Category: Daily News

Quest Diagnostics is an American clinical laboratory and Fortune 500 company. It operates in the United States, Puerto Rico, Mexico, and Brazil.Quest also maintains collaborative agreements with various hospitals and clinics across the globe. As of 2020 the company had approximately 48,000 employees, and it generated more than $7.7 billion in revenue in 2019.

The California Attorney General announced a settlement with Quest Diagnostics, Inc., resolving allegations that the diagnostic laboratory company unlawfully disposed of hazardous waste, medical waste, and protected health information at its facilities statewide.

As part of the settlement, Quest Diagnostics will be required to pay nearly $5 million for penalties, costs, and supplemental environmental projects and make significant changes to its operations and practices at its California facilities. The Attorney General was joined by the district attorneys of Alameda, Los Angeles, Monterey, Orange, Sacramento, San Bernardino, San Joaquin, San Mateo, Ventura, and Yolo Counties in the settlement.

The settlement is the result of over 30 inspections conducted by the district attorneys’ offices at Quest Diagnostics laboratories and Patient Service Centers (PSCs) statewide. During those inspections, the district attorneys’ offices reviewed the contents of Quest Diagnostics’ compactors and dumpsters and found hundreds of containers of chemicals, as well as bleach, reagents, batteries, and electronic waste; unredacted medical information; medical waste such as used specimen containers for blood and urine; and hazardous waste such as used batteries, solvents, and flammable liquids. The unlawful disposals are alleged to violate the Hazardous Waste Control Law, Medical Waste Management Act, Unfair Competition Law, and civil laws prohibiting the unauthorized disclosure of personal health information.

After being notified of the investigations, Quest Diagnostics implemented numerous changes to bring its facilities into compliance with California law, including hiring an independent environmental auditor to review the disposal of waste at its facilities and modifying its operating and training procedures to improve its handling, storage, and disposal of hazardous waste, medical waste, and personal health information at all four laboratories and over 600 PSCs in California.

The settlement resolves the allegations above and requires Quest Diagnostics to pay $3,999,500 in civil penalties, $700,000 in costs, and $300,000 for a Supplemental Environmental Project to support environmental training and enforcement in California. The settlement also imposes injunctive terms, including requirements that Quest Diagnostics maintain an environmental compliance program, including hiring a third-party waste auditor, and report annually on its progress.

Quest Diagnostics set a record in April 2009 when it paid $302 million to the government to settle a Medicare fraud case alleging the company sold faulty medical testing kits. It was the largest qui tam (whistleblower) settlement paid by a medical lab for manufacturing and distributing a faulty product.

In May 2011, Quest paid $241 million to the state of California to settle a False Claims Act case that alleged the company had overcharged Medi-Cal, the state’s Medicaid program, and provided illegal kickbacks as incentives for healthcare providers to use Quest labs.

It is also worthy of note that in 2017 Quest Diagnostics Inc. agreed to pay $6 million to resolve a lawsuit by the United States alleging that Berkeley HeartLab Inc., of Alameda, California, violated the False Claims Act by paying kickbacks to physicians and patients to induce the use of Berkeley for blood testing services and by charging for medically unnecessary tests. Quest, which is headquartered in Madison, New Jersey, acquired Berkeley in 2011, and ended the conduct that gave rise to the settlement.

And in 2019 Quest Diagnostics confirmed a third-party billing company has been hit by a data breach affecting 11.9 million patients. The laboratory testing company revealed the data breach in a filing with the Securities and Exchange Commission.

Jeffrey Mazik is the former “Senior Practice Leader for Kaiser’s National Compliance Office” and has over 25 years of experience in fraud control, auditing, and compliance. He was “employed by Kaiser” from 2008 to 2017, joining as an “Information Technology Audit Specialist” in May 2008 and transitioning to the role of “Senior Practice Leader in the Fraud Control Program” in March 2012.

His duties included working with regional compliance leadership to implement compliance and fraud control initiatives, using data analytics to improve compliance and fraud-mitigation initiatives, investigating potential fraud, and developing corrective action plans to address fraud risks.

He has filed federal lawsuit in the United States District Court tor the Eastern District of California against Kaiser Foundation Health Plan, Inc. (“KFHP”), Kaiser Foundation Hospitals (“KF Hospitals”), The Permanente Medical Group, Inc., Southern California Permanente Medical Group, and Colorado Permanente Medical Group, P.C. (“the PMG defendants”). The PMG defendants are groups of physicians that “contract with the other Kaiser entities” to provide medical services Each PMG defendant operates within its individual territory and is funded primarily by reimbursements from its respective regional Kaiser Foundation Health Plan entity.

