Category: Daily News

Federal prosecutors announced the indictment of 18 former professional basketball players and one spouse, who are accused of submitting fraudulent reimbursement claims for fictitious medical and dental expenses.

The alleged “ringleader” of the scheme was said to be Terrence Williams. He was drafted by the then-New Jersey Nets as their 11th overall pick in 2009. Williams allegedly recruited other NBA health plan participants into the scheme, providing them with falsified invoices to claim medical and dental services that were never rendered.

Terrence Williams, Alan Anderson, Anthony Allen, Desiree Allen (Alan’s wife), Shannon Brown, William Bynum, Ronald Glen Davis, Christopher Douglas-Roberts, a/k/a “Supreme Bey,” Melvin Ely (former Fresno State standout), Jamario Moon, Darius Miles, Milton Palacio, Ruben Pattierson, Eddie Robinson, Gregory Smith, Sebastian Telfair, Charles Watson Jr., Antoine Wright, and Anthony Wroten are each charged with one count of conspiracy to commit health care fraud and wire fraud, which carries a maximum sentence of 20 years in prison. Tennence Williams is also charged with one count of aggravated identity theft, which carries a mandatory minimum sentence of two years in prison.

Ronald Glen Davis will be prosecuted in the Central District of California. The other defendants will be prosecuted in other jurisdictions. Anthony Allen Douglas-Roberts, and Robinson remain at large. Milt Palacio, a current Trail Blazers assistant coach, was put on administrative leave by the team after being one of the 18 players arrested.

The indictment charges the defendants with conspiracy to commit health care fraud and wire fraud, in connection with a scheme to defraud the National Basketball Associations Health and Welfare Benefit Plan out of nearly $4,000,000.

The National Basketball Association Players’ Health and Welfare Benefit Plan is a health care plan providing benefits to eligible active and former players of the NBA.

From at least 2017, up to about 2020 the defendants engaged in a widespread scheme to defraud the Plan by submitting and causing to be submitted fraudulent claims for reimbursement of medical and dental services that were not actually rendered.  

Williams orchestrated the scheme to defraud the Plan. He recruited other Plan participants to defraud the Plan by offering to provide them with false invoices to support their fraudulent claims. Williams provided some of the other defendants with false provider invoices, which those defendants then submitted to the Plan for reimbursement of fraudulent claims. Several of the fake invoices stood out because, “they are not on letterhead, they contain unusual formatting, they have grammatical errors.”

Williams provided the other charged defendants fake invoices from a particular Chiropractic Office in California, which were created by individuals working with Williams. In addition, Williams obtained fraudulent invoices from a dentist affiliated with dental offices in Beverly Hills, California, and from a doctor at a Wellness Office in Washington State. The fraudulent invoices purported to document that some of the defendants,and, in some cases, members of their families, had been recipients of expensive medical and dental services.

But the defendants had not received the medical or dental services described in the invoices Williams provided them. In many instances, the defendants were not even located in the vicinity of the service providers on the dates the invoices stated they received medical or dental services. In particular, GPS location information and/or documents, such as flight records, show that the defendants were in locations other than the vicinity of the medical or dental offices falsely claimed as the providers of services.

In return for his provision of false supporting documentation for their fraudulent claims, many of the defendants paid Williams kickbacks, totaling at least $230,000. Williams also used the personal identifying information of an employee of the Administrative Manager, which managed the Plan, in the course of the fraud scheme.

The prosecution of this case is being overseen by the Office’s Complex Frauds and Cybercrime Unit. Assistant United States Attorneys Kristy J. Greenberg and Ryan B. Finkel are in charge of the prosecution.

A three-judge Ninth Circuit panel affirmed a federal court dismissal of a lawsuit filed by the American Society of Journalists and Authors and the National Press Photographers Association challenging the State’s passage of Assembly Bill 5 and its various amendments.

The American Society of Journalists and Authors and the National Press Photographers Association filed a federal lawsuit challenging, on First Amendment and Equal Protection grounds, California’s Assembly Bill 5 and its subsequent amendments, which codified the more expansive ABC test previously set forth in Dynamex Operations West, Inc. v. Superior Court of Los Angeles, 416 P.3d 1 (Cal. 2018), for ascertaining whether workers are classified as employees or independent contractors.

AB5 and its subsequent amendments, now codified at section 2778 of the California Labor Code, provides for certain occupational exemptions.

Because freelance writers, photographers and others received a narrower exemption than was offered to certain other professionals, plaintiffs sued, asserting that AB5 effectuates content-based preferences for certain kinds of speech, burdens journalism and burdens the right to film matters of public interest.

