begin the first quarter of 2026 with plans to occupy the space by the first quarter of 2027. Additionally, workforce recruitment and retention are essential to Sutter’s efforts to expand care access. Workforce housing is just one growing need for health care professionals, especially in rural areas. The Sutter system is committed to exploring affordable housing initiatives, starting in Crescent City, as well as other potential solutions that can further enhance recruitment and retention. Sutter closed escrow on more than 6.5 acres of land to develop for workforce housing, that will support the additional primary care, urgent care and rehabilitation services, as well as the physician residency program. $17.5 million has been approved to date to support planning for these two projects. Sutter Health is also investing $5.5 million to build a new 6,900-square-foot care center in Lake County’s Hidden Valley Lake—long known as a health care desert with limited options for care. The new site will help address provider shortages and reduce long appointment wait times. When it opens in June 2026, the care center will offer urgent care, primary care, on-site lab and X-ray services, and rotating specialty care in cardiology, OB/Gyn and orthopedics. As a not-for-profit health system, Sutter Health said it is committed to helping close health care gaps - especially in rural communities. Sutter’s investments in Del Norte and Lake counties are the latest examples of the system’s efforts to provide care that is aligned with local community health needs that can also have a ripple effect on the overall health and well-being of those throughout California ...

Munir Uwaydah was an orthopedic surgeon well known as a treating physician in California workers’ compensation cases. He had been charged as the ringleader in one of California’s biggest health fraud schemes allegedly perpetrated by his company Frontline Medical Associates, which included unnecessary operations by an untrained assistant that scarred patients forever, according to indictments unsealed in Los Angeles County years ago. A total of 102 people testified during two separate Grand Jury proceedings. A new civil appellate case involving Frontline (as a plaintiff) decided in May 2025 depicts Uwaydah’s absence from the United States as beginning in 2010, allegedly to evade criminal investigations, with subsequent indictments in 2015 and 2019 solidifying his fugitive status in the civil case defendants’ view. Frontline’s conflicting representations - ranging from Uwaydah choosing not to return, to being under a strict travel ban, to potential extradition for perjury in the civil case - were deemed misleading by the court, contributing to the pattern of misconduct that led to the case’s dismissal by the trial court. This new case, Frontline Medical Associates v. Bird, Marella, Boxer, etc. (CA2/1, B336038) a May 2025 unpublished appellate case involves Frontline Medical Associates, Inc. appealing a trial court's decision to grant terminating sanctions, resulting in the dismissal of their case against the law firm of Bird, Marella, Boxer, Wolpert, Nessim, Drooks, Lincenberg & Rhow, P.C., and Benjamin Gluck (collectively, Bird Marella). The dismissal was based on the trial court's finding of Frontline's pervasive misconduct during litigation of this case. Frontline filed this lawsuit in July 2019, with an amended complaint in December 2021, alleging that Bird Marella, their former legal counsel, committed professional misconduct. Specifically, Frontline claimed that Bird Marella made misrepresentations to induce Frontline to pay $2,250,000 for legal services to represent Paul Turley, who operated Frontline before September 2015. Additionally, Frontline alleged that Bird Marella, which had also represented Frontline and Uwaydah, failed to adequately advise Frontline about potential conflicts of interest arising from their simultaneous representation of Turley. The complaint included causes of action for breach of fiduciary duty, fraud by intentional misrepresentation, fraud by fiduciary, conversion, common counts, and declaratory relief, seeking to address the alleged financial and ethical misconduct by Bird Marella. Paul Turley was a chiropractor and a key figure associated with Frontline Medical Associates. His involvement with Frontline and its owner, Munir Uwaydah, placed him at the center of significant legal and criminal proceedings related to an alleged massive insurance fraud scheme that allegedly generated $150 million in fraudulent workers’ compensation claims. In September 2015, Turley was arrested as part of a Los Angeles County District Attorney’s investigation. Over 18 months following the 2015 indictments, a judge dismissed most of the 132 counts in the initial indictments due to insufficient evidence, particularly the aggravated mayhem charges, which carried potential life sentences. In March 2017, at the prosecutors’ request, Los Angeles County Superior Court Judge Kathleen Kennedy dismissed the pending charges against 13 defendants, including Turley, except for two fugitives. Prosecutors immediately refiled new charges in three separate criminal complaints, listing 194 counts, including aggravated mayhem, money laundering, insurance fraud, and unlawful patient referrals. Benjamin Gluck, Turley’s attorney, criticized the refiling as an attempt to restart the case after prosecutorial missteps, stating, “They want to basically say, ‘We don’t like the way this game is going so we’re turning the board over.’” In December 2018, Paul Turley pleaded guilty to multiple charges, including conspiracy to commit insurance fraud, insurance fraud, unlawful referrals, and mayhem. As part of his plea, he confirmed in a factual statement that Frontline paid “cappers” to recruit injured workers