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WCAB En Banc Concludes Electronic Testimony be Readily Permitted

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Tyson Perez filed an Application for Adjudication of Claim on August 24, 2022, alleging a cumulative trauma injury while working as a professional baseball player for the Houston Astros from June 1, 2011, to June 25, 2022. He later filed an Amended Application joining the Chicago Dogs as a party defendant.

The Chicago Dogs and its carrier, Liberty Mutual, filed a Declaration of Readiness to Proceed seeking adjudication on the sole issue of personal jurisdiction. The matter was set for a trial on personal jurisdiction over the Chicago Dogs at the Mandatory Settlement Conference on May 23, 2024. The Pre-Trial statement listed the applicant, Tyson Perez, and also Trish Zuro, the Chief Operating Officer of the Chicago Dogs as witnesses, among other individuals. On June 11, 2024, the undersigned served all parties with an affidavit from Trish Zuro.

At trial, the Chicago Dogs offered a witness statement into evidence. Counsel for the Applicant and Co-Defendant, Houston Astros, objected to the witness statement of Trish Zuro because it was not served before the close of discovery and because admitting the written statement into evidence would deprive the parties of their due process to cross-examine the witness.

The applicant attorney and co-defendant objected to the testimony and the admission of the affidavit at the Trial date, and after 8 months when the affidavit was previously served to the parties and more than 8 months when the parties were notified on the Pre-Trial Conference statement that Ms. Zuro was listed as a witness. The witness was to rebut the applicant’s contentions of minimum contacts of the team with California.The WCJ denied Chicago Dogs’ request to permit witness Trish Zuro to testify by telephone.

The Findings and Order, dated May 13, 2025, found that the California Workers’ Compensation Appeals Board may exercise personal jurisdiction over the Chicago Dogs for the Applicant’s alleged cumulative trauma injury claim.

The WCJ did not permit Trish Zuro to testify by telephone because the Chicago Dogs did not file a petition before the trial, showing good cause for why she should be allowed to testify remotely. Per CCR 10618(a), “If a witness intends to testify electronically, a petition showing good cause shall be filed pursuant to rule 10510 by the witness or by the party offering the witness’s testimony before the hearing, and shall identify the witness and contain the witness’s full legal name, mailing address, email address, and telephone number. There was no such petition requesting remote appearance filed in this matter.

Chicago Dogs filed a Petition for Reconsideration, appealing the trial court’s decision not to allow the witness statement into evidence and not allow the witness to testify remotely. Reconsideration was granted in the En Banc decision of Tyson Perez v Chicago Dogs -ADJ16597333 (August 2025).

The issue was the interpretation and application of WCAB Rule 10817(a), which states in relevant part that: “If a witness intends to testify electronically, a petition showing good cause shall be filed pursuant to rule 10510 by the witness or by the party offering the witness’s testimony before the hearing, and shall identify the witness and contain the witness’s full legal name . . . .” (Cal. Code Regs., tit. 8, § 10817(a).)

“As a matter of due process, all parties to a workers’ compensation proceeding retain the fundamental right to due process and a fair hearing under both the California and United States Constitutions. (Rucker v. Workers’ Comp. Appeals Bd. (2000) 82 Cal.App.4th 151, 157-158 [65 Cal.Comp.Cases 805].”

A fair hearing includes, but is not limited to, the opportunity to call and cross-examine witnesses; introduce and inspect exhibits; and to offer evidence in rebuttal.

In 1890, the California Supreme Court opined: “The principal purpose of vesting the court with the discretionary power to correct ‘a mistake in any other respect’ is to enable it to mold and direct its proceedings so as to dispose of cases upon their substantial merits, when it can be done without injustice to either party, whether the obstruction to such a disposition of cases be a mistake of fact or a mistake as to the law, although it may be that the court should require a stronger showing to justify relief from the effect of a mistake of law than of a mistake of fact.” (Ward v. Clay (1890) 82 Cal.502, 23 P.50, 1890 Cal. LEXIS 591.

