Author: WorkCompAcademy

Two California Democratic lawmakers took separate aim Tuesday at pandemic disinformation they argue receives a broad audience and misplaced credibility through social media platforms – rejecting concerns that their legislation might carry free speech or business privacy considerations.

Assemblyman Evan Low said his bill would label doctors’ promoting of misinformation or disinformation about COVID-19 to the public as unprofessional conduct that could draw disciplinary action from the California Medical Board. Disinformation is generally considered to be intentional or deliberate falsehoods, while misinformation can be inadvertent.

The California Medical Association hasn’t taken a position on Low’s bill. But the association’s president, Dr. Robert E. Wailes, said in a statement that misinformation has prolonged the pandemic, “making the work of our frontline health care workers more difficult and dangerous while harming community health.”

The legislation differs from efforts in some other states like Florida and Tennessee, where Republican lawmakers have resisted doctor discipline proposals.

Tennessee’s Board of Medical Examiners unanimously adopted in September a statement that said doctors spreading Covid misinformation – such as suggesting that vaccines contain microchips – could jeopardize their license to practice.

But before any physicians could be reprimanded for spreading falsehoods about covid-19 vaccines or treatments, Republican lawmakers threatened to disband the medical board.

The growing tension in Tennessee between conservative lawmakers and the state’s medical board may be the most prominent example in the country. But the Federation of State Medical Boards, which created language adopted by at least 15 state boards, is tracking legislation introduced by Republicans in at least 14 states that would restrict a medical board’s authority to discipline doctors for their advice on Covid.

In Florida, a Republican-sponsored bill making its way through the state legislature proposes to ban medical boards from revoking or threatening to revoke doctors’ licenses for what they say unless “direct physical harm” of a patient occurred. If the publicized complaint can’t be proved, the board could owe a doctor up to $1.5 million in damages.

Some medical boards have opted against taking a public stand against misinformation. The Alabama Board of Medical Examiners discussed signing on to the federation’s statement, according to the minutes from an October meeting. But after debating the potential legal ramifications in a private executive session, the board opted not to act.

A few physician groups are resisting attempts to root out misinformation, including the Association of American Physicians and Surgeons, known for its stands against government regulation.

And Sen. Richard Pan’s proposal, which still is being finalized, would require online platforms like Facebook to publicly disclose how their algorithms work and how they promote user content, including which data sets are used and how they rank the prominence of user posts.  The platforms would also be required to confidentially share more detailed information with researchers, with the goal of creating more responsible algorithms.

Congress is considering a Platform Transparency and Accountability Act with a similar goal at the federal level, Pan said, but he wants California to take the lead.

As the world gets closer to the eventual end of the virus pandemic, more than ever, white-collar workers worldwide are working remotely, and last year most said they want to keep that arrangement with employers. Just 3% of white collar workers wanted to return to the office five days a week, according to a poll by Accenture Research last year. But this year, the love affair with hybrid work may be fading.

A full 86% of employees wanted to work from home at least two days a week, the report said after surveying nearly 10,000 people around the world last year, across areas including finance, technology and energy. All age groups felt the same way, they added. Workers reported a preference for commuting into cities on Tuesdays, Wednesdays and Thursdays, raising the prospect of empty offices for the rest of the week.

Many banks geared up for flexible working after two years of COVID lockdowns, with the likes of Citigroup Inc., HSBC Holdings Plc and NatWest Group Plc allowing hybrid working for many staff. Some fintech companies like Revolut Ltd. and Eigen Technologies Ltd. are even allowing staff to work entirely remotely.

NatWest expects around 87% of its 60,000 staff to split work between home and the office in the longer term. For now about 10,000 of its staff, including traders and employees in branches and data centers, still work entirely in the office, Sam Bowerman, one of the bank’s human resources directors, said in an interview earlier this month.

“We’re keen to avoid mandating X number of days per week. It’s customer led,” Bowerman said. “So far we’ve seen no detriment to productivity and the flexibility has produced a lot of goodwill.”

In theory, hybrid offers the best deal for both employer and employee. It combines pre-Covid-19 patterns of office-based working with remote days, in a working schedule that would allow both in-person collaboration and team building, as well as greater flexibility and the opportunity for focused work at home.