to maximize billing, regardless of patient needs, and that services like prescriptions and surgeries were prioritized for profitability. Returning to the civil case appeal decided this month, Uwaydah’s role was pivotal in the Frontline case against Bird Marella due to his historical control over Frontline and his status as a key witness. The defendants alleged that Frontline was essentially a "fake company" operated by Uwaydah, who had fled to Lebanon in 2010 amid criminal investigations for healthcare fraud. Frontline claimed Uwaydah transferred his ownership interest in Frontline to Medconsult, S.A.L., a Lebanese company, in early 2022 to satisfy a debt, though this was contested as a misrepresentation. Uwaydah’s inability or unwillingness to travel to Los Angeles for trial or deposition, coupled with contradictory statements about his travel restrictions, was a significant issue. The court ordered a bench trial to determine if Uwaydah was Frontline’s alter ego, and his status as a fugitive and the ownership transfer claims were central to the defendants’ arguments for dismissal. The trial court ultimately dismissed Frontline’s case with prejudice on October 27, 2023, granting Bird Marella’s third motion for terminating sanctions due to Frontline’s deliberate, egregious misconduct that rendered a fair trial impossible. The court cited both its inherent authority and statutory authority under Code of Civil Procedure section 2023.030 for the dismissal. The specific conduct included misrepresentations about attorney Browne’s conflict of Interest. Frontline’s attorney, David Browne, declared on May 4, 2023, that he had to withdraw due to an unwaivable conflict of interest stemming from a contempt proceeding related to his representation of Medconsult, S.A.L., the purported owner of Frontline. On June 13, 2023, he reiterated this conflict was mandatory and unwaivable. However, evidence showed Browne continued to act as Frontline’s counsel, preparing key witnesses Paul Turley and Amber Woodley for depositions and trial in July 2023. The court found Browne’s claims about the conflict’s severity were exaggerated to delay proceedings, constituting a fraud on the court. The court dismissed Frontline’s expert testimony defending Browne’s actions as unpersuasive, noting Browne’s post-withdrawal work contradicted his stated ethical concerns. The court additionally found that Frontline repeatedly failed to comply with discovery obligations and court orders over several years. Itfailed to timely respond to multiple sets of interrogatories and requests for production of documents served between March 2021 and August 2022. Despite court orders to provide code-compliant responses, Frontline missed deadlines, ignored meet-and-confer efforts, and provided incomplete or evasive responses. The court imposed monetary sanctions ($3,000 and $7,500) for these failures, but Frontline’s noncompliance persisted. Frontline obstructed depositions of its Person Most Qualified (PMQ) and other witnesses. Frontline failed to appear for PMQ depositions noticed for March and September 2022. When it produced David Livingston as PMQ in November 2022, he was unprepared, answering “I don’t know” over 500 times. A subsequent PMQ, Amber Woodley, arrived late and left early, limiting testimony. The court found these actions willful and noncompliant with court orders. Depositions of Janek Hunt and Adib Kassir were disrupted by late arrivals, excessive breaks, refusals to answer, and early terminations. Frontline failed to produce Ali Mohsen and Mazen Helou for depositions despite court orders, further evidencing noncompliance. The court rejected Frontline’s excuses (e.g., documents seized in raids, witnesses overseas) as insufficient, finding a “pattern of willful noncompliance” that violated numerous court orders. Frontline initially represented that Uwaydah was its primary principal (until December 8, 2022). After the court ordered an alter ego trial, Frontline claimed in January 2023 that Uwaydah had transferred his ownership to Medconsult in early 2022 to satisfy a debt. Contradictory evidence, including a January 11, 2022 contract showing Medconsult paid $1 million for Frontline (despite its assets being worth millions and Medconsult already holding a 2005 security interest), and the lack of documentation for a $10 million arbitration award, led the court to find these representations “highly misleading, if not wholly false.” The court concluded Frontline misrepresented ownership to manipulate the use of Uwaydah’s testimony. Frontline provided conflicting statements about Uwaydah’s ability to travel to Los Angeles. Initially, it claimed Uwaydah chose not to return due to criminal charges (July 2022), with Browne guaranteeing in January 2023 that Uwaydah could travel if he agreed to extradition. Later, Frontline asserted Uwaydah was under a travel ban in Lebanon, unable to leave legally. A Lebanese decree and Uwaydah’s extradition waiver suggesting Frontline misrepresented his status to avoid in-person testimony while seeking to use his deposition, potentially evading perjury accountability. The court found that Frontline’s cumulative misconduct - misrepresentations, discovery abuses, and disregard for court orders - demonstrated a “mockery of the judicial process.” Previous monetary and evidentiary sanctions had failed to deter Frontline’s behavior, and the court concluded that lesser sanctions would not ensure future compliance. The pervasive, deliberate, and egregious nature of the misconduct, which prejudiced the defendants and undermined trial fairness, justified terminating sanctions. The appellate court affirmed the trial court's dismissal of the case, finding substantial evidence supported the trial court’s findings and no abuse of discretion in the dismissal ...

