Author: WorkCompAcademy

Walgreens Boots Alliance Inc. is making the opioid antidote naloxone available without a prescription in all its pharmacies in New Mexico, part of a plan to make the drug readily available in 35 states and Washington D.C., by the end of this year.The drugstore chain has already made naloxone available without a prescription in Alabama, Indiana, Massachusetts, New Jersey, New York, Ohio, Pennsylvania and Rhode Island.

In March, New Mexico Governor Susana Martinez signed a bill into law that expands access to naloxone, allowing it to be available in more than 70 Walgreens pharmacies throughout the state. The law also protects those who administer naloxone from civil liability and criminal prosecution.

California is one of the states that will be served with this program by Walgreens by the end of the year.

“Walgreens’ expansion of medications access in northern New Mexico and throughout the state will make it easier for families to help their loved ones suffering from addiction,” said Richard Martinez, a Democratic member of the state Senate.

Naloxone, administered by injection or nasal spray, can be used in the event of an overdose to reverse the effects of heroin and other opioid drugs. The Obama administration has been funding expanded distribution of naloxone amid a growing epidemic of addiction to opioid drugs in the United States.

In 2014, a record number of Americans died from drug overdoses. New Mexico had one of the highest rates of overdose deaths, along with West Virginia, New Hampshire, Kentucky and Ohio. Approximately 78 people die in the United States every day due to drug overdose, with half of those deaths related to prescription opioid pain medications, according to the U.S. Centers for Disease Control and Prevention.

“We want to make sure that we work together with all the states in accordance with each state’s pharmacy regulations and make this life saving drug available to all,” a representative of Walgreens said.

Walgreens also provides a safe method to dispose of unwanted medications. The medication disposal kiosks allow individuals to safely and conveniently dispose of their unwanted, unused or expired prescriptions, including controlled substances, and over-the-counter medications, at no cost.

The kiosks at Walgreens pharmacies will be available during regular pharmacy hours (24 hours a day at most of these locations) and will offer one of the best ways to ensure medications are not accidentally used or intentionally misused by someone else. The initial installation of the safe medication disposal kiosks has begun in California and is expected to be completed at more than 500 Walgreens locations this year.

A business owner and his bookkeeper were arraigned on charges of $1.5 million tax evasion and an insurance fraud scheme.

Ronald Scott Dee, 63, Irvine, and Pamela Palmer Quast, 61, Santa Ana, are each charged with 28 felony counts of failing to file a return with intent to evade tax, 28 felony counts of willful failure to pay tax, 24 felony counts of willful failure to pay disability insurance deductions, six felony counts of misrepresenting facts to workers’ compensation insurance company, and sentencing enhancement allegations for committing a theft exceeding $100,000. Dee is also charged with two felony counts of willful failure to file or make fraudulent tax returns. If convicted, Dee faces a maximum sentence of 64 years and eight months in state prison and Quast faces a maximum sentence of 63 years and four months in state prison.

They are out of custody on $350,000 bail and are scheduled for a pre-trial hearing on Aug. 17, 2016, at 8:30 a.m. in Department C-55, Central Justice Center, Santa Ana.

Dee is accused of operating Venetian Stoneworks, a tile and stone company in Irvine and Quast is accused of being the bookkeeper for the business. Between Jan. 1, 2006, and Jan. 31, 2013, the defendants are accused of underreporting their payroll to the insurance company, failing to report to the Employment Development Department (EDD) quarterly reports, failing to pay over withholding deductions, disability insurance, and disability insurance withholdings to EDD. Dee is accused of filing a fraudulent tax return with the Franchise Tax Board (FTB).

The Orange County District Attorney’s Office Bureau of Investigation began investigating this case after receiving a fraudulent activity report from the defendants’ insurance company. The defendants are accused of underreporting their payroll to the worker’s compensation insurance carrier in order to pay a lower premium rate for their insurance coverage.

The OCDA Bureau of Investigation, EDD, and FTB investigated this case.

Deputy District Attorney Debbie Jackson of the Insurance Fraud Unit is prosecuting this case.

The Division of Workers’ Compensation (DWC) Acting Administrative Director George Parisotto has appointed Ellen Sims Langille to serve as a member of the Workers’ Compensation Ethics Advisory Committee. The appointment is effective June 1, 2016.

