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Author: WorkCompAcademy

Kaiser Health News Says Smartphone May Become Next Doctors’ Office

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A fingertip pressed against a phone’s camera lens can measure a heart rate. The microphone, kept by the bedside, can screen for sleep apnea. Even the speaker is being tapped, to monitor breathing using sonar technology. In the best of this new world, the data is conveyed remotely to a medical professional for the convenience and comfort of the patient or, in some cases, to support a clinician without the need for costly hardware.

But using smartphones as diagnostic tools is a work in progress, experts say. Although doctors and their patients have found some real-world success in deploying the phone as a medical device, the overall potential remains unfulfilled and uncertain.

Smartphones come packed with sensors capable of monitoring a patient’s vital signs. They can help assess people for concussions, watch for atrial fibrillation, and conduct mental health wellness checks, to name the uses of a few nascent applications.

Companies and researchers eager to find medical applications for smartphone technology are tapping into modern phones’ built-in cameras and light sensors; microphones; accelerometers, which detect body movements; gyroscopes; and even speakers. The apps then use artificial intelligence software to analyze the collected sights and sounds to create an easy connection between patients and physicians. Earning potential and marketability are evidenced by the more than 350,000 digital health products available in app stores, according to a Grand View Research report.

“It’s very hard to put devices into the patient home or in the hospital, but everybody is just walking around with a cellphone that has a network connection,” said Dr. Andrew Gostine, CEO of the sensor network company Artisight. Most Americans own a smartphone, including more than 60% of people 65 and over, an increase from just 13% a decade ago, according the Pew Research Center. The covid-19 pandemic has also pushed people to become more comfortable with virtual care.

Some of these products have sought FDA clearance to be marketed as a medical device. That way, if patients must pay to use the software, health insurers are more likely to cover at least part of the cost. Other products are designated as exempt from this regulatory process, placed in the same clinical classification as a Band-Aid. But how the agency handles AI and machine learning-based medical devices is still being adjusted to reflect software’s adaptive nature.

Ensuring accuracy and clinical validation is crucial to securing buy-in from health care providers. And many tools still need fine-tuning, said Dr. Eugene Yang, a professor of medicine at the University of Washington. Currently, Yang is testing contactless measurement of blood pressure, heart rate, and oxygen saturation gleaned remotely via Zoom camera footage of a patient’s face.

Big tech companies like Google have heavily invested in researching this kind of technology, catering to clinicians and in-home caregivers, as well as consumers. Currently, in the Google Fit app, users can check their heart rate by placing their finger on the rear-facing camera lens or track their breathing rate using the front-facing camera.

“If you took the sensor out of the phone and out of a clinical device, they are probably the same thing,” said Shwetak Patel, director of health technologies at Google and a professor of electrical and computer engineering at the University of Washington.

Google’s research uses machine learning and computer vision, a field within AI based on information from visual inputs like videos or images. So instead of using a blood pressure cuff, for example, the algorithm can interpret slight visual changes to the body that serve as proxies and biosignals for a patient’s blood pressure, Patel said.

Google is also investigating the effectiveness of the built-in microphone for detecting heartbeats and murmurs and using the camera to preserve eyesight by screening for diabetic eye disease, according to information the company published last year.

The tech giant recently purchased Sound Life Sciences, a Seattle startup with an FDA-cleared sonar technology app. It uses a smart device’s speaker to bounce inaudible pulses off a patient’s body to identify movement and monitor breathing.

Binah.ai, based in Israel, is another company using the smartphone camera to calculate vital signs. Its software looks at the region around the eyes, where the skin is a bit thinner, and analyzes the light reflecting off blood vessels back to the lens. The company is wrapping up a U.S. clinical trial and marketing its wellness app directly to insurers and other health companies, said company spokesperson Mona Popilian-Yona.