Eric Benjamin “Ben” Halem, 37, of Porter Ranch, a former full-time Los Angeles Police Department officer and current LAPD reserve officer, and his brother, Jacob Halem, 32, of Tarzana, were arraigned on felony insurance fraud charges following an investigation by the California Department of Insurance. The investigation found the brothers allegedly filed a fraudulent auto insurance claim in an attempt to obtain benefits they were not entitled to receive. The Department of Insurance began its investigation after receiving a fraud referral alleging Eric Halem falsely reported a crash involving his 2020 Bentley Continental GT, stating his brother Jacob Halem had borrowed the vehicle and was involved in a solo-collision on January 5, 2023. However, the investigation revealed that the luxury vehicle had actually been rented out through Eric Halem’s exotic car rental company, Drive LA, and crashed by the renter three days earlier. Los Angeles Sheriff’s Department (LASD) deputies responded to the accident scene, documenting the vehicle’s damage with body-worn camera footage before it was impounded. Shortly after, Eric Halem contacted his insurance company twice to obtain proof of insurance, which he then used to release the Bentley from impound. Meanwhile, the renter filed a claim with their insurance company, but it was denied due to lack of first-party collision coverage. Upon learning that the rental driver’s claim had been denied, Eric Halem allegedly filed a fraudulent claim with his insurance company on his personal policy, misrepresenting the accident details. He claimed that his brother, Jacob Halem, had been driving the vehicle at the time of the crash. To support their false claim, Eric and Jacob Halem submitted staged photographs of the damaged Bentley on a tow truck near the alleged accident location. These photos were intended to mislead adjusters, but the investigation discovered that the damage in the photos was identical to the damage captured in LASD’s body-worn camera footage from January 2, 2023, showing the damage was created before when the brothers claimed. Further investigation revealed that Jacob Halem also provided a false statement to the insurance company investigator in an effort to corroborate his brother’s fraudulent claim. The total potential loss from the fraudulent claim was $229,283. Insurance fraud impacts all Californians by driving up costs for consumers and businesses. If you suspect insurance fraud, report it to the California Department of Insurance at 800-927-4357 or visit www.insurance.ca.gov. The National Insurance Crime Bureau assisted with the investigation and the Los Angeles County District Attorney’s Office is prosecuting this case ...

