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SCOTUS Rules Against OSHA Vaccine Mandate

Federal OSHA recently enacted a vaccine mandate for much of the Nation’s work force. The mandate, which employers must enforce, applies to roughly 84 million workers, covering virtually all employers with at least 100 employees. Many States, businesses, and nonprofit organizations challenged OSHA’s rule in Courts of Appeals across the country. The litigation efforts to stop the mandate ultimately ended up in the US Supreme court which heard oral arguments on the issues, and published a ruling in the case of National Federation of Independent Businesses v OSHA.

The 6-3 majority of Justices ruled against the OSHA imposed vaccine mandate finding that “Applicants are likely to succeed on the merits of their claim that the Secretary lacked authority to impose the mandate. Administrative agencies are creatures of statute. They accordingly possess only the authority that Congress has provided. The Secretary has ordered 84 million Americans to either obtain a COVID-19 vaccine or undergo weekly medical testing at their own expense. This is no ‘everyday exercise of federal power.’ “

The dissenting opinion said that OSHA’s mandate is comparable to a fire or sanitation regulation imposed by the agency. But the majority responded that “a vaccine mandate is strikingly unlike the workplace regulations that OSHA has typically imposed. A vaccination, after all, ‘cannot be undone at the end of the workday.’ “

“We expect Congress to speak clearly when authorizing an agency to exercise powers of vast economic and political significance.”  And the opinion added that “Although Congress has indisputably given OSHA the power to regulate occupational dangers, it has not given that agency the power to regulate public health more broadly,” Requiring the vaccination of 84 million Americans, selected simply because they work for employers with more than 100 employees, certainly falls in the latter category.”

President Biden responded to the ruling by saying “I am disappointed that the Supreme Court has chosen to block common-sense life-saving requirements for employees at large businesses that were grounded squarely in both science and the law,” And he concluded by saying that “The Court has ruled that my administration cannot use the authority granted to it by Congress to require this measure, but that does not stop me from using my voice as President to advocate for employers to do the right thing to protect Americans’ health and economy,”

However in the companion case of Biden v Missouri, the 5-4 majority approved the HHS/CMS omnibus rule mandating that medical facilities nationwide order their employees, volunteers, contractors, and other workers to receive a COVID-19 vaccine.

The majority reasoned that “COVID-19 is a highly contagious,dangerous, and – especially for Medicare and Medicaid patients – deadly disease. The Secretary of Health and Human Services determined that a COVID-19 vaccine mandate will substantially reduce the likelihood that healthcare workers will contract the virus and transmit it to their patients.”

They concluded that the HHS/CMS rule “thus fits neatly within the language of the statute. After all, ensuring that providers take steps to avoid transmitting a dangerous virus to their patients is consistent with the fundamental principle of the medical profession: first, do no harm.”

EDD Suspends 345,000 Suspected Fraudulent SDI Claims

The Employment Development Department just announced that it suspended account activity for approximately 27,000 suspicious medical provider registrants and 345,000 claims associated with those providers or other suspicious activity.

While the majority of these providers and claims were likely fraud attempts, the Department has partnered with state regulators and medical provider organizations to coordinate the verification process to clear any legitimate claims as quickly as possible. This is EDD’s top priority. That includes working to contact all claimants who have had their claim held up in this identity theft scam.

Purported medical providers must complete further identity verification with ID.me to potentially certify any disability claims. These personalized requests for medical provider verification through ID.me only come from an official EDD email address ending in @edd.ca.gov.

Medical providers who receive emails with information about how to verify identity through ID.me should carefully confirm the sender’s @edd.ca.gov email address.

Scammers attempt to impersonate government agencies in an attempt to trick people into clicking fake links. Such scam efforts are unfortunately common and slow verification and payment for legitimate claimants and providers.

Californians should safeguard financial and personal information online and elsewhere and remain vigilant to guard against identity theft.

Those who receive communications from EDD regarding a medical provider online account being created in the DI system, or an application for public benefits (such as disability or unemployment insurance) and believe someone filed the claim falsely, should file a fraud report by visiting Ask EDD and selecting the Report Fraud category to complete the Fraud Reporting Form.

Identity theft victims may also want to file an identity theft report with the Federal Trade Commission (FTC). EDD continues to enhance and update information on the Help Fight Fraud webpage.

EDD took action in recent weeks to clamp down on a new disability insurance (DI) identity theft scam involving suspected organized criminal elements filing false DI claims using stolen credentials of individuals and medical or health providers. Disability insurance claimants have continued to receive payments if they were not associated with the recent scam attempts.