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January 9, 2023 – News Podcast

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Rene Thomas Folse, JD, Ph.D. is the host for this edition which reports on the following news stories: WCAB Says Injured County Inmate on Work Program is an Employee. Judge Issues Order Stopping the DIR From Implementing Fast Food Act. California Privacy Rights Act (CPRA) Now Applicable to Employers. CWCI Study Shows WC Hospitalizations Continue to Decline. NIH Launches Pilot Telehealth Research Program. Hospital Closure Triggers Central California Emergency Declarations. Study Shows Robotic Knee Surgeries Reduce Bone and Soft-Tissue injury. Researchers Find Good Knee and Hip Surgery Outcomes in Patients Over 90.

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Panel Clarifies WCAB Limits for Vacating Stipulations of Parties

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Wendy Johnson was injured while employed by the Santa Ynez Valley Journal, who was insured by SCIF. Her case proceeded to trial in 2019.The WCJ issued a Findings & Award, finding Johnson was permanently totally disabled and allowing an attorney fee of 20%. SCIF sought reconsideration and the Appeals Board granted the petition for further study and the matter was referred to mediation.

As a result of the mediation, the parties entered into a Compromise and Release in the total amount of $685,000.00.

Paragraph 7 of the C&R provides that “The parties agree to settle the above claim(s) on account of the injury(ies) by the payment of the SUM OF: $685,000.00 The following amounts are to be deducted from the settlement amount: $25,300.00 for permanent disability advances through [June 26, 2013[;] $121,058.93, payable to WENDY THOMPSON FOR NON-SUBMIT MSA[;][and] $137,000.00 request as applicant’s attorney’s fee.”

The $137,000.00 attorney fee amounts to 20% of the settlement. Applicant and applicant’s attorney signed the C&R on October 12, 2022 and the attorney for defendant State Compensation Insurance Fund (SCIF) signed it on October 14, 2022.

The Appeals Board rescinded the August 14, 2019 Findings of Fact and Award and remanded this matter to the WCJ for consideration of the C&R. The WCJ issued an Order Approving Compromise and Release on October 24, 2022, approving the settlement terms agreed to by the parties, including the attorney fee of $137,000.00.

SCIF again filed a Petition for Reconsideration, arguing that the WCJ’s finding that an attorney’s fee of $137,000.00 is unreasonable and not supported by evidence. The WCAB denied reconsideration of the attorney fee award in the panel decision of Thompson v Santa Ynex Valley Journal – ADJ8004567 (January 2023).

In its Opinion Denying Reconsideration, the panel noted that a stipulation between the parties need not be supported by substantial evidence citing County of Sacramento v. Workers’ Comp. Appeals Bd. (Weatherall) (2000) 77 Cal.App.4th 1114, 1121 [65 Cal.Comp.Cases 1]),”

A stipulation is an agreement between opposing counsel … ordinarily entered into for the purpose of avoiding delay, trouble, or expense in the conduct of the action, and serves ‘to obviate need for proof or to narrow range of litigable issues in a legal proceeding.(Weatherall, supra, 77 Cal.App.4th at p. 1119.)

Stipulations are designed to expedite trials and hearings and their use in workers’ compensation cases should be encouraged. (Robinson v. Workers’ Comp. Appeals Bd. (Robinson) (1987) 194 Cal.App.3d 784, 791 [52 Cal.Comp.Cases 419].)

Stipulations are binding on the parties unless, on a showing of good cause, the parties are given permission to withdraw from their agreements. (Weatherall, supra, at p. 1121.)

While the Appeals Board has the authority to reject parties’ stipulations, this “discretion does not validate capricious decisionmaking.” (Weatherall, supra, 77 Cal.App.4th at p. 1119.)

The panel concluded by stating: “Permitting a party to subsequently withdraw from an agreement because they have changed their mind endangers the finality of approved settlements and undermines transactional stability in the workers’ compensation system and risks discouraging future settlements. Defendant here has not even alleged grounds in its petition that could constitute good cause to set aside the C&R.”

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California/Illinois Attorney Generals Sue Drugmakers for Price Gouging

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A vial of insulin can cost as little as $2 to manufacture. Yet at the pharmacy counter, people with diabetes often end up paying hundreds for the life-saving medicine.

In the U.S., insulin is so expensive that many diabetics struggle to afford it even when covered by health plans, and are forced to ration their use – sometimes with deadly consequences. More than 3 million adults in California – over 10% of the state’s adult population – have been diagnosed with diabetes.