“Therefore, based on these principles, interpretation of our rules must necessarily incorporate California’s public policy in favor of adjudication of claims on their merits, rather than on the technical sufficiency of the pleadings.”

Thus the WCAB concluded “Therefore, based on these principles, interpretation of our rules must necessarily incorporate California’s public policy in favor of adjudication of claims on their merits, rather than on the technical sufficiency of the pleadings.”

Thus the WCAB concluded that “In considering the application of WCAB Rule 10817(c), we preliminarily conclude that a request on the record for electronic witness testimony at the beginning of the hearing, with an opportunity for any party to respond, satisfies the petition requirement and is sufficient to adjudicate the issue of electronic testimony. Moreover, we preliminarily conclude that the due process right to a fair hearing and a determination based on the merits is good cause to allow the electronic testimony of the witness. Therefore, when a witness is unable to appear in person, as a matter of due process, a request to testify electronically should be readily permitted.”

“Accordingly, we grant defendant’s Petition for Reconsideration, and order that a final decision after reconsideration is deferred pending further review of the merits of the Petition for Reconsideration and further consideration of the entire record in light of the applicable statutory and decisional law.”

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Federal Rule 702 Helps Monsanto Defend Roundup Cancer Case

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Federal Rule of Evidence 702 was first adopted in 1975 as part of the original enactment of the Federal Rules of Evidence. Beginning in 1993 the Rule was interpreted by the U.S. Supreme Court in three landmark decisions that are now know as the “Daubert Trilogy.” The Rule requires a high level of scrutiny of scientific evidence in a “Daubert” hearing before a federal trial commences.

This Daubert standard is mandatory in all federal trial courts. And approximately 42 states have adopted the Daubert standard or a substantially similar standard for the admissibility of expert testimony in their state courts, either fully or with modifications. California state courts have not. Instead, California uses the “Fry” standard which is far more lenient. And in California experts who rely on controversial science in forming an opinion may testify, and the controversy applies for the “weight” of the evidence rather than admissibility, compared to the Daubert standard which makes controversial scientific evidence inadmissible.

Large corporate defendants who are sued in California may be entitled to remove the case to federal court under some circumstances such as diversity jurisdiction. Often, their reason for doing so it to take advantage of the mandated use of Rule 702.

This new published 9th Circuit Court of Appeals decision in Favor of Monsanto in one of its “Roundup” toxic injury cases is a clear example of why employers may move to have California state cases removed to federal courts when they meet the requirements to do so.

From 1990 to 2015, Peter Engilis, Jr. routinely hand- sprayed Roundup several times per month at each of his three homes in Florida. In 2014, he was diagnosed with a blood cancer known as chronic lymphocytic leukemia (CLL), which is a type of non-Hodgkin’s lymphoma (NHL).

In November 2019, Engilis filed a lawsuit against Roundup manufacturer Monsanto in the Middle District of Florida, invoking the court’s diversity jurisdiction and asserting claims under Florida state law that were premised on the allegation that exposure to Roundup caused him to develop CLL. The case was subsequently transferred to a multidistrict litigation proceeding in the Northern District of California, in which thousands of cancer victims have alleged that Roundup caused their NHL.

In a “toxic tort claim for physical injuries,” a plaintiff must “show that he was exposed to chemicals that could have caused the physical injuries he complains about (general causation), and that his exposure did in fact result in those injuries (specific causation).” Golden v. CH2M Hill Hanford Grp., 528 F.3d 681, 683 (9th Cir. 2008).

To demonstrate that Roundup caused Engilis’s cancer, Engilis relied on the expert opinion of board-certified oncologist Dr. Andrew Schneider. Dr. Schneider submitted an expert report offering opinions on both general causation and specific causation.