Court Affirms Cal/OSHA Citation for Freeway Construction Injury

In June 2014, while Atkinson Construction LP’s employees were erecting “falsework” near the I-405/I-605 interchange in Seal Beach for a new freeway bridge, an accident occurred, which seriously injured one of it’s employees.

Specifically, a forklift attempting to position a long steel beam atop two vertical falsework structures, known as “bents,” accidentally hit another beam, causing that beam and another to overturn and fall off the bents. Each of the steel beams weighed approximately 60,000 pounds.

As the beams collapsed Ramon Torres, an employee standing on one of the bents fell nearly 30 feet to the ground. Torres suffered serious physical injuries from the fall.

After an investigation, the Division cited Atkinson for violating a construction safety order – section 1709, subdivision (b)(1) – that requires beams to be “braced laterally and progressively” to prevent overturning.

Atkinson appealed the citation, but the Occupational Safety and Health Appeals Board denied the appeal. It then filed a petition for a writ of administrative mandate in the superior court which also was denied.

Atkinson appealed the denial of its writ petition, arguing that (1) the cited safety order does not apply because another, more specific, safety order governs falsework operations; and that (2) it complied with the more specific safety order. The Court of Appeal was not persuaded by these arguments, and affirmed the citation in the unpublished case of Atkinson Construction LP v. DIR Division of Occupational Safety and Health.

Atkinson requested the court of appeal to review the regulatory history of section 1709, subdivision (b)(1). However the court found no basis for doing so. The language clearly states that “[t]russes and beams shall be braced laterally and progressively during construction to prevent buckling or overturning.” (§ 1709, subd. (b)(1).) There is no ambiguity in the text to justify an inquiry into its regulatory history.

Despite the safety order’s plain language, Atkinson argues that section 1709 does not apply to falsework operations. It contends that falsework is a “separate and distinct” type of construction, with its own specific safety order (section 1717), and therefore the absence of any reference to falsework in section 1709 necessarily implies that it applies only to nonfalsework construction.

Prior Board decisions establish that more than one safety order may apply to a particular set of facts, even when the construction involves falsework. Here, section 1709 is part of the specific industry safety orders promulgated for the construction industry. Such construction safety orders establish minimum safety standards that apply to any employment “in connection with the construction, alteration, painting, repairing, construction maintenance, renovation, removal, or wrecking of any fixed structure or its parts.”

Thus, Atkinson’s falsework operations were covered by the construction safety orders, including section 1709.

Omicron Surge Forces Closure of Northern California Courts

The Santa Clara County Superior Court announced Wednesday that it is closing public counters and restricting courthouse entry through the end of the month because of staffing absences driven by the rapidly spreading omicron variant of COVID-19, joining other Bay Area courts that have also been limiting public access.

The decision to decrease the public’s access to South Bay court facilities is effective through Jan. 31, by which point officials plan to reevaluate whether to rescind or modify the restrictions.

This marks at least the third large-scale order in Santa Clara County to restrict court availability. Courthouses across the state were largely shuttered in the first few months of the pandemic and began widely installing teleconference and videoconference lines to maintain some level of court access.

Mercury News reports that the order echoes past restriction orders, limiting courthouse access to people directly involved in a court hearing; those submitting an in-person pleading; family-court petitioners seeking protective orders regarding domestic violence, gun violence, civil harassment, workplace and school violence, elder abuse, and juvenile dependency; and those seeking emergency orders for eviction and child-safety matters.

Our court is experiencing a significant number of employee absences, creating staffing shortages across all departments of the court,”  Presiding Judge Theodore Zayner said in a statement. “We are hopeful that these circumstances are transitory and will frequently reexamine conditions as we continue to serve the public through the pandemic and the current omicron variant surge.”

In San Mateo County, court officials have shifted many non-criminal hearings from in-person to Zoom, and have consolidated preliminary hearings to court facilities in Redwood City. Both San Mateo and Contra Costa counties have obtained emergency authorization from the state’s Judicial Council – which governs Superior Court operations in California – to postpone jury selection panels and trials that were set to start in January by as many as 30 days.

In Alameda County, the court has temporarily decreased telephone and in-person access to clerk’s offices to “allow the court to mitigate the ongoing surge in COVID cases brought about as a result of the rapid spread of the Omicron variant,” according to a court statement. The court will continue to monitor the situation and make additional changes as circumstances warrant.

