Author: WorkCompAcademy

Gallagher Basset announced the promotion of Mike Hessling to the newly created position of CEO, North America.

The position is effective immediately and reports directly to Gallagher Bassett Global CEO, Scott Hudson.

Prior to this appointment, Mr. Hessling was North American chief client officer and led the Rolling Meadows, Illinois-based TPA’s sales and account management teams.

In 2017, Mr. Hessling was named a Break Out Award winner by Business Insurance.

Mike Hessling’s work ethic and commitment to customer service began at a young age as a newspaper carrier for the Washington Post. These values have transcended his academic and professional career including qualifying as a CPA and gaining an MBA, then working as a consultant, first at Bridge Strategy Group and then at Bain & Co., where he served as a manager and later principal. In 2012, he joined Gallagher Bassett Services Inc. as chief client officer.

When asked about the newly created role to lead North America, Mr. Hudson stated, “Mike has been a leader with GB for over seven years and has a tremendous track record as North America Chief Client Officer, leading our sales and account management teams.

He has also been a driving force behind the building of our industry-leading analytics team. Mike’s knowledge of the North America market, proven ability to work across all functions, and passion for GB’s culture and team, makes him the perfect person to lead our North America business.”

On his promotion, Mr. Hessling said, “I’m excited and humbled to lead GB’s North America business. We have an incredible team of talented professionals, who are extremely passionate about making a positive impact for our clients, their businesses and the people they employ and serve.”

The newly elected Orange County District Attorney is dropping all charges against a doctor and his girlfriend, alleging that his predecessor “manufactured” allegations that the couple drugged and sexually assaulted up to 1,000 women.

The stunning turn of events comes a year and a half after the case against Grant Robicheaux, an orthopedic surgeon who appeared on the TV show The Online Dating Rituals of the American Male, and substitute teacher Cerissa Riley exploded into the headlines.

At the time, Orange County’s then-district attorney, Tony Rackauckas, claimed the pair lured women to their Newport Beach home, knocked them unconscious, and raped them.

At a press conference in September 2018, he said investigators had seized “hundreds” of incriminating videos from the couple’s phones. Asked whether the number could be as a high as a thousand, Rackauckas said, “I think so.”

A few months later, though, Rackauckas was out of office, replaced by current DA Todd Spitzer, who eventually ordered a review of the evidence. He says he was appalled by what he found.

“The prior District Attorney and his chief of staff manufactured this case and repeatedly misstated the evidence to lead the public and vulnerable women to believe that these two individuals plied up to 1,000 women with drugs and alcohol in order to sexually assault them – and videotape the assaults,” Spitzer said in a blistering statement.

“As a result of the complete case review I ordered beginning in July, we now know that there was not a single video or photograph depicting an unconscious or incapacitated woman being sexually assaulted.”

Rackauckas has not responded to his former rival’s allegations. But Robicheaux’s attorney praised the reversal.

Robicheaux, 39, and Riley, 32, insisted from the start that all their liaisons were consensual. They were swingers, their attorneys argued, and the so-called victims were willing participants.

They claimed Rackauckas inflated the allegations, hoping that media attention would buoy his re-election effort. And last June, unsealed transcripts of a deposition showed the ex-prosecutor thought the publicity would help him.

Spitzer said that’s when he assembled a team to re-evaluate the case. “A team of prosecutors with a combined 175 years of experience determined there is no provable evidence that Robicheaux and Riley committed any sexual offense,” he said in a press release.

The charges that will be dropped include kidnapping and rape; Robicheaux and Riley would have faced up to life in prison if convicted.

At least some of the women who accused Robicheaux and Riley maintain they were assaulted.

Michael Fell, an attorney for one of them, told the Los Angeles Times the decision is a betrayal of his client.

A licensed acupuncturist was sentenced to 30 months in prison for fraudulently billing Amtrak’s health care plan for $7.1 million in acupuncture, massages and facials that either were medically unnecessary or were never provided.

Guiqiong Xiao Gudmundsen, 53, a.k.a. “Kimi” Gudmundsen, of Anaheim Hills, was sentenced and also ordered her to pay $2,683,903 in restitution to Amtrak.

Back in October 2019, Gudmundsen pleaded guilty to one count of health care fraud and one count of money laundering.

Gudmundsen owned Healthy Life Acupuncture Center, which operated in Riverside and Los Angeles. From January 2008 until December 2015, Gudmundsen recruited Amtrak employees to visit Healthy Life and then, among other things, billed the Amtrak health care plan for acupuncture, which she knew wasn’t being provided.

She billed the health plan for medically unnecessary services such as massages and facials, as well as for work-related injuries she knew the Amtrak plan did not cover. Gudmundsen also provided medical services to non-Amtrak health care plan participants and then billed the plan for it under the name of an actual Amtrak plan participant.

Gudmundsen regularly waived co-payments, co-insurance, and deductibles for Amtrak health care plan participants, something the plan did not permit. She double billed to other insurance plans, and she provided services to returning patients falsely billed as “new patients” in order to take advantage of higher reimbursement rates.