Monsanto moved to exclude Dr. Schneider’s opinion. At the hearing on the motion to exclude, Monsanto’s counsel extensively cross-examined Dr. Schneider about his basis for ruling out Engilis’s obesity as a potential cause of Engilis’s cancer. In response, Dr. Schneider sought to defend his assertion that Engilis was not obese. But after conceding that he had not examined Engilis and could not say whether Engilis was obese or not, Dr. Schneider testified that, regardless of whether Engilis was obese, he did not view obesity as a potential cause of NHL. During follow-on questioning, he stated that although some medical literature reports an association between obesity and the development of NHL, his clinical experience led him to believe that obesity does not contribute to NHL.

After the hearing, the district court issued an order excluding Dr. Schneider’s specific causation opinion. The 9th Circuit Court of Appeals affirmed in the published case of Engilis et al v Monsanto 3:19-cv-07859- VC (August 2025).

The admissibility of expert testimony is controlled by Federal Rule of Evidence 702. That Rule provides that, “before admitting expert testimony, the district court must perform a gatekeeping role to ensure that the [proffered] testimony is both relevant and reliable.” The parties parties dispute the significance of the 2023 amendment to Rule 702 and the effect of that amendment on existing precedent.

Thus the Court of Appeals reviewed the current precedent starting with the “Daubert Trilogy” which refers to three landmark U.S. Supreme Court cases that established the modern standard for admitting scientific expert testimony in federal courts. These cases clarified the admissibility of expert evidence under the Federal Rules of Evidence, particularly Rule 702, replacing the earlier Frye standard. In 2000, Rule 702 was amended for the first time to codify the holdings of the Daubert trilogy, and to resolve conflicts that had arisen within the courts about the meaning of that trilogy.

The Rule was amended again in December 2023 to expressly require a proponent of expert testimony to “clarify and emphasize” that proffered expert testimony must meet the admissibility requirements of Rule 702 by a preponderance of the evidence. Before the amendment, “many courts” had erroneously held “that the critical questions of the sufficiency of an expert’s basis, and the application of the expert’s methodology, are questions of weight and not admissibility.”

“Here, the district court properly concluded that Engilis failed to establish by a preponderance of the evidence that Dr. Schneider’s conclusion was based on sufficient facts or data.”

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Spine Device Company CEO Sentenced for False Statements to CMS

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SpineFrontier, Inc., founded in 2006 by Dr. Kingsley R. Chin, is a Massachusetts-based medical device company. SpineFrontier faced a multi-year investigation by the U.S. Department of Justice (DOJ) starting in 2016, initiated by whistleblower allegations under the False Claims Act. The civil case, settled in November 2023, alleged that SpineFrontier paid kickbacks to spine surgeons consulting with the company.

SpineFrontier products, such as doughnut-shaped plastic cages, titanium screws, and other spinal implants, are used by spine surgeons across the United States, including in surgeries reimbursed by federal health care programs like Medicare and Medicaid, which are active in California.

In addition to the civil cases, in 2021, SpineFrontier, Dr. Chin, and CFO Aditya Humad were indicted on criminal charges including conspiracy to violate the Anti-Kickback Statute and money laundering.

Dr. Chin pleaded guilty in May 2025 to one count of making false statements to the Centers for Medicare & Medicaid Services (CMS) under the Physician Payment Sunshine Act. The false statements involved misreporting a $4,750 payment to a surgeon as “consulting” fees, despite no actual consulting work being performed.

Money laundering charges were dismissed in December 2024, and all criminal charges against Dr. Chin and SpineFrontier were dismissed by May 2025, except for a guilty plea to one count of false statements to CMS.

Dr. Kingsley R. Chin was sentenced on August 7th by U.S. District Court Judge Indira Talwani to one year of supervised release with the first six months to be served in home confinement. He was also ordered to pay a fine of $9,500, in addition to $40,000 he personally agreed to pay as part of a related civil settlement, and $855,000 his wholly-owned company, KICVentures, agreed to pay as part of the same settlement.