The Alameda County court has also obtained authorization to postpone jury trials set to start in January and also to treat most of January as a holiday when it comes to many court filing deadlines. But it has also revived an emergency order, which was highly criticized as a due process violation when it was implemented in the first few months of the pandemic, to extend the allowable arraignment deadline for someone arrested and in jail custody from 48 hours to as many as seven days.

UC San Diego Health Resolves Medicare Billing Suit for $3 M

UC San Diego Health, the academic health system of the University of California, San Diego, has paid $2.98 million to resolve allegations that it violated the False Claims Act by ordering medically unnecessary genetic testing reimbursed by Medicare, the Justice Department announced today.

The settlement resolves allegations that, from December 2015 to October 2019, UC San Diego Health ordered and submitted referrals for medically unnecessary genetic testing performed by CQuentia Arkansas Labs, CQuentia NGS, and Total Diagnostic II (collectively “the CQuentia labs”). The government alleged that this conduct led to the submission of false claims for payment to Medicare for unnecessary genetic testing.

UC San Diego Health did not admit any liability as part of the settlement, which allowed the provider to continue to focus on patient care, said UC San Diego Health spokesperson Jacqueline Carr.

“Working at the forefront of patient care sometimes involves the use of new technologies from emerging companies. When UC San Diego Health learned that the Department of Justice had concerns about one of our technology providers, we fully cooperated and promptly resolved the matter,” Carr said in a statement. “The DOJ’s settlement announcement alleges that our doctors ordered tests from a company that then allegedly made false claims about those orders.”

“UC San Diego Health remains committed to integrating the leading best practices and technology into our research, teaching and patient care missions, in accordance with the highest standards of ethical conduct and all applicable laws and regulations,” Carr added.

Tennessee-based C Quentia has since apparently gone out of business.as it’s Website simply states “C Quentia has been closed” and tells previous customers how to obtain medical records.

The resolution obtained in this matter was the result of a coordinated effort between the Civil Division’s Commercial Litigation Branch, Fraud Section, and the U.S. Attorney’s Office for the Southern District of California, with assistance from the U.S. Department of Health & Human Services Office of Inspector General and the FBI.

“Ordering unnecessary genetic tests creates a drain on vital government-funded health care programs like Medicare,” said U.S. Attorney Randy Grossman. “This settlement is another example of this office’s commitment to work with our law enforcement partners to hold medical providers accountable when their conduct leads to taxpayers bearing the cost of improper billing practices.” Grossman thanked the prosecution team and investigators for their excellent work on this case.

Hospitals are the gatekeepers for medical care and are expected to ensure that all services performed at their direction, including genetic tests, are medically appropriate,” said Acting Assistant Attorney General Brian M. Boynton for the Justice Department’s Civil Division. “The department will continue to pursue those who undermine the integrity of federal health care programs and waste taxpayer dollars.”

This matter was handled by Nicholas C. Perros of the Civil Division’s Commercial Litigation Branch, Fraud Section, and Assistant U.S. Attorneys Joseph Price and Joseph Purcell of the U.S. Attorney’s Office for the Southern District of California.

The claims resolved by the settlement are allegations only, and there has been no determination of liability.

COVID Outbreak Returns WCAB to Telephonic Hearings

The Division of Workers’ Compensation announced that as of January 12, 2022, all hearings will be heard virtually.

Until further notice, DWC will telephonically hear all trials, lien trials, expedited hearings, and special adjudication unit (SAU) trials.

In addition, mandatory settlement conferences, priority conferences, status conferences, SAU conferences, and lien conferences will continue to be held on the individually assigned judges’ conference lines as announced in Newslines issued on April 3, April 28, May 28, August 12, September 9, 2020, and Sept. 1, 2021.

The division acknowledges that due to the recent surge in COVID-19 cases, a pause of in-person hearings is necessary at this time.

The pause will continue through the end of the month and will be reevaluated at that time.

DWC hearing notices will not change but parties should be aware that as of January 12, 2022, if a trial, expedited hearing, lien trial or SAU trial is set at a district office, all parties should call the judges’ assigned conference line and not appear in person.

The judges’ assigned conference lines may be found on the DWC webpage. All division offices will remain open during this time.

If a party to a DWC hearing has a question on a specific case, they may contact the DWC call center at (909) 383-4522.

Budget Proposes $4.9 B to Overhaul California Courts

California’s courts would see a sizable funding boost as part of Governor Gavin Newsom’s $4.9 billion judicial branch budget package that reflects a commitment to cybersecurity and other tech investments.