During the course of the scheme, Gudmundsen billed Amtrak’s health care plan in amounts comparable to large research hospitals and medical institutions that dwarfed other acupuncturists, court papers state. In 2013, Gudmundsen was ranked 32nd in the United States among health care providers for the amount billed to the Amtrak health care plan – above Johns Hopkins Hospital in Baltimore, which was ranked 39th, according to court documents.

Finally, she knowingly and routinely funneled her ill-gotten gains through bank accounts opened in the names of a shell company and her relatives.

Gudmundsen’s “entire business model was based on fraud, infiltrating all the services that she provided (and those she did not provide),” prosecutors wrote in their sentencing memorandum.

This matter was investigated by Amtrak Office of Inspector General, IRS Criminal Investigation, and the U.S. Department of Labor’s Employee Benefits Security Administration.

Pharmacy giant Walgreens has agreed to pay $7.5 million to settle a consumer protection lawsuit, accusing the company of allowing a phony pharmacist to handle over 745,000 prescriptions. The lawsuit was filed and settled on Monday jointly by the Alameda County and Santa Clara County District Attorneys’ Offices in Alameda County Superior Court.

The settlement comes just over a year after the Mercury News revealed a California State Board of Pharmacy investigation alleging Walgreens stores in Fremont, Milpitas and San Jose allowed Kim Thien Le to perform pharmacist duties for more than a decade without ever having a pharmacist’s license.

During Le’s more than 15 years as both an intern pharmacist and a pharmacist, she handled more than 100,000 prescriptions for controlled substances such as oxycodone, fentanyl, morphine, and codeine, officials said.

“Walgreens failed to vet Ms. Le thoroughly when it promoted her to positions requiring a license and failed to make sure that its internal systems were strong enough to prevent an employee from evading them,” a statement from the Alameda County District Attorney’s Office said.

After the state investigation began, Walgreens “undertook a re-verification of the licenses of all our pharmacists nationwide,” Walgreens spokesman Jim Cohn said in an email.

He also noted that Le’s employment with the company ended in October 2017, but did not offer further comment on the settlement, which had been under negotiation between prosecutors and the company.

Under the settlement, Walgreens will also be required to create a verification program, post proof that all of its employees are licensed if their position requires one, conduct annual audits, and submit an annual compliance report to the Alameda County DA’s office, Lin said.

This settlement is not the first legal fallout since the revelations about the investigation came to light.

The California Attorney General’s office in July charged Le with false impersonation, identity theft and obtaining money, labor or property by false pretenses. The case is still pending in Alameda County courts. Le has pleaded not guilty to all charges.

The Walgreens stores involved could have received a range of disciplines for their part in the case, from a reprimand up to suspension or revocation of their pharmacy licenses, officials said previously.

But Becerra’s office ultimately required Walgreens to pay a $335,000 civil penalty and $19,500 to cover the Department of Justice’s investigation costs, and to admit to the truth of the claims in the state board’s investigation, according to State Board of Pharmacy documents reviewed by this news organization.

Teresa Drenick, a spokeswoman for the Alameda County DA’s office, said of the $7.5 million settlement money from Walgreens, the two DA’s offices will split roughly $250,000 to cover investigative costs, while about $250,000 will go to the state’s Consumer Protection Trust.

The remaining $6,992,500 is evenly divided between the two DA’s offices to be used for consumer protection and enforcement in the future.

The California Department of Justice sued Johnson & Johnson in May 2016, after a years-long multistate investigation revealed the company had neglected to inform both patients and doctors of possible severe complications from its mesh products and misrepresented the frequency and severity of risks the products posed. The products are permanent surgical implants designed to treat stress urinary incontinence and pelvic organ prolapse in women.

After a nine-week trial, a San Diego Superior Court Judge issued the 128 page Statement of Decision requiring Johnson & Johnson to pay $343.99 million in penalties. Additional injunctive terms may be added after further briefing.

The suit filed by the California Department of Justice is one of several the company has faced worldwide regarding the mesh products.  This judgment marks the first time a court of law has issued findings of fact and ruled that Johnson & Johnson did indeed engage in illegal false and deceptive business practices.

The lawsuit alleged that Johnson & Johnson misrepresented the safety of these products by concealing and misleading consumers about the possibility of serious and irreversible complications caused by mesh, including permanent pain with intercourse, loss of sexual function, chronic pain, permanent urinary or defecatory dysfunction, and potentially devastating impact on overall quality of life.

The ruling notes that “complications could be so severe that mesh removal would be necessary but, unlike other implants, removal is difficult and harmful and can take multiple surgeries; J&J also knew that some of the most severe complications of mesh can be irreversible.”

The Judge also wrote the marketing for the products “repeatedly touted mesh’s benefits while misrepresenting, downplaying, and concealing its potential for serious, long-term complications.”

From 2008 to 2014, Johnson & Johnson sold more than 470,000 pelvic mesh products nationally, including more than 30,000 in California. Worldwide, more than 2 million women have had these mesh products implanted in their bodies.

The court affirmed that Johnson & Johnson and its subsidiaries Ethicon Inc. and Ethicon US LLC, violated California’s Unfair Competition Law and False Advertising Law.

Johnson & Johnson has faced over 35,000 personal injury lawsuits related to its pelvic mesh products. It has settled similar claims with the state of Washington for $9.9 million and with a coalition of 42 other states for $117 million.