Langille is general counsel of the California Workers’ Compensation Institute (CWCI). She will fill the position of a member of the public representing insurers previously held by Michael McClain of CWCI.

As civil servants, WCALJs are not subject to review by the California Commission on Judicial Performance,the agency responsible for investigating misconduct complaints directed at judges serving on the Supreme, Superior, and Appellate courts. Instead, they are subject to review by the Ethics Advisory Committee. The committee was established in 1995 by Title 8, California Code of Regulations, section 9722.  The committee is independent of the DWC.

The committee reviews all complaints without learning the names of complainant’s or judges, and then makes recommendations to the administrative director and the DWC court administrator. The committee meets quarterly and members serve without compensation.

The regulation provides that the committee must include: three members of the public individually representing organized labor, insurers and self -insured employers; an attorney who formerly practiced before the Workers’ Compensation Appeals Board and who usually represented insurers or employers; an attorney who formerly practiced before the Workers’ Compensation Appeals Board and who usually represented applicants; a presiding judge; a workers’ compensation administrative law judge (WCALJ) or retired WCALJ; and two members of the public outside the workers’ compensation community.

According to the committee’s 2015 annual public report, the EAC considered a total of 38 of the 44 new complaints it received in calendar year 2015, in addition to 6 complaints pending from 2014. Six complaints filed in 2015 are pending ongoing investigation, and six pending complaints were filed after the EAC final calendar meeting for 2015. The EAC also resolved 10 complaints pending ongoing investigation in 2014. The complaints set forth a wide variety of grievances. A large proportion of the complaints alleged legal error not involving judicial misconduct or expressed dissatisfaction with a judge’s decision.

A judicial ethics complaint form and instructions can be found on the forms page of the DWC website .

The Division of Workers’ Compensation (DWC) has added an easy-to-use search tool to help the public find Independent Medical Review (IMR) determinations quickly and efficiently. The DWC IMR search tool is available on the DWC website.

Over 300,000 IMR cases have been decided since the medical dispute resolution process was implemented on January 1, 2013. Following a determination by a physician reviewer, information for each case is posted to the DWC website. The public can use the new tool to search for decisions by case number, date of injury, specialty of reviewer, and/or category of treatment request.

“The DWC IMR search tool allows the public to easily research the database of IMR decisions,” said DWC Acting Administrative Director George Parisotto. “Increased knowledge about the program’s past performance will ultimately lead to a more effective IMR process.”

Each IMR case pertains to one or more requested treatments that were denied, delayed or modified following utilization review (UR). The IMRO’s expert reviewers useevidence-based guidelines contained in the DWC Medical Treatment Utilization Schedule (MTUS) to determine whether to uphold or overturn the UR decision. The rationale for a reviewer’s decision for each requested treatment is provided in the IMR final determination letter.

Maximus Federal Services is the current Independent Medical Review Organization (IMRO) contracted by DWC to conduct IMR.

Maximus is based in Reston, Virginia, and is a publicly-traded for-profit corporation that receives government contracts to provide “business process services” to government health and human services agencies in the United States, Australia, Canada, the United Kingdom, and Saudi Arabia. The company focuses primarily on “operating government-sponsored programs for vulnerable populations, such as Children’s Health Insurance Program (CHIP), Medicaid, health insurance exchanges and other health care reform initiatives under the Affordable Care Act, Medicare, welfare-to-work, and child support services,” according to its annual report.

And Maximus seems to be doing well. For the second quarter of fiscal 2016, Maximus revenue increased 26% to $606.5 million compared to $481.8 million reported for the same period last year. The increase in revenue was attributable to acquisitions that accounted for growth of 15% and organic growth of 13%, principally from the Health Services Segment. The increase in revenue was partially offset by a 2% decline from unfavorable foreign currency translation.

Health Services Segment revenue for the second quarter of fiscal 2016 increased 22% to $330.6 million compared to $270.9 million reported for the same period last year. The Company still expects revenue to range between $2.4 billion and $2.5 billion for fiscal 2016.

CNN reports that America’s addiction to opioid-based painkillers and heroin just got exponentially more dangerous. The most potent painkiller on the market, prescribed by doctors for cancer treatment, is being made illicitly and sold on the streets, delivering a super high and, far too often, death.