KICVentures is a private equity firm led by Dr. Kingsley R. Chin. It focuses on advancing outpatient spine surgery through the Less Exposure Spine Surgery (LESS) philosophy. The firm manages a portfolio of spine technology companies aimed at improving patient outcomes and empowering physician-led innovation.

Pursuant to the Physician Payment Sunshine Act, device manufacturers, like SpineFrontier, are required to report any payments or transfers of value to physicians, including spine surgeons. CMS maintains a database, via the Open Payments website, which makes all such payments or transfers of value publicly accessible.

SpineFrontier offered surgeons the opportunity to engage in purported consulting on product development. Specifically, Chin directed his employees to report the payment of fees paid to a surgeon as consulting fees that were not compensation for actual consulting work.

Chin caused his employees to report a payment of $4,750 on Jan. 19, 2016, to the surgeon as a “consulting” payment, even though Chin knew that the surgeon had not performed actual consulting work for the payment. He also knew that he and SpineFrontier were required to accurately report any payments or transfers of value to the surgeon.

United States Attorney Leah B. Foley; Roberto Coviello, Special Agent in Charge of the U.S. Department of Health & Human Services’ Office of the Inspector General; Ted E. Docks, Special Agent in Charge of the Federal Bureau of Investigation, Boston Division; Christopher Algieri, Special Agent in Charge of the Veterans Affairs Office of Inspector General, Northeast Field Office; and Ketty Larco-Ward, Inspector in Charge of the U.S. Postal Inspection Service’s Boston Division made the announcement today. Assistant U.S. Attorneys Abraham R. George, Christopher R. Looney and Mackenzie A. Queenin prosecuted the case.

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Kidnapping Charges Added to LAPD Officer Facing Insurance Fraud

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Eric Benjamin “Ben” Halem, 37, of Porter Ranch, a former full-time Los Angeles Police Department officer and current LAPD reserve officer, and his brother, Jacob Halem, 32, of Tarzana, were arraigned in May 2025 on felony insurance fraud charges following an investigation by the California Department of Insurance. The investigation found the brothers allegedly filed a fraudulent auto insurance claim in an attempt to obtain benefits they were not entitled to receive.

The Department of Insurance began its investigation after receiving a fraud referral alleging Eric Halem falsely reported a crash involving his 2020 Bentley Continental GT, stating his brother Jacob Halem had borrowed the vehicle and was involved in a solo-collision on January 5, 2023. However, the investigation revealed that the luxury vehicle had actually been rented out through Eric Halem’s exotic car rental company, Drive LA, and crashed by the renter three days earlier.

Upon learning that the rental driver’s claim had been denied, Eric Halem allegedly filed a fraudulent claim with his insurance company on his personal policy, misrepresenting the accident details. He claimed that his brother, Jacob Halem, had been driving the vehicle at the time of the crash.

On August 11, 2025 the Los Angeles District Attorney announced that felony charges have been filed against Halem and three other men in connection with a violent home invasion and kidnapping for ransom in Koreatown last December.

Also charged in the case are Luis Banuelos (dob 5/25/97) of Jurupa Valley in Riverside County, Pierre Louis (dob 12/8/98) of Attleboro, Mass. and Mishael Mann (dob 7/31/05) of Los Angeles. Each defendant faces counts of kidnapping for ransom, first-degree residential robbery, and home invasion robbery in concert. Mann and Halem are being held on no bail, and Louis and Banuelos are each being held on $1.3 million bail.

On Dec. 28, 2024, at approximately 2:30 a.m., Halem and Mann allegedly entered an apartment in Koreatown, where they handcuffed two victims, transferred money from the victims’ cryptocurrency account, and stole cash and jewelry before fleeing. Banuelos and Louis are accused of serving as getaway drivers who waited outside the location.

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Cal Supreme Court Improves Arbitration Rules for Employers

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Dana Hohenshelt sued his employer, Golden State Foods Corporation, in Los Angeles County Superior Court in November 2020. Hohenshelt alleged discriminatory retaliation, failure to prevent harassment, and Labor Code violations stemming from his reports of workplace sexual harassment and subsequent termination in April 2020.