According to the report by Courthouse News, the proposal includes $34.7 million for electronic filing, digitizing records and updating case management software in fiscal year 2022-23, with plans to increase that amount to $40.3 million in fiscal year 2025-26.

It also devotes $33.2 million for better access to remote proceedings each year for two years, with $1.6 million in ongoing funding thereafter. “These resources will be used to provide a publicly accessible audio stream for every courthouse in the state,” Newsom said.

Cybersecurity and remote technology have taken center stage as courts moved proceedings online during the Covid-19 pandemic, a change made all the more permanent with the passage of Assembly Bill 716 last year. AB 716 requires courts to provide streaming audio or a public call-in line when courthouses close for public health reasons.

Discussing budget priorities with reporters in December, Judicial Council administrative director Martin Hoshino said “There’s a big year coming up for the trial courts. In this window in time we see the courts are still dealing with pandemic impacts, trying to safety operate and having some limited operational capacities. At the same time they have to groove and balance two modes of operation, which are in-person and remote stuff that people have pivoted to during the pandemic. We’re pushing hard for funds to be able to support so we can find our way through that in this particular year,”

The budget proposal also provides funding for other online services, like $2.6 million in 2022-23 and $1.7 million ongoing for electronic filing systems for domestic and gun violence restraining orders.

Newsom also assigned $15 million in general fund dollars to “timely and accurate data collection” from trial and appellate courts, saying, “This investment will enhance the ability of all three branches of government to assess court programs and resource needs.”

Criminal fines and accompanying administrative fees have historically been a leading source of court funding for the courts – adding $1 billion in revenue in 2020-21. But with the support of Chief Justice Tani Cantil-Sakauye, Newsom and his predecessor Jerry Brown have sought to eliminate what they see as undue burdens on the poor.

Other funds include $42.6 million in 2022-23 and $42.3 million ongoing to hire 23 state court judges, funding for new courthouses in Fresno, Santa Clarita, Fairfield, Quincy, and San Luis Obispo, as well as three projects already approved by the council — a new courthouse in Mendocino County and renovations to juvenile facilities in San Bernardino and Butte counties.

Newsom’s proposal drew an initial positive reaction from the chief justice on Monday. “I welcome the governor’s continuing commitment to sustainable funding in his budget proposal for the judicial branch. He clearly recognizes how important equal access to justice is for all Californians,” she said in a statement. “We look forward to working on this landmark budget proposal with his administration and the Legislature in the next few months as the budget becomes finalized.”

HHS Mandates Insurers Cover At-Home COVID Tests

On January 10, 2022, the Departments of Health and Human Services (HHS), Labor, and Treasury announced new guidance outlining how insurers and group health plans will be required to cover and reimburse enrollees for up to eight at-home tests for COVID-19 per enrollee per 30-day period. This policy applies to tests purchased beginning on January 15, 2022 through the end of the declared public health emergency.

Healthaffaris.org reports that under the new guidance, insurers are incentivized to use their bargaining power with in-network pharmacies and other retailers to ensure that enrollees can obtain at-home COVID-19 tests without cost sharing (i.e., for free) at the pharmacy or retail counter.

The January 10 guidance clarifies that insurers and plans must cover and reimburse members for up to eight OTC COVID-19 diagnostic tests per enrollee per 30-day period.

In general, insurers and plans cannot limit coverage or reimbursement to only tests purchased at in-network pharmacies and other retailers. Put another way, a member can seek reimbursement no matter where they purchased their test from – whether at an in-network pharmacy or through Amazon.

But HHS strongly encourages insurers and plans to pay manufacturers or sellers directly for OTC COVID-19 tests. To that end, the guidance creates a safe harbor from enforcement for those that set up a “direct coverage” option. Under this option, the insurer or plan will arrange for OTC COVID-19 tests to be free (i.e., with no cost sharing) for enrollees through its in-network pharmacies and other retailers. Insurers and plans cannot impose prior authorization or medical management requirements – and must ensure that members truly have access to COVID-19 tests through an adequate number of retail locations.

Those that offer direct coverage will be allowed to limit reimbursement to $12 per test or the actual price of the test (whichever is lower) when a member purchases a test from a non-network pharmacy or retailer. This $12 limit helps mitigate the risk of price gouging by manufacturers and sellers. If payer reimbursement was uncapped, manufacturers and sellers might be tempted to raise the price of tests significantly, putting COVID-19 tests further out of reach for millions of people.