The California Attorney General filed a lawsuit against the nation’s largest insulin makers and pharmacy benefit managers (PBMs) for driving up the cost of the lifesaving drug through what he alleges is unlawful, unfair, and deceptive business practices in violation of California’s Unfair Competition Law.

The lawsuit alleges manufacturers Eli Lilly, Novo Nordisk, and Sanofi, and pharmacy benefit managers CVS Caremark, Express Scripts, and OptumRx, have leveraged their market power to overcharge patients. A 2021 report found that insulin costs roughly ten times more within the United States than outside it.

The three manufacturers named in the lawsuit produce over 90% of the global insulin supply and the three PBMs administer pharmacy benefits for roughly 80% of prescription claims managed. The lawsuit argues that because competition is highly limited in both their markets, these six companies are able to keep aggressively hiking the list price of insulin at the expense of many patients.

The lawsuit alleges that manufacturers and PBMs are complicit in overcharging for insulin. Manufacturers set the drug’s list price and PBMs then negotiate for rebates on behalf of health plans. Because rebates are based on a percentage of list price, manufacturers raise their list prices to provide the largest rebates they can offer PBMs.

PBMs are often paid for their services with a portion of the rebate they have negotiated. This creates an incentive to negotiate a drug with a higher rebate, not necessarily the lowest price for consumers. As a result, the drug becomes unaffordable for uninsured or underinsured patients, who have to pay the full price of insulin. High list prices also make insulin unaffordable for other patients as well, including those with high deductible health plans or coverage gaps.

And the California Attorney general is not going it alone. The California lawsuit comes on the heels of a similar case filed in December by Illinois Attorney General Kwame Raoul.

In a 125-page fraud lawsuit filed in Cook County Circuit Court, the office accused Eli Lilly, CVS Pharmacy, Novo Nordisk and several other pharmaceutical companies of artificially inflating the cost of insulin by over 1,000% since the late 1990s.

“Today, insulin has become the poster child for skyrocketing and inflated drug prices,” the suit states.The complaint singles out Eli Lilly in particular, noting the price for a dose of its analog insulin Humalog rose by 1,527% between 1997 and 2018.

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January 2, 2023 – News Podcast

WorkCompAcademy

Rene Thomas Folse, JD, Ph.D. is the host for this edition which reports on the following news stories: WCAB Orders Attorney to Identify Name of Employer per Rule 10390(a). NLRB Says USC Student Athletes are USC, Pac-12 and NCAA Employees. NLRB Reinstates Off-Duty Employee Rights to Access Employer’s Property. San Diego Pain Management Doctor and Office Manager Indicted. Fake Doctor Charged for 2nd Offense of Illegal Botox Injections. Labor Commissioner Collects $1.3M for Bakersfield Contractor Violations. WCIRB Reports Premiums Up 7% – But Combined Loss Ratio is 111%. Private Equity Firms Invest $206B In 1,400 Healthcare Acquisitions in 2021. Hospital Size and Teaching Status Produce Better Orthopedic Outcome. Factoring Decline in Life Expectancy When Reserving Lifetime Awards.

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Major McDonald’s Franchise to Pay $2 Million to Settle EEOC Lawsuit

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AMTCR, Inc., AMTCR Nevada, Inc., and AMTCR California, LLC have been collectively operating as a single employer and/or integrated enterprise in Nevada, Arizona, and California, and have common management and ownership, centralized control of labor operations, and interrelation operations.

These three entities Collectively own, manage, and operate approximately twenty-two McDonald’s fast food restaurants in this tri-state region, and are collectively doing business as “McDonald’s.” The 22 restaurants operate under the common ownership and management of President/Owner Abelardo “Abe” Martinez III. And they share common managers, such as Director of Operations Theresa Hernandez and Area Supervisor Ruben Benitez, who both oversee employees throughout the tri-state region.

They share a common corporate headquarters and/or main office and human resources department for the entire tri-state region located in Kingman, Arizona.

And the EEOC just announced that this major McDonald’s franchisee has agreed to pay nearly $2 million to settle an EEOC sexual harassment lawsuit.