But in reviewing the phenomena, the BBC claims in a story reported in January, that emerging data is beginning to back up anecdotal evidence: many workers report, that hybrid work is emotionally draining.

In a recent global study by Seattle based employee engagement platform Tinypulse, more than 80% of people leaders reported that such a set-up was exhausting for employees. Workers, too, reported hybrid was more emotionally taxing than fully remote arrangements – and, even full-time office-based work.

“There was a feeling that hybrid would be the best of both worlds,” says Elora Voyles, an industrial organizational psychologist and people scientist at Tinypulse, based in California. “For bosses, it means they retain a sense of control and that they can see their workers in person. For employees, it offers more flexibility than full-time in the office and means they can work safely during the pandemic.”

However, as the novelty of hybrid working has faded, so too has workers’ enthusiasm. “We found that people were less positive about hybrid through 2021 as the year went on,” explains Voyles.

Optimism among workers soon gave way to fatigue. In Tinypulse’s survey of 100 global workers, 72% reported exhaustion from working hybrid – nearly double the figures for fully remote employees and also greater than those based fully in the office. Voyles says the small sample size reflects a wider trend; she believes it’s the disruption to employees’ daily routines – and the staccato nature of hybrid – that workers find so tiring.

Physically carrying work back-and-forth between home and the office may also come with a psychological impact for some. A recent study found 20% of UK workers reported difficulties switching off from work and feeling ‘always on’; struggling to adapt to hybrid, and the permeable boundaries between home and work, was cited as a major factor.

A San Fernando Valley woman pleaded guilty to federal criminal charges for conspiring to defraud health insurance companies by causing millions of dollars in fraudulent claims to be submitted to provide patients with “free” cosmetic procedures, including Botox injections. The indictment included several co-conspirators, including an insurance company SIU investigator who helped her avoid detection.

Roshanak Khadem, 54, a.k.a. “Roxanne Khadem” and “Roxy Khadem,” of Sherman Oaks, pleaded guilty to one count of conspiracy to commit health care fraud and one count of subscribing to a false income tax return. She was the last of the group to plead guilty.

According to her plea agreement, she owned and operated facilities that provided aesthetic services to clients, including R&R Med Spa in Valley Village and Nu-Me Aesthetic and Anti-Aging Center in Woodland Hills.

Khadem caused patients to visit her clinics to receive cosmetic procedures, including Botox injections, facials and laser hair removal. Khadem knew these procedures were not covered by the patients’ health insurers. Khadem also knew that her employees informed some patients that, if they turned over their health insurance information to the Khadem-owned clinics, the patients could receive free or discounted cosmetic procedures pursuant to a “credit” they would earn.

Health insurance information from these patients was provided to the insurance biller for the clinics, knowing and intending that the information would be used to submit false and fraudulent claims to the health insurers for medical procedures that Khadem knew were either not actually provided to the patients or were not medically necessary.

Then, based on the amount that the health insurers paid on those false and fraudulent claims, Khadem and others would calculate an amount, which the co-conspirators referred to as a “credit,” that the patients could use to receive free or discounted cosmetic procedures from the clinics. Those patients would then come into the clinics to receive the free or discounted cosmetic procedures.

Khadem and her co-conspirators submitted claims, which included false and fraudulent claims for which those companies paid out at least $1,361,200.  Prosecutors estimate the amounts paid based on false and fraudulent claims submitted as part of the health care fraud conspiracy in which Khadem participated could be as much as $7,991,406.

Khadem failed to report this income on her income tax returns for 2013, 2014 and 2015. Khadem’s underreporting of her income for these three years caused a total tax loss of $453,451.

A June 27 sentencing hearing hearing has been scheduled, at which time she will face a statutory maximum sentence of 13 years in federal prison.

44 year old Gary Jizmejian, who lives in Santa Clarita, and who was a former senior investigator at the Anthem Special Investigations Unit, the anti-fraud unit within Anthem, previously pleaded guilty to using his cell phone to send text messages to co-defendants as part of a this commercial bribery scheme was also sentenced to 18 months in federal prison.

