Author: WorkCompAcademy

The Governor Newsom’s March 19, 2020 Executive Order and the ongoing COVID-19 public health emergency requires the California Division of Workers’ Compensation to cancel the Annual DWC Educational Conference in Los Angeles until next year.

The conference, which had been originally scheduled for March 26-27 at the Marriott LAX Hotel, was rescheduled for June 22-23.

Instead, the conference will take place in March 2021 in both Oakland and Los Angeles.

Please save the following dates for the 28th Annual DWC Educational Conference: March 4-5, 2021 at the Oakland Marriott and March 25-26 at the Marriott LAX Hotel in Los Angeles.

Registration fees paid to attend or exhibit at the Los Angeles conference will be refunded in full by the International Workers’ Compensation Foundation (IWCF) in the coming weeks.

Early last month, a Rhode Island bank received an application for a $144,050 loan under the Paycheck Protection Program, the massive federal effort to assist small businesses hurt by the coronavirus crisis.

The application purported to be on behalf of the owners of Remington House, a restaurant on Post Road in Warwick, R.I. It listed 18 employees and an average monthly payroll of $46,000.

But when a bank official drove past the building, there were indications that the restaurant had been shut down before the pandemic. There were dumpsters on the property and notices ordering the stoppage of work were posted on the door and windows.

The once-popular restaurant had been closed since November 2018, according to federal prosecutors, who this week charged two men with conspiracy to commit bank fraud.

The case is the first criminal fraud prosecution in connection with the paycheck program. Industry officials warn that it will not be the last – not by a long shot. In fact, individuals who are working with banks to combat misconduct in the $660 billion program – including former California banking commissioner Walter Mix – estimate that fraud rates could be as high as 10% to 12%.

Those estimates, which are based on initial reviews of loan files at dozens of banks, are roughly consistent with what has happened after other disasters. In the aftermath of Hurricane Rita and Hurricane Katrina, a government audit found that around 16% of applicants for federal disaster assistance used invalid information. If 10% of the PPP’s funding went to fraudsters, taxpayers would be defrauded by tens of billions of dollars.

Assistant Attorney General Brian Benczkowskil told The Wall Street Journal earlier this week that prosecutors are mounting a broad search for fraud, and that they will apply scrutiny to the conduct of banks, in addition to the actions of borrowers.

Treasury Secretary Steven Mnuchin and SBA Administrator Jovita Carranza have pledged to review all PPP loans of $2 million or more.

Also in recent weeks, many banks have begun accepting applications from new small-business customers, which has left them more vulnerable to fraud.

Existing small-business customers are generally seen as safer, because bankers have already satisfied rules that require them to know those customers. Often, they have met the business owner face-to-face and shaken hands.

“The risk of fraud in the first round was probably not very significant because everybody was cherry-picking their customers,” said Adam Jiwan, chairman and CEO of Spring Labs, a Los Angeles technology company that offers tools to ferret out fraud. “The likelihood of fraud in phase two is high, as banks move beyond their existing relationships.”

The relatively late addition of online lenders to the program may have also increased the risk of fraud, since those companies are less likely than traditional banks to have a personal relationship with their customers. On the other hand, online lenders may have relatively sophisticated risk management procedures.

Omnicare, Inc., a subsidiary of CVS Health and a provider of pharmacy services to long-term care facilities, has agreed to pay the United States a $15.3 million civil penalty to resolve allegations that it violated federal law by, among other things, allowing opioids and other controlled substances to be dispensed without a valid prescription, United States Attorney Nicola T. Hanna announced today.

The Cincinnati-based Omnicare operates “closed door” pharmacies – meaning they were not open to the public – that deliver controlled substances to nursing homes and other long-term care facilities (LTCFs).

Omnicare makes daily deliveries of prescription medications to residents of LTCFs, and it also pre-positions limited stockpiles of controlled substances at LTCFs in “emergency kits,” which are to be dispensed to patients on an emergency basis. These emergency kits, which often include opioids and other controlled substances that are commonly abused and diverted, remain part of Omnicare’s inventory and must be tightly controlled and tracked. The controlled substances may be dispensed only pursuant to a valid prescription.

The United States alleged that Omnicare violated the federal Controlled Substances Act in its handling of emergency prescriptions, its controls over the emergency kits, and its processing of written prescriptions that lacked required elements such as the prescriber’s signature or DEA number.

The federal investigation found that Omnicare failed to control emergency kits by improperly permitting LTCFs to remove opioids and other controlled substances from emergency kits days before doctors provided a valid prescription. The investigation also revealed that Omnicare had repeated failures in its documentation and reporting of oral emergency prescriptions of Schedule II controlled substances.

As part of the settlement agreement announced today, Omnicare agreed to pay the $15.3 million civil penalty and entered into a Memorandum of Agreement with the Drug Enforcement Administration that will require Omnicare to increase its auditing and monitoring of emergency kits placed at LTCFs.