Prior to filing the civil action, the EEOC investigated a charge of discrimination that had been filed with the Commission. Following the investigation, the Commission issued Letters of Determination to the employer, finding reasonable cause to believe that Title VII was violated and inviting them to join with the Commission in informal methods of conciliation to endeavor to eliminate the discriminatory practices and provide appropriate relief.

But the Commission was unable to secure from Defendants a conciliation agreement acceptable to the Commission. Therefore, in September 2021, the U.S. Equal Employment Opportunity Commission filed a civil lawsuit against the companies in the United States District Court District of Nevada, charging them with sexual harassment and constructive discharge in stores/restaurants in Nevada, Arizona, and California.

The EEOC alleged in general that the “sexual harassment included, but was not limited to, constant groping, grabbing, and rubbing of the arms, shoulders, thighs, and buttocks; offensive comments and gestures regarding male genitalia; sexual advances; and sexual ridicule, intimidation, and insults.” And that due to the employer’s failure to remedy the ongoing sexual harassment, “the Charging Party and many other adversely affected employees could no longer tolerate the hostile and abusive work environment and were subjected to constructive discharge.”

One of the several specific instances of misconduct listed in the Complaint involved a twenty-six-year-old female Shift Manager, and another by a twenty-one-year-old male Cook. Both were employed at Defendants’ McDonald’s store in Blythe, California. Both claimed to be sexually harassed by the at Defendants’ McDonald’s store in Blythe, California, the by same General Manager, and who was also the hiring manager at this McDonald’s store.

This Blythe General Manager was in charge of receiving and reviewing job applications, interviewing applicants, and making hiring decisions. He was allegedly particularly fond of the young male applicants. After conducting interviews, The General Manager would message young male applicants via Facebook and send them sexually inappropriate messages and requests for dates. The General Manager admitted to Claimant 5 that he informed these male applicants via Facebook that if they refused to sexually engage with him and/or date him, he would not hire them.

During 2017 to mid-2019, many employees complained to “Claimant 5” about the General Manager’s sexual comments and conduct. Claimant 5 would relay these employee complaints to upper management, but Defendants did nothing to stop the harassment.

In July 2019, Claimant 5 felt compelled to compile a list of all the sexual harassment complaints that she had received. Claimant 5 submitted the list of complaints to upper management with a request for an investigation and remedial action. Later in July 2019, an employee meeting was held at the store where Defendants required employees were required to sign an agreement regarding sexual harassment. However, allegedly no other remedial action was taken.

After the July 2019 employee meeting, Claimant 5 continued to receive complaints from employees about being subjected to sexually offensive comments by male managers and co-workers. These comments often related to co-workers’ body parts such as breast size.

The company has agreed to pay $1,997,500 to resolve the sexual harassment lawsuit. And it has agreed to provide significant, franchise-wide injunctive relief aimed at preventing discrimination and harassment in the workplace.

AMTCR has also agreed to retain an outside third-party EEO monitor who will conduct internal audits of AMTCR’s practices in handling harassment and retaliation complaints; establish a centralized tracking system for discrimination, harassment, and retaliation complaints; and ensure accountability and appropriate disciplinary action occur.

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The Mark Cuban Cost Plus Drug Company Expands Social Mission

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The Mark Cuban Cost Plus Drug Company, a Public Benefit Corporation (PBC), aims to fundamentally change the way the pharmaceutical industry operates. As a public-benefit corporation, its social mission of improving public health is just as important as the bottom line.

Cost Plus Drugs transparently charges a standard markup on every drug it sells. The costplusdrugs.com online pharmacy launched in January 2022 now carries over 1,000 prescription products, delivered by mail to thousands of happy customers every day. Cost Plus Drugs is working with health plans, managed-care organizations, pharmacy benefits managers (PBMs) and self-insured employers to bring these same savings to employer-sponsored benefit plans nationwide.