The indictment alleged that, in return for cash payments, Jizmejian assisted Khadem and others by providing them with confidential Anthem information that helped them submit fraudulent bills to Anthem. In September 2012, Jizmejian gave Khadem insurance billing codes – CPT Codes – that Jizmejian knew could be used to submit fraudulent claims to Anthem without Anthem detecting the fraudulent claims. Jizmejian gave Khadem the billing code for an allergy-related lab test and instructed her to submit to Anthem large numbers of bills with this CPT code. Khadem and other members of the conspiracy used this billing code to submit approximately $1 million in fraudulent claims to Anthem, according to the indictment.

The indictment further alleged that Jizmejian worked to prevent the insurance companies from detecting the fraud at the clinics, which included helping Khadem to avoid responding to inquiries from fraud investigators, diverting attention of other Anthem SIU investigators away from the clinics, and closing Anthem investigations into fraud that was being committed at the clinics.

In September 2015, based on confidential information obtained from Anthem, Jizmejian tipped Khadem off about a federal criminal investigation into the clinics, according to the indictment.

The remaining three defendants in this case each have pleaded guilty. Lucine Ilangezyan, 42, of North Hills, pleaded guilty to one count of conspiracy to commit health fraud, and was sentenced to 18 months in federal prison. Dr. Roberto Mariano, 63, of Rancho Cucamonga, a physician who helped operate the clinics, and Marina Sarkisyan, 52, of Panorama City, who was the office manager at the clinics, await sentencing.

A San Francisco psychiatrist was sentenced in federal court Wednesday to serve 120 days in prison and pay $1.4 million restitution after he pleaded guilty to a scheme to submit false reports for non-disabled clients to receive federal benefits to which they were not entitled.

According to the U.S. Attorney’s Office, 76 year old George Demetrius Karalis pleaded guilty Aug. 11 and was sentenced Wednesday by U.S. District Judge Charles Breyer.

The government’s sentencing memorandum describes meetings between Karalis and undercover agents where the defendant instructed his clients on how to obtain federal and state government benefits to which they were not entitled.

According to his plea agreement, Karalis admitted that between August 2015 and June 30, 2020, he treated U.S. Postal Service employees who were receiving Federal Employees’ Compensation Act (FECA) workers’ compensation benefits for alleged stress and psychological disorders.

Karalis counseled his non-disabled clients on how to continue receiving benefits to which they were not entitled. Karalis also admitted that he submitted false reports and certifications about his clients so that they could continue receiving FECA benefits.

Karalis admitted that the total loss attributable to his conduct and is between $550,000 and $1,500,000. He also agreed to pay $1,400,000 in restitution, $920,000 of which will be paid to the U.S. Postal Service and $480,00 of which will be paid to the California Employment Development Department.

This is however, not the first public record of allegations of worker’s compensation insurance fraud and also grand theft against him.

Records (131 pages) from the Medical Board of California in its disciplinary case D1-90-3188, show a 1996 stipulated resolution of allegations of fraudulent billing pertaining to liens filed in several pending workers’ compensation cases. The attached liens were against multiple carriers including SCIF, Travelers, Industrial Indemnity, Atlantic Mutual and perhaps others. However he specifically denied “any allegations of fraud, dishonesty, corruption, gross negligence, or incompetence.” Nonetheless his probation was continued for three years from June 9, 1995.

His license was restored to “cleared” status following completion of probation on July 31, 1998.

Records from a 1990 disciplinary action against him in disciplinary case D-3800 he was accused of unprofessional conduct claiming that “on or about August 24, 1987, respondent was convicted by a guilty plea in the Superior Court, of County of Alameda, Case No. 89328, on one count of violation of Penal Code section 487(1) [grand theft]. The Accusation said this involved property of Computer Sciences Corporation and the State of California (Medi-Cal Program). He was placed on three years probation, and did not serve any jail time.

He admitted these allegations in his Stipulation and was placed on probation by the Medical Board for 5 years.

He was admitted to practice medicine in California on September 1, 1971 after graduation from the University of California, Irvine College of Medicine in 1970. He is currently still licensed with no current disciplinary charges pending against him.

A six-month CBS News investigation reported in 2021 raised new questions about how effectively state medical boards hold bad doctors accountable and protect patients. It reported from an insider who sits on California’s medical board, which is responsible for licensing and disciplining more than 150,000 doctors. This is one of many similar media stories over the years on the same issue.