Insurers and plans can, of course, take reasonable steps to prevent, detect, and address suspected fraud and abuse, and the guidance identifies some examples of permissible activities for doing so.

For instance, an insurer or plan can require an attestation, signature, or proof of purchase to confirm that an OTC COVID-19 test was purchased for the enrollee’s use (as opposed to someone else’s use), has not been reimbursed by another source, and is not for resale.

Insurers and plans can adopt these types of fraud prevention measures so long as they do not create significant barriers for obtaining tests (such as requiring enrollees to submit documents or delaying reimbursement).

No Quarantine Requirement for California Healthcare Workers

The California Department of Public Health issued guidance that allows health care networks to enable COVID-19-positive employees to keep working if they don’t show any symptoms.

“The department is providing temporary flexibility to help hospitals and emergency services providers respond to an unprecedented surge and staffing shortages. Hospitals have to exhaust all other options before resorting to this temporary tool. Facilities and providers using this tool, should have asymptomatic COVID-19 positive workers interact only with COVID-19 positive patients to the extent possible,” the Department of Public Health said in a statement to news outlets over the weekend.

The Epoch Times contacted the agency for comment.

Health care workers in the state now don’t have to isolate or show a negative COVID-19 test, the guidance said, before coming back to work if they are asymptomatic. The guidance, which remains in effect until Feb. 1, stipulates that staff wear N95 respirator masks while on the job.

After the guidance was handed down, several unions that represent nurses and other hospital staff expressed alarm.

“Healthcare workers and patients need the protection of clear rules guided by strong science. Allowing employers to bring back workers who may still be infectious is one of the worst ideas I have heard during this pandemic, and that’s really saying something,” Bob Schoonover, the head of union SEIU California, told CBS Sacramento.

Schoonover added that while his union supports “supplemental paid sick leave,” the latest guidance imperils a “critical piece of the protection that workers and the public need.”

The president of the California Nurses Association, Sandy Reding, told local media that the California health department’s guidance will put patients at risk.

“We are very concerned,” she told KNTV news. “If you have health care workers who are COVID positive care for vulnerable populations, we can spread the COVID virus inside the hospital as well.”

Union officials did not mention the rampant staffing issues that have plagued hospitals across the United States and California in recent days.

Health giant Kaiser Permanente suspended more than 2,000 employees who were not vaccinated in October. Other California systems such as Santa Clara Valley Medical Center and Sutter Health also terminated or suspended their employees who weren’t vaccinated in the fall of 2021.

Meanwhile, Dr. George Rutherford, professor of Epidemiology at the University of California San Francisco, told KNTV that the guidance revision isn’t anything new.  “This is about having infected people taking care of infected people. We did this with Ebola in South Africa. We’ve done it before. It’s not the first play option in our playbook. I think staffing issues are such that it led the state to put this guidance out,” he told the outlet.

It comes days after the Newsom administration mandated that booster shots be given to certain health care staffers by Feb.

Study Says Common Cold T-Cells Provide COVID-19 Protection

Is there any good news in the horizon about the COVID Pandemic.

A new study just published today in Nature Communications by Imperial College London found that High levels of t-cells from common cold coronaviruses can provide protection against COVID-19. T-cells are also believed to play a vital role in providing protection, however, evidence of whether these T cells could provide such a protective effect has been lacking.

The study, one of the first designed to find such scientific evidence, began in September 2020, looked at levels of cross-reactive T-cells generated by previous common colds in 52 household contacts of positive COVID-19 cases shortly after exposure, to see if they went on to develop infection.

It found that the 26 who did not develop infection had significantly higher levels of those T-cells than people who did get infected. Imperial did not say how long protection from the T-cells would last.

We found that high levels of pre-existing T cells, created by the body when infected with other human coronaviruses like the common cold, can protect against COVID-19 infection,” study author Dr Rhia Kundu said.

Current COVID-19 vaccines target the spike protein, which mutates regularly, creating variants such as Omicron which lessen the efficacy of vaccines against symptomatic infection.

“In contrast, the internal proteins targeted by the protective T-cells we identified mutate much less,” Professor Ajit Lalvani, co-author of the study, said.

“Consequently, they are highly conserved between the various SARS-CoV-2 variants, including Omicron. New vaccines that include these conserved, internal proteins would therefore induce broadly protective T cell responses that should protect against current and future SARS-CoV-2 variants.