RxPreferred Benefits claims it is transforming healthcare through transparent, pass-through Pharmacy Benefit Administration. In collaboration with self-funded employers and health plans, RxPreferred develops custom solutions that drive savings and promote healthcare accessibility for members with innovative strategies, technology, and data access. Headquartered in Nashville, TN, RxPreferred is privately-held and operates nationally, also offering a variety of pharmacy solutions including 340b Administration and PBM Services for Hospice, Long-Term Care, and Workers’ Compensation.

Cost Plus Drugs and RxPreferred have announced a new partnership, focused on improving healthcare access and lowering drug spend. With this venture, employers and their members utilizing RxPreferred for their pharmacy benefit will have access to all medications available through Cost Plus Drugs within their benefits package, with future plans to expand this offering along with local independent pharmacies.

“Our partnership with RxPreferred is another step in the direction of bringing transparency to healthcare and lowering drug costs for individuals and families across the country.,” said Mark Cuban. “We are excited to work with a like-minded company that aligns with our goals and puts improving access to affordable prescriptions first.”

Healthcare and prescription drug spend has continued to be a rising concern for both individuals and companies hosting their insurance benefits plan or plan sponsors. The pricing of drugs and schematics behind the industry are complex and traditionally been veiled from the end-consumer, leading to the need for transparency and control back in the hands of those ultimately paying for the drugs.

“There is an education component for employers and employees needed to help people and their families access the appropriate medications at the best possible costs and live healthy lives.,” says Jeff Malone, CEO of RxPreferred. “In an otherwise opaque industry, we’re committed to bringing transparency to the prescription drug space, making this partnership with Mark Cuban Cost Plus Drug Company vital to our continued efforts in improving healthcare.”

With this partnership, RxPreferred and Mark Cuban Cost Plus Drug Company will bring together employer-sponsored benefits with the option to use Cost Plus Drugs as part of their plan, previously only offered to individuals outside of their insurance package. Cost Plus Drugs makes all drugs and pricing publicly available, giving everyone the opportunity to make informed decisions about their healthcare needs.

RxPreferred started their efforts in transforming healthcare in 2011 with transparent custom pharmacy solutions and now work with employers nationwide to administer their pharmacy benefits plan. This partnership is the next iteration of strategic innovation it provides its’ customers as part of an ever-evolving environment with the goals of sustainable prescription drug spend, improved member access, and transparency for employers and their members.

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Fatal Occupational Injuries Increased 8.9% in 2021

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The U.S. Bureau of Labor Statistics reported that there were 5,190 fatal work injuries recorded in the United States in 2021, an 8.9-percent increase from 4,764 in 2020. The fatal work injury rate was 3.6 fatalities per 100,000 full-time equivalent (FTE) workers, up from 3.4 per 100,000 FTE in 2020 and up from the 2019 pre-pandemic rate of 3.5.

Key findings from the 2021 Census of Fatal Occupational Injuries

– – The 3.6 fatal occupational injury rate in 2021 represents the highest annual rate since 2016.
– – A worker died every 101 minutes from a work-related injury in 2021.
– – The share of Black or African American workers fatally injured on the job reached an all time high in 2021, increasing from 11.4 percent of total fatalities in 2020 to 12.6 percent of total fatalities in 2021. Deaths for this group climbed to 653 in 2021 from 541 in 2020, a 20.7-percent increase. The fatality rate for this group increased from 3.5 in 2020 to 4.0 per 100,000 FTE workers in 2021.
– – Suicides continued to trend down, decreasing to 236 in 2021 from 259 in 2020, an 8.9-percent decrease.
– – Workers in transportation and material moving occupations experienced a series high of 1,523 fatal work injuries in 2021 and represent the occupational group with the highest number of fatalities. This is an increase of 18.8 percent from 2020.
– – Transportation incidents remained the most frequent type of fatal event in 2021 with 1,982 fatal injuries, an increase of 11.5 percent from 2020. This major category accounted for 38.2 percent of all work related fatalities for 2021.