“Omnicare dispensed powerful opioids without valid prescriptions and failed to inform federal authorities of significant losses of opioids and other drugs,” United States Attorney Hanna stated. “With the opioid crisis still a very real concern, every entity that handles dangerous drugs will be held accountable to ensure powerful narcotics are properly dispensed and not diverted to the black market.”

“Omnicare failed in its responsibility to ensure proper controls of medications used to treat some of the most vulnerable among us,” said DEA Acting Administrator Uttam Dhillon. “DEA is committed to keeping our communities safe by holding companies like Omnicare accountable for such failures, while ensuring continuity of care and necessary access to emergency prescription drug supplies.”

Angelique Diaz sustained injury to her bilateral upper extremities, psyche, and in the form of hypertension while working for the Southern California Gas Company.

On July 11, 2017, the UR physician denied a treatment request for an EMG, which was overturned by a MAXIMUS IMR Final Determination Letter dated September 12, 2017.

On October, 2, 2017, the UR physician denied a treatment request for Norco, which was overturned by a MAXIMUS IMR Final Determination Letter dated November 8, 2017.

On January 24, 2018, the UR. physician denied a treatment request for Norco and chiropractic treatment, which was overturned by a MAXIMUS IMR Final Determination Letter dated March 26, 2018.

On March 15, 2018, the UR physician denied a treatment request for bilateral upper extremity nerve conduction studies, which was overturned by a MAXIMUS IMR Final Determination Letter dated April 24, 2018.

Applicant’s attorney filed a petition for LC5814 penalties for the four UR denials that IMR overturned. The issues went to trial and the WCJ found that the UR doctors had used inappropriate guidelines.

The WCJ found that there was no wrongdoing by the defendant employer/carrier and that the UR doctors are not agents of the defendant and are not parties. Thus, there is no LC5 814 penalty.

The applicant’s petition for reconsideration was denied in the panel decision of Diaz v Southern California Gas Company.

Labor Code section 4610.1 provides as relevant herein: An employee shall not be entitled to an increase in compensation under Section 5814 for unreasonable delay in the provision of medical treatment for periods of time necessary to complete the utilization review process in compliance with Section 4610. (§ 4610.1 )

The WCAB panel agreed with the WCJ that, since applicant argues that she is entitled to penalties for delay that occurred while the utilization review was in the process of completion-i.e., while the UR physicians failed to properly address the requests of her treating physician-applicant is barred by section 4610.1 from recovering section 5814 penalties.

Accordingly, it concluded that the WCJ correctly determined that defendant is not liable for section 5 814 penalties based upon alleged delay occurring during the UR process.

Some California businesses and others are taking legal action against Gov. Gavin Newsom over his announced plans to reopen California for business. He now faces a slew of lawsuits over his handling of the ongoing pandemic.

Tesla filed a lawsuit Saturday against Alameda County in an effort to invalidate orders that have prevented the automaker from reopening its factory in Fremont, California. The lawsuit seeks injunctive and declaratory relief. and was filed in U.S. District Court for California’s Northern District. Elon Musk has now also threatened to move its headquarters and future programs to Texas or Nevada immediately.

Tesla had planned to bring back about 30% of its factory workers Friday as part of its reopening plan, defying Alameda County’s stay-at-home order.

A San Diego resident on Thursday filed a federal lawsuit against California Governor Gavin Newsom over his stay-home-orders and the closure of businesses. JD Bols, the man at the center of the lawsuit, said it is “a move aimed at freeing the people of California from home confinement, reopening the state’s $3.1 trillion economy, and putting Californians back to work immediately.”

A federal judge last week said Gov. Newsom had the right to ban church assemblies to prevent the spread of the coronavirus. Judge John Mendez ruled Tuesday that Newsom’s stay-at-home order did not violate the constitutional rights to free assembly and religion when the Cross Culture Christian Center in Lodi was ordered to cease holding services. The church held services until its landlord, under threat of misdemeanor from county health officials, changed the locks on the church doors.

A civil rights attorney in the Bay Area has filed half a dozen lawsuits claiming Newsom’s current orders are an infringement on human rights. “The governor is overreaching on a number of grounds,” said civil rights attorney Harmeet Dhillon. “The governor has chosen to limit protests to zero in this state, which is outrageous and absurd.”

Nail salons statewide are now planning to sue the governor after he claimed the origin of coronavirus in the state stemmed from the salons. “I think my brain stopped working and I was saying, what the hell?” explained Kelvin Pham, producer of the “Nailed It” documentary which explores the history of Vietnamese salons. “I never heard anything like that before.”

Salon owners have said Newsom’s statement can be detrimental to its future business and are demanding the evidence behind his claim.

Meanwhile, the governor has also recently announced his plan to help illegal aliens with a $500 check at taxpayer’s expense. The Center for American Liberty filed the emergency petition with the California Supreme Court last Wednesday on behalf of two plaintiffs, Ricardo Benitez and Jessica Martinez, both are candidates for a seat on the California State Assembly; The California Supreme Court ordered the governor to respond to the Center for American Liberty’s emergency Writ.

California’s stay-at-home order is has no set end date, but the Democrat governor said stage three of reopening could be just a month away.