Hohenshelt had signed a pre-dispute arbitration agreement governed by the Federal Arbitration Act (FAA), requiring binding arbitration for employment claims. Golden State was responsible for paying arbitration fees and costs.

The trial court compelled arbitration in August 2021 via JAMS. Arbitration proceeded for about a year. In July and August 2022, the arbitrator issued invoices totaling over $44,000 to Golden State, due upon receipt. Golden State paid late (after 30 days), citing inadvertence due to the arbitrator’s unavailability notice and counsel’s paternity leave.

Hohenshelt moved to withdraw from arbitration and lift the court stay under California Code of Civil Procedure § 1281.98 (part of the California Arbitration Act, or CAA), claiming Golden State’s late payment constituted a material breach. The trial court denied the motion, interpreting the statute to allow payment within 30 days of a later deadline set by the arbitrator.

The Court of Appeal (Second District, Division Eight) reversed, holding the payment was untimely and § 1281.98 was not preempted by the Federal Arbitration Act. It directed the trial court to lift the stay..

The California Supreme Court reversed the Court of Appeal decision in the published case of Hohenshelt v. Superior Court -S284498 (August 2025).

Under California law, employer must pay arbitration fees “within 30 days after the due date” (invoices are due upon receipt unless parties agree otherwise). Late payment constitutes a “material breach,” default, and waiver of the right to compel arbitration. The employee may withdraw or continue arbitration (if the provider agrees). The breaching party must pay the other’s reasonable expenses (mandatory); courts may impose additional sanctions unless justified.

The Legislature enacted section 1281.98 in 2019 (Senate Bill 707) to deter employers/companies from strategically delaying arbitrations by withholding fees, affirming federal cases like Brown v. Dillard’s, Inc. (9th Cir. 2005) and Sink v. Aden Enterprises, Inc. (9th Cir. 2003), which treated willful nonpayment as material breach.

The FAA requires arbitration agreements to be enforced like other contracts (no special rules disfavoring arbitration). Section 1281.98’s default 30-day rule (modifiable by parties) promotes arbitration’s goals of speed and efficiency without deviating from general contract law (e.g., time can be “of the essence” in urgent contexts; willful breaches discharge duties).

The Supreme Court rejected prior appellate interpretations treating section 1281.98 as a “bright-line” rule automatically forfeiting arbitration rights for any late payment (e.g., regardless of inadvertence). For example Gallo v. Wood Ranch USA, Inc. (2022) interpreting section 1281.98 rigidly.

Instead, it harmonized the statute with longstanding contract law principles (Civ. Code §§ 3275, 1511; Code Civ. Proc. § 473(b)), which allow relief from forfeiture for non-willful, non-fraudulent, or non-grossly negligent breaches if the breaching party compensates the other. The Legislature aimed to deter strategic nonpayment (per legislative history and cases like Brown and Sink), not penalize good-faith errors. This avoids preemption concerns by aligning with general contract defenses.

The Supreme Court reversed the Court of Appeal’s directive to lift the stay and remanded for the trial court to assess if Golden State’s delay was excusable (e.g., good faith mistake) and if Hohenshelt suffered compensable harm.

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OSHA Hosts Safe and Sound Week August 11-17

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OSHA hosts Safe + Sound Week every August.This nationwide event raises awareness about workplace safety and health programs. These invaluable programs are vital to help prevent injuries, illnesses and fatalities among workers who are exposed to hazards in the workplace or on jobsites. Safe + Sound Week gives employers and employees alike a chance to share ideas, make positive changes and celebrate achievements.

Employees who complete an event during Safe + Sound Week can download a certificate of recognition and a participant web badge that honors their commitment to safety.