The drug, fentanyl, has been around since the 1960s. Its potency works miracles, soothing extreme pain in cancer patients who are usually prescribed patches or lozenges. But an illicit version of the drug is flooding into communities across America, and casual users are finding out that their fentanyl pills and powder are delivering a powerful high that is easy to overdose on. It can even kill. The Drug Enforcement Administration and the Centers for Disease Control say we have another national health crisis on our hands.

Fentanyl, a synthetic and short-acting opioid analgesic, is 50-100 times more potent than morphine. Although pharmaceutical fentanyl can be diverted for misuse, most cases of fentanyl-related morbidity and mortality have been linked to illicitly manufactured fentanyl and fentanyl analogs, collectively referred to as non-pharmaceutical fentanyl (NPF). NPF is sold via illicit drug markets for its heroin-like effect and often mixed with heroin and/or cocaine as a combination product – with or without the user’s knowledge – to increase its euphoric effects. While NPF-related overdoses can be reversed with naloxone, a higher dose or multiple number of doses per overdose event may be required to revive a patient due to the high potency of NPF. [

The latest state statistics on fentanyl-related deaths compiled by the CDC tell a sobering story. It first showed up in deadly doses on the streets in 2007. The DEA traced the illicit fentanyl to a single lab in Mexico and shut it down. Fentanyl drug seizures subsided for a while, but in 2014, they spiked in 10 states. It’s been an uphill battle. Americans are buying it in record numbers, and highly organized drug cartels are spreading it far and wide. What is curious is where the drug or elements to make it originate. Its street nickname is “China White” or “China girl,” offering a hint at where most of it is coming from.

Illicit fentanyl is a bestseller on the streets and a prolific killer. It is so potent that when law enforcement goes in to seize it, officers have to wear level A hazmat suits, the highest protection level made, the same kind of suits health care workers use to avoid contamination by the deadly Ebola virus. “Just micrograms can make a difference between life and death. It’s that serious,” said DEA Special Agent John Martin, who is based in San Francisco. An amount the size of a few grains of sand of fentanyl can kill you. “All you have to do is touch it. It can be absorbed through the skin and the eyes.”

And as far as profits go, the other opioids commonly sold on the streets — heroin, hydrocodone, OxyContin and Norco — can’t even touch fentanyl. Hydrocodone sells for about $30 a pill on the street. A fentanyl pill may look and cost the same but requires only a fraction of the narcotic to give users an even stronger reaction. The DEA estimates that drug traffickers can buy a kilogram of fentanyl powder for $3,300 and sell it on the streets for more than 300 times that, generating nearly a million dollars. Fentanyl is often trafficked through the cartels’ standard maze of routes through Mexico and into the U.S. But sometimes it’s simply ordered on the notorious dark web and shows up straight from China in the buyer’s mailbox.

“They look like what you’re getting from the pharmacy,” forensic scientist Terry Baisz said. She was taken aback by just how much the counterfeit pills look like the ones sold by pharmaceutical companies. After 26 years in the Orange County crime lab, south of Los Angeles, she has never seen anything like what is coming in these days. It worries her. “I was shocked the first time I tested this stuff and it came back as fentanyl. We hadn’t seen it before 2015,” Baisz said, “and now we’re seeing it a lot.” Fentanyl had entered Orange County, and it was killing people.

“It’s so dangerous and so lethal, I had to get involved,” California state Sen. Patricia Bates said. “Two minutes, and you could be in respiratory arrest and be dead. It’s kind of like, get high and die.” Bates knows those details because the fentanyl overdose deaths started racking up in one of the areas she represents, South Orange County. She is trying to push through a bill that would put harsher penalties on high-volume sellers of fentanyl. The bill “will enhance the penalties, by weight,” Bates said. “We’re talking about … catching the big guys, because when you take them out of the food chain, you really do reduce the incidents of the trafficking and what’s available on the streets.” She knows it’s a tough sell in a time when California voters have passed laws to lessen prison sentences for nonviolent offenders. And, of course, there is the matter of prison overcrowding in the state. But Bates is pushing it forward because she is certain this is the next epidemic, similar to what is happening with heroin but more deadly.