Defendant KF Hospitals is a nonprofit corporation headquartered in California that operates hospitals and provides facilities for the benefit of the PMG defendants. (Id.) It also receives its funding from defendant KFHP. (Id.) Defendant KFHP is a nonprofit corporation headquartered in California that enrolls members in health plans and provides medical services for its members through contracts with defendant KF Hospitals and the PMG defendants.

On April 2, 2021 Mazik filed his operative first amended complaint under seal on behalf of the United States of America and the states of California, Colorado, Georgia, Hawaiʻi, Maryland, Virginia,, and Washington pursuant to the federal False Claims Act,

He alleges defendants have schemed to defraud the federal government by allowing external, i.e., “non-Kaiser,” healthcare providers to submit false diagnosis codes, which defendants in turn submit to CMS in order to inflate their capitation rates. In particular, defendants intentionally fail to properly use fraud-detection tools to monitor claims errors. Defendants contract with data analytics vendors to review their external provider claims for each region. The vendors provide software applications that perform various types of reviews. For instance, some programs”detect claims that are incorrectly billed . . . [while] other programs identify intentionally manipulated claims that technically fall within plan rules . . . .”

However, he alleges defendants intentionally misused these programs and used them at minimum capacity, such as by disabling key features, in order to reduce the chances of detecting claims errors. In this way, defendants were actively working to avoid detecting and correcting fraudulent claims.

In late 2015, Mazik was tasked with comparing the functionalities offered by two claims analytics vendors, McKesson and Verisk, with which defendants routinely contracted. McKesson offers auditing software called ClaimsXten that detects fraudulent billing practices using “a robust set of rules.” However, defendants chose to deactivate 25 of the 54 rules used by ClaimsXten – “the principal software program that they were supposedly relying on [to] detect such billing fraud.” When a group of employees including Mazik used a Verisk program to double-check data from “the Georgia region” produced by ClaimsXten, the group found $5.3 million in overpayments stemming from defendants’ decision to deactivate nearly half the rules in ClaimsXten. Defendants neither reactivated the disabled rules nor rectified the $5.3 million in overpayments.

When Mizak audited regional office claims from August 2010 through July 2016, he discovered that inflated diagnosis codes caused $209 million in Medicare Advantage overpayments, $181 million in Medi-Cal overpayments and $181 million in other Medicaid programs.Additional allegations similar to the above were made in the lawsuit, and Mazik claims that ultimately he was “stripped of his duties and responsibilities” On January 5, 2017, Mazik was fired.

On July 13, 2022, defendants filed their motion to dismiss Mazik’s First Amended Complaint. In their pending motion, defendants argued that Mazik’s federal FCA claim is barred by the first-to-file rule and the first amended complaint filed by the relator, Dr. James Taylor, in United States ex rel. Taylor v. Kaiser Permanente, No. 21-cv-03894-EMC (N.D. Cal.) (“the Taylor Complaint”). The Court compared the allegations in both cases and concluded that Mazik’s FCA claim was barred by the first-to-file rule except to the extent relator alleges that defendants deliberately tampered with compliance software to ensure that it did not identify erroneous diagnosis codes.

And on February 13, 2024 the Court issued its ruling granting in part and denying in part the Motion to Dismiss. Thus parts of the Mazik case will proceed, and there is additionally the Taylor case proceeding in another California Federal District Court based upon similar allegations.  

The American Property Casualty Insurance Association (APCIA) is the primary national trade association for home, auto, and business insurers. APCIA promotes and protects the viability of private competition for the benefit of consumers and insurers, with a legacy dating back 150 years. APCIA members represent all sizes, structures, and regions—protecting families, communities, and businesses in the U.S. and across the globe.

The APCIA just announced special award winners among the 2024 Class of Emerging Leaders during the Emerging Leaders Conference in San Antonio, Texas. This year, 13 individuals were recognized among a class of 201 insurance professionals with an award for their exceptional work and outstanding impact in 2023.

“I am thrilled to congratulate the exceptional industry leaders who were honored with awards at this year’s Emerging Leaders Conference,” said David A. Sampson, president and CEO of APCIA. “It is a privilege for APCIA to recognize the industry’s top talent and provide meaningful opportunities for networking and professional development. I also want to congratulate the entire 2024 Class of Emerging Leaders for being nominated and selected to participate in this prestigious conference.”

The awards announced during the 2024 Emerging Leaders Conference include: Business Excellence Award; Business Impact Award; Business Leadership Award; Exceptional Philanthropic Impact Award; Innovation Leadership Award; Leadership Award; Outstanding Diversity, Equity, and Inclusion Leadership Award; and Talent Leadership Award.

“This year’s winners reflect the innovation and collaboration of the industry’s best and brightest future leaders,” said Marguerite Tortorello, managing director of the Insurance Careers Movement. “The diverse categories of awards also demonstrate the significant impact the winners are having across their organization and in their community through their leadership.”