Why Are Safety and Health Programs in the Workplace Important? Safety and health programs are designed to help ensure a safe workplace by proactively addressing hazards before they cause serious injuries, illnesses or fatalities. Rather than reacting to a problem that has already occurred, successful safety and health programs stop preventable accidents in their tracks by identifying and fixing hazards and providing safety training and equipment for workers.
How Can You Get Involved?

Safe + Sound is a nationwide event intended to raise awareness and encourage businesses to think proactively about safety. Getting involved is easy, and participation might look a little different for every organization. From hosting a public event, luncheon or training session to creating a presentation or video, the goals of Safe + Sound are simple:

    – – Raise awareness about the value of safety and health programs in the workplace
    – – Strengthen management leadership
    – – Improve worker participation
    – – Find and fix hazards to ensure workers go home safe every day

OSHA said that participating in Safe + Sound Week will help a company and its workers reap lasting benefits throughout the year:

    – – Implement a new safety and health program
    – – Review and improve existing safety and health programs
    – – Renew your commitment to safety to workers, customers, partners, and the community

Need help getting started? For fun ideas and customizable tools you can download, click to learn how to plan and promote your events.

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L.A. Fire Captain Charged with Falsifying Disability Claim

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A Los Angeles County Fire Department captain has been charged with fraudulently claiming long-term disability insurance for a work injury that could not have occurred because he was not at work.

45 year old Thomas Merryman was charged in case 25CJCF04929 with one felony count of insurance fraud, one felony count of false personation and two felony counts of forgery.

Merryman is accused of fraudulently claiming long-term disability benefits from Colonial Life & Accident Insurance Company by submitting forged paperwork from a physician and another Los Angeles County Fire Department captain. Merryman allegedly defrauded the insurance company of more than $25,000.

News sources report that Merryman retired on March 1.

The complaint was filed for a warrant on Aug. 8, and his arraignment is scheduled for Sept. 9 at the Clara Shortridge Foltz Criminal Justice Center in downtown Los Angeles. Authorities say Merryman currently resides in Georgetown, Texas. If convicted as charged, Merryman faces a maximum sentence of five years in state prison.

The case is being prosecuted by Deputy District Attorney Arunas Sodonis of the Healthcare Fraud Division and was investigated by the District Attorney’s Bureau of Investigation.

The charges filed in this case are allegations. The defendant is presumed innocent unless and until proven guilty in a court of law.

“Fake disability claims will not be tolerated under my watch, especially by first responders charged with keeping our county safe,” Los Angeles County District Attorney Nathan J. Hochman said. “False healthcare claims raise insurance premiums and make it more difficult for people with legitimate work injuries to claim benefits. My message to public servants who abuse the system is clear: We are watching you. Prosecutors and investigators in my office are working closely with the Los Angeles County Fire Department and other agencies to root out fraud.”

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PET-enabled Dual-Energy CT is Major Step Forward in Imaging

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The National Institutes of Health (NIH) has awarded the UC Davis Department of Radiology a National Institute of Biomedical Imaging and Bioengineering R01 Research Project Grant with a budget of $2.5 million for four years. The funding will advance a groundbreaking medical imaging technique that could significantly improve how doctors detect and understand cancer and bone and heart disease.

The innovation combines two powerful technologies — PET (Positron Emission Tomography) and dual-energy CT (Computed Tomography) — in a way that’s never been done before.

CT scans provide detailed images of the body’s internal structures. PET scans highlight areas where cells are very active. PET/CT scans are already widely used together to detect cancer and monitor how it spreads. However, traditional CT scans in PET/CT use a single energy level, which limits their ability to tell different types of tissues apart.

The new method, called PET-enabled Dual-Energy CT, changes that. It allows doctors to see not just where something is happening in the body, but also what it’s made of — without needing new machines or exposing patients to more radiation.

A paper published in the European Journal of Nuclear Medicine and Molecular Imaging late last year highlights the progress of the technological development. The research was previously supported by a Trailblazer R21 Award from the NIH and resources from UC Davis Comprehensive Cancer Center.