Fatal event or exposure

– – Despite experiencing an increase from 2020 to 2021, transportation incidents are still down 6.6 percent from 2019 when there were 2,122 fatalities.
– – Fatalities due to violence and other injuries by persons or animals increased to 761 fatalities in 2021 from 705 fatalities in 2020 (7.9 percent). The largest subcategory, intentional injuries by person, increased 10.3 percent to 718 in 2021.
– – Exposure to harmful substances or environments led to 798 worker fatalities in 2021, the highest figure since the series began in 2011. This major event category experienced the largest increase in fatalities in 2021, increasing 18.8 percent from 2020. Unintentional overdose from nonmedical use of drugs or alcohol accounted for 58.1 percent of these fatalities (464 deaths), up from 57.7 percent of this category’s total in 2020.
– – Work related fatalities due to falls, slips, and trips increased 5.6 percent in 2021, from 805 fatalities in 2020 to 850 in 2021. Falls, slips, and trips in construction and extraction occupations accounted for 370 of these fatalities in 2021, and an increase of 7.2 percent from 2020 when there were 345 fatalities. Despite the increase this is still down 9.3 percent from 2019 when construction and extraction occupations experienced 408 fatalities due to this event.

Occupation

– – There was a 16.3-percent increase in deaths for driver/sales workers and truck drivers which went up to 1,032 deaths in 2021 from 887 deaths in 2020. This was the primary factor behind the increase in fatalities to workers in transportation and material moving occupations which reached a series high in 2021.
– – Construction and extraction occupations had the second most occupational deaths (951) in 2021, despite experiencing a 2.6-percent decrease in fatalities from 2020. The fatality rate for this occupation also decreased from 13.5 deaths per 100,000 FTE workers in 2020 to 12.3 in 2021.
– – Protective service occupations (such as firefighters, law enforcement workers, police and sheriff’s patrol officers, and transit and railroad police) had a 31.9-percent increase in fatalities in 2021, increasing to 302 from 229 in 2020. Almost half (45.4 percent) of these fatalities are due to homicides (116) and suicides (21). About one-third (33.4 percent) are due to transportation incidents, representing the highest count since 2016.
– – Installation, maintenance, and repair occupations had 475 fatalities in 2021, an increase of 20.9 percent. Almost one-third of these deaths (152) were to vehicle and mobile equipment mechanics, installers, and repairers.
– – The fatal injury rate for fishing and hunting workers decreased from 132.1 per 100,000 FTEs in 2020 to 75.2 in 2021.

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Owner of Home Health Care Agencies Sentenced for $31M Fraud

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42 year old Liana Karapetyan, who lives in El Dorado Hills, was sentenced to 18 months in prison for one count of conspiracy to commit health care fraud and one count of conspiracy to pay and receive health care kickbacks.

According to court documents, Karapetyan and her husband, Akop Atoyan, owned and controlled home health care and hospice agencies in the greater Sacramento area: ANG Health Care Inc., Excel Home Healthcare Inc., and Excel Hospice Inc.

On behalf of the agencies, Karapetyan and Atoyan certified to Medicare that they would not pay kickbacks in exchange for Medicare beneficiary referrals to the agencies.

Despite their certifications, from at least July 2015 through April 2019, Karapetyan and Atoyan paid and directed others to pay kickbacks to multiple individuals for beneficiary referrals, including employees of health care facilities, as well as employees’ spouses. The kickback recipients included John Eby, a registered nurse who worked for a hospital in Sacramento; Anita Vijay, the director of social services at a skilled nursing and assisted living facility in Sacramento; Jai Vijay, Anita Vijay’s husband; and Mariela Panganiban, the director of social services at a skilled nursing facility in Roseville.

In total, Karapetyan, Atoyan, and others caused the agencies to submit over 8,000 claims to Medicare for the cost of home health care and hospice services. Based on those claims, Medicare paid the agencies approximately $31 million. Of that amount, Medicare paid the agencies at least $2 million for services purportedly provided to beneficiaries referred in exchange for kickbacks paid to, among others, Eby, Anita Vijay, Jai Vijay, and Panganiban. Because the agencies obtained the beneficiary referrals by paying kickbacks, the agencies should not have received any Medicare reimbursement.

This case was the product of an investigation by the Federal Bureau of Investigation and the Department of Health and Human Services’ Office of Inspector General. Assistant U.S. Attorney Matthew Thuesen prosecuted the case.