“The stellar 2024 Class of Emerging Leaders included rising stars from 80 different companies,” said Jessica Hanson Hanna, APCIA’s senior vice president of public affairs. “The incredible participation in this elite conference demonstrates a true commitment among the industry to recognize and cultivate talent. I want to congratulate the award winners for their special and well-deserved recognition.”

Class of 2024 Emerging Leaders Award Winners

– – Business Excellence Award: Michelle Page, The Hartford
– – Business Impact Award: Mukund Nair, CSAA Insurance Group and Kenji Swepson, Everest
– – Business Leadership Award: Joe Alessi, Universal Shield Insurance Group, Enjonli Hutchison, Amerisure Insurance and Craig Woodworth, Argo Group
– – Exceptional Philanthropic Impact Award: Megan Williams, Auto Club Group
– – Innovation Leadership Award: Wendy Coffing, Great American Insurance Group, Jonathan Macenski, Ally Insurance, and Glen Norton, Illinois Casualty Company
– – Outstanding Diversity, Equity, and Inclusion Leadership Award: Shameem Awan, Amica Mutual Group and Sandra Polanco, Zurich North America
– – Talent Leadership Award: Jon O’Camb, ERIE Insurance Group.

The Emerging Leaders Conference provides candid insights by industry executives, networking, and tools and resources for emerging leaders to succeed in this fast-changing world. After the Emerging Leaders Conference, the rising stars will join their fellow alumni in serving as ambassadors for the industry and in helping expand career opportunities in insurance.

The Association of Independent Judicial Interpreters of California (AIJIC) is a nonprofit trade association that represents the voice of independent court interpreters in California in matters that have, or could have, a significant impact on the independent interpreting profession in the private sector.Its principal office located in Studio City, Los Angeles County, California.

One Call Corporation dba One Call, One Call Care management, and/or One Call Care Transport & Translate is a corporation registered with the Florida Secretary of State, with its principal office located in Jacksonville, California. ONE CALL provides care coordination services to the workers’ compensation industry, which services include providing interpreters. Interpretation services which are provided nationwide.

On January 31, 2024, AIJIC sued One Call in the Los Angeles Superior Court. The lawsuit stems from allegations of multiple cases of identity theft of court interpreters’ names and credentials in Workers Compensation depositions.

The AIJIC lawsuit was brought pursuant to California’s Unfair Competition Law, Business & Professions Code sections17200 et seq., to enjoin defendants from unlawful, fraudulent, and unfair business practices and false advertising.

The plaintiffs allege One Call employs individuals and businesses that are impersonating certified court interpreters in California worker’s compensation cases, resulting in harm to workers alleging industrial injuries who cannot proficiently speak or understand English, However AIJIC alleges that One Call “has publicly disseminated untrue or misleading statements and advertising as regards the company’s ability to provide certified interpreters for worker’s compensation cases.”

AIJIC also alleges on “numerous occasions, individuals employed by defendants appeared in California worker’s compensation cases, and these individuals have falsely impersonated certified California interpreters. Some of these individuals have falsely impersonated certified California interpreters in more than one instance.” And that “defendants not only impersonated others, but these individuals also were not certified to interpret in California for worker’s compensation proceedings.”

The lawsuit goes on to allege that “On or about December 1, 2022, Plaintiff sent a letter to ONE CALL to inform it that California certified interpreters were being impersonated by unknown individuals employed through ONE CALL at Zoom depositions based in California. This letter, which was supported by sworn declarations from court reporters and impersonated interpreters, identified nine specific instances where impersonations had occurred in 2021 and 2022.”

“ONE CALL responded by stating it would no longer do business with the individuals or contractors who had provided interpreters for the Zoom depositions addressed in the December 1, 2022 letter. ONE CALL, however, refused to identify any of the individuals or contractors by name.”

However AIJIC continues to allege that “ONE CALL again employed one of the individuals previously involved in impersonating certified California interpreters. On this occasion, the individual appeared for a pre- deposition meeting with a worker and his attorney. On or about July 14, 2023, Plaintiff notified ONE CALL of this impersonation and asked that the impersonator’s true name be provided. ONE CALL did not respond to Plaintiff’s request.”

“Since July 14, 2023, individuals employed through ONE CALL and/or DOE defendants have continued to appear in California worker’s compensation cases, and these individuals have falsely impersonated others in their official capacity as certified California interpreters. In some instances, these individuals also have provided fake Judicial Council of California badges bearing the names of the certified court interpreters they were impersonating “

Plaintiff seeks “an accounting of all defendants for any and all profits derived by defendants from their business acts and practices in violation of the UCL” among other relief.;

One Call will have 30 days from the date they are served with this lawsuit to respond, and the parties will then conduct discovery followed by law and motion activities.