“This is a major step forward compared to other possible solutions,” said Guobao Wang, professor of radiology and principal investigator. “We’re using the PET scan’s own data to create a second, high-energy CT image. When combined with the regular CT scan, it enables dual-energy imaging that provides a much clearer picture and more detailed information about tissue composition.”

The new hybrid PET/CT dual-energy imaging technology was invented in Wang’s lab with broad applications for cancer imaging. The research employs EXPLORER, the first-of-its-kind total body PET scanner that was invented by UC Davis Health and United Imaging Healthcare, as a platform to validate the technique.

The potential benefits are wide-ranging:

    – – Cancer imaging – it could help distinguish between healthy and cancerous tissues more accurately.
    – – Bone marrow scans – it could improve how doctors measure disease activity more accurately.
    – – Heart disease – it could provide new insights into the role of bone and bone marrow in systemic inflammation and cardiovascular risk.

The method also opens new possibilities for combining PET metabolic information with CT-based tissue composition in a single scan, enhancing the ability to characterize tumors and detect treatment response. Notably, the technique can be implemented on many existing PET/CT scanners without requiring new hardware.

The research team is now working to test and refine the technique. If successful, this approach could be adopted in hospitals without the need for expensive equipment upgrades — making advanced hybrid imaging more accessible to patients everywhere.

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Kaiser Patient Portal Deployment Study Shows Good Outcomes

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Kaiser Permanente has been experimenting with AI in its patient portal, increasing patient engagement and experience in the process.

“Care is local, but at the same time it’s virtual and it’s become a global commodity,” Khang Nguyen, MD, assistant executive medical director for care transformation at Southern California Permanente Medical Group and chief medical officer of care navigation for the Permanente Federation, told Becker’s. “So patients are really expecting artificial intelligence to support healthcare in a way that is supporting other industries, in the sense that people are able to describe what they want versus being given choices.”

A new study, published in npj Digital Medicine in partnership with Seoul National University Bundang Hospital, focused on the deployment of the Kaiser Permanente Intelligent Integration (KPIN) system by the Southern California Permanente Medical Group (SCPMG), which serves 3.9 million patients. Implemented in October 2024, KPIN is an advanced patient portal system designed to enhance care navigation and patient experience.

KPIN replaced older systems (Microsoft’s LUIS and VSN Query Report) and integrated natural language processing (NLP) to generate clinical alerts for high-acuity cases and recommend appropriate care pathways. It supports multiple channels, including a web-based portal, mobile app, and self-service interactive voice response (IVR) system, ensuring consistent care navigation. The system verifies patient identity and guides them through booking processes, redirecting emergencies to 911 or hospitals.

October 1, 2024, to March 1, 2025, KPIN facilitated 2,960,945 digital visits, with 1,046,504 unique patients interacting with the system. Demographic data showed 36.6% of users were aged 30–49, 47.8% were female, and 38.9% were of Hispanic origin.

The study evaluated KPIN’s Clinical Alert System (CAS) and Virtual Safety Net (VSN) models for detecting high-acuity symptoms (e.g., chest pain, dyspnea) and guiding care navigation. Metrics included accuracy, precision, recall, F1-score, and area under the curve (AUC).

KPIN processed an average of 193,134 encounters daily, with a peak of 19,364. The adjusted successful booking rate was 53.8%, reflecting effective appointment scheduling. The abandonment rate was low at 0.94% (IQR: 2.7–3.1%), indicating high user engagement, attributed to a streamlined interface limiting interactions to nine per page.

Patient surveys showed an 8.6 percentage point increase in positive sentiment, suggesting improved user satisfaction. The system struggles with vague “Reason for Visit” entries, which can affect care pathway accuracy.

The authors of the study concluded that “KPIN’s integration into the patient portal significantly improved care navigation, clinical alert accuracy, and patient satisfaction within an integrated value-based care model, demonstrating the effectiveness of advanced digital tools in healthcare delivery.”