In separate cases, Atoyan, Eby, Jai Vijay, Anita Vijay, and Panganiban pleaded guilty for their roles in the kickback scheme. They await sentencing.

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Girardi Lawfirm CFO Denied Bail in $10 Million Client Theft Case

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Courthouse News reports that the former chief financial officer of the defunct Girardi & Keese California personal injury law firm lost his bid to be released from jail while fighting charges he stole $10 million from the firm in a “side fraud” scheme separate from the estimated $100 million disgraced attorney Thomas Girardi is accused to have siphoned off from his clients’ trust funds.

Tom Girardi, a titan of the California plaintiffs bar, is believed to have used his client settlement funds as his own personal piggy bank for years. The 83-year-old lawyer is suffering from Alzheimer’s and his firm went bankrupt two years ago as reports of his malfeasance came out.

Last year, a Chicago law firm accused singer and “Real Housewives of Beverly Hills” star Erika Jayne of acting as a “frontwoman” for her then-husband, Girardi. The court filing called Girardi’s now-shuttered law firm “the largest criminal racketeering enterprise in the history of plaintiffs’ law.”

U.S. District Judge Dale Fischer on Monday rejected the arguments by a lawyer for Christopher Kamon that his client wanted a “fresh start” and that there are perfectly innocent explanations why he liquidated his assets in the U.S., transferred millions of dollars to overseas bank accounts, and bought a $2.4 million home in the Bahamas.

“The government has proven that he’s a flight risk,” Fischer said at the hearing in LA federal court. “The transfer of funds is extremely suspicious in my view.”

Kamon, 49, has been in jail since his arrest Nov. 5 at the airport in Baltimore when he returned from the Bahamas. Prosecutors with the U.S. Attorney’s Office in LA say that Kamon planned to leave the county, change his name and hide, citing an unidentified witness who they say was an unwitting co-schemer who believed the accountant had authority to use the law firm’s funds for his private pursuits.

Prosecutors say Kamon, who worked at the Girardi Keese accounting department for almost two decades, used falsified invoices, fraudulent transfers and cash kickbacks from the firm’s accounts to steal millions of dollars. They also claim he improperly used the firm’s funds for his personal expenses, including home renovations, travel around the world on private planes and and tens of thousands a month for “female companionship.”

It was highly doubtful that he was authorized to provide a $20,000 monthly allowance to an escort, Assistant U.S. Attorney Ali Moghaddas said at the hearing.

If convicted, the accountant could face 11 to 14 years in prison just for his “side fraud,” according to the government. That doesn’t take into account Kamon possible culpability in the broader fraud scheme perpetrated by Girardi and others, which involved an estimated $100 million stolen from client settlement funds, the government said.

In addition, prosecutors said, the $1 million secured bond Kamon proposes to post as bail is far from sufficient to secure his return to court because he still has millions of dollars in foreign bank accounts.

The judge agreed Kamon could easily reimburse his family members and friends who have agreed to put up equity in their homes as part of his bond should he decide to flee rather than risk a possible 15 years in prison.

Jack DiCani, one of Kamon’s attorneys, told Fischer everybody knew where his client was going and that he travelled to the Bahamas and sought residency there under his own name. According to DiCani, he had repeatedly reached out to federal prosecutors in Chicago, where there’s a criminal investigation into the purported fraud by Girardi, and there hadn’t been any indication that Kamon was a target in that probe, which could have prompted him to flee.

“Mr. Kamon wanted a fresh start at life,” DiCani told the judge. “They’ve taken objective facts and read into them a nefarious explanation – that he was trying to hide from law enforcement.”

Kamon doesn’t have a criminal record, is charged with only one nonviolent crime, and nothing in his past or present conduct suggests that he is a flight risk, DiCani previously said in his request for pretrial release.

The government, however, said Kamon has been trying to avoid being served with lawsuits in civil litigation stemming from his role at Girardi Keese and that even his own lawyers didn’t know where he was. They also scoffed at the argument that there was nothing unusual about the fact that he had four mobile phones on him when he was arrested, saying that for some busy professionals it might be normal to have more than one phone, but not for someone who’s unemployed.

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