This lawsuit has now had nationwide attention in the media including Bloomberg Law and the Daily Journal in California.

A seven-person jury in Syracuse, New York returned a verdict to resolve a disability discrimination lawsuit filed by the U.S. Equal Employment Opportunity Commission (EEOC). The jury awarded $1.675 million to Shelley Valentino, a deaf individual, who unsuccessfully applied for two positions in McLane’s warehouse located in Lysander, N.Y., for which she was fully qualified. The facility employs approximately 650 people and distributes products to retail businesses throughout the Northeast.

On March 12, 2018, Valentino applied online for two open positions with Defendant: Warehouse Selector II and Warehouse Selector IV. Her application indicated two prior work experiences: working as a hostess and busser at Plainville Restaurant between August 2007 and July 2008, and as a filing and data entry clerk between January and October 2003. Her resume indicated that she received her GED in 2005, a certification in medical billing and coding in 2011, and an associate degree in health information technology in 2016. Valentino’s application nowhere indicates that she has any disability or requires any accommodation.

McLane contacted her the same day she applied for the two jobs, and left a message. She then returned McLane’s call using a Telecommunications Relay Service, which uses an operator to facilitate calls for people with hearing and speech disabilities. After being contacted via the Relay Service, McLane did not return her call and rejected her application the next day. McLane filled the positions with individuals who are not hearing impaired. The reason given in the applicant tracking system was that Valentino did not meet the company’s preferred qualifications.

McLane received a total of 208 applications for the Warehouse Selector II position and hired 15 individuals. Similarly, they received 209 applications for the Warehouse Selector IV position and hired eight individuals.

The EEOC filed suit in the U.S. District Court for the Northern District of New York (EEOC v. McLane/Eastern, Inc. d/b/a McLane Northeast, Civil Action No. 5:20-cv-01628-BKS-ML) after first attempting to reach a pre-litigation settlement through its conciliation process. The EEOC sought back pay, front pay, compensatory damages, and punitive damages for the applicant, as well as injunctive relief designed to remedy and prevent future disability discrimination in the hiring process.

In January 2023, the court heard a motion for summary judgment filed by McLane, who pointed out that courts regularly dismiss ADA disability discrimination claims where the plaintiff cannot establish that the employer had knowledge of the plaintiff’s disability, on the ground that such a plaintiff cannot establish the causation element of a prima facie case. An employer “cannot be liable under the ADA for firing an employee when it indisputably had no knowledge of the disability,” because an employer cannot take an adverse action with respect to an employee or applicant “because of a disability unless it knows of the disability.”

“[A] plaintiff alleging discrimination on account of his protected status must offer evidence that a decision-maker was personally aware of his protected status to establish a prima facie case of discrimination.” Murray v. Cerebral Palsy Ass’ns of N.Y., Inc., No. 16-cv-662, 2018 WL 264112, at *7, 2017 U.S. Dist. LEXIS 213553, at *19-20 (S.D.N.Y. Jan. 2, 2018) ( other citations omitted).

McLane argued that the evidence “plainly demonstrates” that it had no knowledge of Valentino’s deafness when her applications were rejected, because (1) Defendant’s Human Resources Manager, Anne Orr – the decisionmaker -testified that she did not know Valentino is deaf until Valentino filed a charge of discrimination with the EEOC in August 2018; (2) the other three members of the Human Resources Department testified that they were not aware of Valentino’s disability at the relevant time, did not speak to Valentino on the phone or recall a TRS call, and played no role in the hiring process; and (3) Valentino herself never expressly informed Defendant of her disability and does not know for sure whether the TRS operator did so.

The Court denied the motion for summary judgment, concluding that there is evidence from which a reasonable factfinder could conclude that Defendant had knowledge of Valentino’s disability at the time it decided not to interview or hire her in March 2018, based on the transcript of the March 12 Telecommunications Relay Service, that someone in McLane’s HR department received.

After a 3 ½-day trial, the jury found, following just two hours of deliberation, that McLane Northeast violated the Americans with Disabilities Act (ADA) by first refusing to interview Valentino, once the company learned that the candidate was disabled. Then the company further violated the ADA by refusing to hire the candidate for the two entry-level warehouse jobs that she applied for, the EEOC.

The jury awarded Valentino $25,000 in back pay, $150,000 in emotional distress damages, and $1.5 million in punitive damages.

Caitlin Brown, one of the EEOC trial attorneys who litigated the case, said, “The jury clearly understood that what McLane did here was wrong ” Deaf applicants, and all applicants with disabilities, deserve a fair chance to get jobs to enable them to support themselves and their families.”