As policymakers nationwide focus on the rising costs of health care, a new study from the Workers Compensation Research Institute (WCRI) reveals that hospital outpatient payments for workers’ compensation grew faster in states with fee schedules based on a percentage of hospital charges and in states without fee schedules. “This study provides meaningful state comparisons at a time when many are considering or revising hospital fee regulations,” said Sebastian Negrusa, vice president of research at WCRI. “It offers a clear, evidence-based perspective on how different regulatory approaches influence cost growth and payment levels.” The report, Hospital Outpatient Payment Index: Interstate Variations and Policy Analysis, 14th Edition, analyzes payments for common outpatient surgeries across 36 states, representing 88 percent of the nation’s workers’ compensation benefits. Covering data from 2005 to 2023, the study also compares workers’ compensation hospital payments to Medicare rates. The following are among the major findings: - - Faster growth in states with charge-based fee regulations and in non-fee schedule states: From 2011 to 2023, growth in outpatient payments for common surgeries reached 61–81 percent among states with charge-based fee schedules, and 55–88 percent in non-fee schedule states, substantially higher than 24 percent in the median fixed-amount fee schedule state. - - Higher payments in states without fee schedules: Outpatient payments were 63 to 154 percent higher than the median of states with fixed-amount fee schedules. In these states, workers’ compensation paid $7,550 to $22,002 more per surgical episode than Medicare. - - Percent-of-charge states cost more: States like Alabama and Louisiana, using percent-of-charge-based fee schedules, paid 83 to 233 percent more than states with fixed-amount fee schedules. - - Wide variation vs. Medicare: Average workers’ compensation payments for a common group of outpatient surgeries ranged from 40 percent below Medicare in Nevada to 480 percent above in Alabama. The report also tracks the impact of recent policy reforms. In May 2023, Florida expanded its fixed-amount fee schedule by eliminating charge-based reimbursement for unlisted procedures. This policy change led to a 6 percent decrease in hospital outpatient payments per surgical episode within the same year ...

The founder and former CEO of the now-defunct Sovereign Health Group addiction treatment provider was arrested on an eight-count federal grand jury indictment alleging he submitted more than $149 million in fraudulent claims to health insurers – including for fraudulent urinalysis claims – and, in addition, paid more than $21 million in illegal kickbacks for patient referrals. Tonmoy Sharma, 61, of Tustin, was arrested at Los Angeles International Airport and is expected to make his initial appearance and be arraigned in United States District Court in downtown Los Angeles. Sharma is charged with four counts of wire fraud, one count of conspiracy, and three counts of illegal remunerations for referrals to clinical treatment facilities. Also arrested was co-defendant Paul Jin Sen Khor, 45, of Irvine, who worked as Sovereign’s cash management and accounts payable supervisor. Khor is charged with one count of conspiracy and one count of illegal remunerations for referrals to clinical treatment facilities. Khor was arraigned in United States District Court in Santa Ana. He pleaded not guilty and a July 29 trial date was scheduled. A federal magistrate judge ordered him released on $20,000 bond. According to the indictment, the San Clemente-based Sovereign once was a prominent addiction treatment provider throughout Southern California and several other states. From 2014 to 2020, Sovereign billed private insurance companies for drug addicted and mentally ill patients often at high, out-of-network rates. At Sharma’s direction, Sovereign employees aggressively pursued patients through various forms of marketing, directing the patients to contact the company at its toll-free phone number. Once patients called in to Sovereign’s call center, employees used various tactics to enroll patients into the company’s treatment facilities, including misrepresentations. One such misrepresentation was that a patient’s treatment would be paid for by a foundation funded by donations from former Sovereign patients. In fact, the foundation was a sham organization and a ruse for Sovereign employees – at Sharma’s direction – to obtain patients’ names, dates of birth, and Social Security numbers for use in surreptitiously obtaining health insurance coverage on their behalf. In order to obtain these private health insurance plans, Sovereign employees, at Sharma’s direction, made false representations on insurance applications, claiming qualifying life events that had not happened in order to obtain new insurance outside the enrollment period and inflating or underreporting their income so the patients would qualify for Affordable Care Act government-subsidized private insurance instead of Medicaid, whose reimbursement rates were significantly lower than private insurers. Patients generally did not know that Sovereign would enroll them into these policies or authorize Sovereign to do so. Sovereign employees at times even pretended to be the patients when calling into those insurance companies. Those insurance companies would not have covered any services under plans obtained by these fraudulent means. Sovereign also fraudulently billed insurers more than $29 million for urinalysis tests not authorized by the purported ordering health providers. At Sharma’s direction, Sovereign submitted fraudulent claims for comprehensive urinalysis screening, including through its laboratory, Vedanta Laboratories Inc. Sovereign patients were frequently drug tested through both cup testing and comprehensive panel testing. The cup testing returned results within minutes, while the panel testing was much more comprehensive, with results taking several days to return. The comprehensive panel testing screened for dozens of different substances and, accordingly, was billed at a significantly higher rate than cup testing. Sharma directed Sovereign employees to frequently administer cup testing and comprehensive panel testing on patients, including comprehensive panel testing up to three times a week. Sovereign submitted thousands of claims to insurance companies, including for comprehensive panel tests that purportedly were authorized by physicians when, in reality, the physicians did not authorize the tests. Sovereign also submitted numerous claims to the insurance companies, including urinalysis tests, after physicians were no longer working at Sovereign. Finally, in addition to the patients obtained through the call center above, Sharma and Khor also procured patients for Sovereign by paying illegal kickbacks to patient brokers. To conceal the nature of these transactions, Sharma and Khor caused Sovereign to enter sham contracts that referred to the brokers’ services as “marketing hours,” a term the brokers used when sending invoices to Sovereign for payment. Sovereign paid more than $21 million in illegal kickbacks for patient referrals. A 2017 investigative series, “Rehab Riviera,” by the Southern California News Group highlighted widespread fraud and lack of oversight in the industry, with Sovereign Health as a key example. Families and advocates have also criticized Sharma’s facilities for negligence, linking poorly run centers to patient deaths, including overdoses. In 2022, a Los Angeles jury ordered Sharma and Sovereign Health to pay nearly $45 million to Health Net for fraudulent claims, finding that they acted with “malice, oppression, or fraud” and violated the Racketeering Influence and Corrupt Organizations Act (RICO). Additionally, in 2008, the British General Medical Council revoked Sharma’s medical license in the UK for lying about his academic qualifications and conducting unethical drug studies. Despite this, he became CEO of Sovereign Health in 2009 ...