Dr. Nguyen called that the “biggest surprise” from the findings. “We all know with websites, if you want to bury anything on a website, just make it two clicks away, and then no one can ever find it,” he said. And when patients abandon the app because they can’t locate what they need, they typically contact the call center.

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Dismissal of Chamber of Commerce Medicare Challenge Affirmed

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The U.S. 6th Circuit Court of Appeals, on August 6, 2025, upheld a lower court’s dismissal of a lawsuit filed by the U.S. Chamber of Commerce, along with the Dayton Area Chamber of Commerce, Ohio Chamber of Commerce, and Michigan Chamber of Commerce, challenging the Medicare Drug Price Negotiation Program, a key component of the Inflation Reduction Act (IRA) signed into law in 2022. The program allows Medicare to negotiate prices for certain high-cost prescription drugs, aiming to reduce costs for beneficiaries and save the program an estimated $98.5 billion over a decade.

The lawsuit, initially filed in June 2023, argued that the program violated the First, Fifth, and Eighth Amendments of the U.S. Constitution, as well as separation of powers, claiming it gave excessive authority to the Department of Health and Human Services (HHS) and imposed unfair price controls. The U.S. Chamber sought a preliminary injunction to halt the program, but U.S. District Judge Michael Newman, a Trump appointee, denied this in September 2023, stating the plaintiffs failed to demonstrate a likelihood of success or irreparable harm. Newman also dismissed the case in August 2024, finding that the regional chambers (Dayton, Ohio, and Michigan) lacked standing to sue on behalf of their members, as their interests were not sufficiently aligned with the pharmaceutical companies’ concerns, such as AbbVie and its subsidiary Pharmacyclics, which were involved in the suit. The judge noted that the U.S. Chamber might have standing if it filed a new suit in a different venue.

The 6th Circuit, in a 12-page opinion written by Senior Judge Ronald Gilman (a Clinton appointee), affirmed the dismissal, agreeing that the regional chambers lacked associational standing. The court emphasized that the Dayton Chamber’s purpose of promoting regional business was not germane to the lawsuit’s focus on the constitutionality of a federal program affecting pharmaceutical manufacturers. The court also criticized the lawsuit as a potential “stalking horse” for forum shopping, as the plaintiffs lacked a direct connection to Ohio. However, the ruling clarified that regional chambers could challenge federal laws with broader impact in some cases, and a lack of corporate headquarters in a region is not necessarily fatal to standing, though it was insufficient here due to the disconnect with the Dayton Chamber’s purpose.

The decision marks the 10th court ruling in favor of the Medicare Drug Price Negotiation Program, which has faced multiple legal challenges from the pharmaceutical industry, including lawsuits from companies like AstraZeneca, Bristol Myers Squibb, Johnson & Johnson, and the trade group PhRMA. None of these challenges have succeeded in blocking the program, which has already negotiated price cuts ranging from 38% to 79% for 10 drugs, set to take effect in January 2026, with projected Medicare savings of $6 billion in the first year. Advocacy groups like Patients For Affordable Drugs hailed the ruling as a victory for over 9 million Medicare beneficiaries who will benefit from lower drug prices.

The U.S. Chamber could appeal to the U.S. Supreme Court, though no comment from them was reported immediately following the ruling. Meanwhile, other lawsuits against the program are ongoing in various federal courts, with potential appeals in the Second, Third, Fifth, and D.C. Circuits, which could lead to conflicting rulings and elevate the issue to the Supreme Court. The program’s voluntary nature – allowing drugmakers to opt out of Medicare entirely – has been a key factor in courts rejecting claims of unconstitutional price controls or takings, as participation is not mandatory.

This ruling reinforces the program’s legal standing, allowing Medicare to continue negotiating drug prices, a process that began with the first 10 drugs announced in August 2023, including treatments for diabetes, blood clots, and cancer from companies like Merck, Novo Nordisk, and AbbVie. The program remains a significant policy achievement for the Biden administration, despite ongoing industry opposition.

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