Felony charges have been filed against Ghada Kalsho Kassab M.D, a 57 year old San Diego dermatologist, for a $1.3 million Medi-Cal fraud scheme. The investigation uncovered that the dermatologist charged Medi-Cal $1,386,995 for services that were never rendered. According to the Medical Board of California, Kassab currently holds a Physician and Surgeon license (A 114457). The physician is reportedly a 1999 graduate of the University of Baghdad College of Medicine. Kassab practices dermatology at GK Dermatology of San Diego, located at 3737 Moraga Ave, Ste A206, San Diego, CA 92117. A complaint was filed in San Diego County Superior Court charging the dermatologist with 22 counts of healthcare insurance fraud, one count of Medi-Cal fraud, the white-collar crime enhancement, and the excessive takings enhancement. Prosecutors alleged that the dermatologist was invoicing for as many as 233 patients on a daily basis, averaging between 60 to 70 patients per day for identical or comparable services. Furthermore, it was found that all patients were undergoing light therapy, with the majority using non-medical lamps. It was further alleged that the crimes committed by defendant Ghada Kassab involved a pattern of related felony conduct, and the pattern of related felony conduct involving the taking of, and resulted in the loss of more than five hundred thousand dollars ($500,000), within the meaning of Penal Code §186.11 (a)(2). This enhancement is known as the aggravated white collar crime enhancement Pursuant to Penal Code §1170(h), prison custody time is to be served in state prison if the enhancement pursuant to Penal Code §186.11(a)(2) is imposed as part of a sentence for the offenses ...

The Madera County Sheriff’s Office arrested 57-year-old Martha Gutierrez DeRomero. She is facing a felony insurance fraud charge after claiming two men stole her van with thousands of dollars’ worth of items inside – but, according to Sheriff Tyson Pogue, that was a lie. On May 23, 2025, DeRomero reported a carjacking at knifepoint near Avenue 21 and Road 26. She claimed an unknown assailant stole her white Chevrolet panel van, which contained $60,000 worth of merchandise. The Madera County Sheriff’s Office, led by Sheriff Tyson Pogue, investigated the incident and discovered it was a staged event orchestrated by DeRomero and her boyfriend, Alfredo Delezma, to commit insurance fraud. The investigation revealed that the van, reported stolen, was later found by the Merced County Sheriff’s Office in a storage facility in Merced, along with the supposedly stolen merchandise. This discovery unraveled the scheme, confirming that no carjacking had occurred. On May 28, 2025, DeRomero was arrested and booked into Madera County Jail on charges of felony insurance fraud, conspiracy, and filing a false police report. Authorities indicated that Alfredo Delezma may also face charges for his role in the conspiracy, although no further details on his status were provided in the reports. The case was reported by multiple news outlets, including ABC30 Fresno, ABC7 Los Angeles, ABC7 Chicago, and KMPH, all citing the Madera County Sheriff’s Office. Sheriff Pogue commended the deputies for their thorough investigation, which prevented an fraudulent insurance claim. For further information, contact the Madera County Sheriff’s Office at (559) 675-7770 or visit www.maderacounty.com/sheriff ...