The panel in the published case of ASJA v Bonta held that section 2778 regulates economic activity rather than speech. It does not, on its face, limit what someone can or cannot communicate. Nor does it restrict when, where, or how someone can speak.

The statute is aimed at the employment relationship – a traditional sphere of state regulation. The panel further acknowledged that although the ABC classification may indeed impose greater costs on hiring entities, which in turn could mean fewer overall job opportunities for certain workers, such an indirect impact on speech does not necessarily rise to the level of a First Amendment violation.

The panel rejected plaintiffs’ assertion that the law singled out the press as an institution and was not generally applicable.

Addressing the Equal Protection challenge, the panel held that the legislature’s occupational distinctions were rationally related to a legitimate state purpose.

Amicus briefs were filed in this case by Cato Institute, Reason Foundation, Individual Rights Foundation, Goldwater Institute, Independent Institute and Liberty Justice Center.

Lion Farms, LLC owned and operated a dried-on-the-vine raisin vineyard in Madera County (Cottonwood Ranch), at which Lion’s employee Isaac Rey Barrientos worked.

On June 10, 2015, Barrientos was killed when he lost control of the Lion-owned ATV he was riding in the vineyard to service Lion’s portable toilets, and the ATV’s right front tire hit an eye ring grape stake, ejecting Barrientos off of the vehicle.

The June 12, 2015, Merced County Sheriff’s Office Report of Autopsy and the Madera County Certificate of Vital Record listed “blunt impact thoracospinal injuries” (not a head injury) as Barrientos’s cause of death. He was not wearing a helmet at the time of his fatal accident.

While Barrientos’s death was not due to the absence of head protection, Division Associate Safety Engineer Randy Chase found that wearing helmets while riding ATV’s would reduce the inherent risk of head injury. However, Chase also found that Lion had no written certification of having conducted a workplace hazard assessment and no requirement that its employees wear helmets as PPE while riding ATV’s.

Lion was therefore cited for violations of workplace safety regulations by the Division of Occupational Safety and Health.

Lion challenged the citations and the penalties by filing an appeal with the Board. Lion engaged the services of a retained industrial safety expert, who opined in his prepared report that a helmet would represent a hazard in itself and should never be worn while riding an ATV in and under the raisin vine “canopy” of hanging fruit and canes, as a helmet would “most probably become tangled within the vines and pull the rider off the vehicle, causing severe injury or death.”

Following the hearings, the ALJ upheld the citations, and reconsideration was denied. Lion filed its petition for writ of administrative mandate with the trial court, which was denied after a hearing on the merits. The Court of Appeal affirmed the citations in the unpublished case of Lion Farms v. Cal Occupational Safety and Health etc.

Among other issues, Lion claimed that section 3380 (particularly with respect to PPE required in the context of ATV usage in agricultural settings), as applied on the facts and circumstances of this case violated Lion’s substantive due process protections because the regulations were unconstitutionally vague and ambiguous. The Court of Appeal rejected this argument.

An administrative regulation violates due process of law if it forbids or requires the doing of an act in terms so vague that persons of common intelligence must necessarily guess at its meaning and differ as to its application. In considering a vagueness challenge to an administrative regulation, courts do not view the regulation in the abstract; rather they consider whether it is vague when applied to the complaining party’s conduct in light of the specific facts of the particular case. Standards under a regulation may be refined and developed on a case-by-case basis.

Section 3380(f)(1)(A)’s requirement that employers assess their workplaces to determine if hazards necessitating the use of PPE are present or likely to be present (and if such a determination is affirmatively made, select and make available the types of PPE that will protect affected employees from the hazards identified in the workplace assessment) is not impermissibly vague.

The Los Angeles Times reports that research conducted in Southern California has confirmed the dramatic erosion of the Pfizer-BioNTech COVID-19 vaccine’s protection against “breakthrough” coronavirus infections.

The new study, one of the largest and longest to track the effectiveness of a vaccine in Americans, found that the vaccine’s ability to protect against infection stood at 88% in its first month, then fell to 47% after just five months.

But even as the Delta variant became the predominant strain across the Southland, the vaccine’s effectiveness at preventing COVID-19 hospitalizations held steady at close to 90% for as long as six months. What’s more, it maintained that power across vaccine recipients of all age groups.

The study, funded by Pfizer and published Monday in the journal Lancet, also provides strong new evidence that the waning immunity against infection probably would have been seen with or without the arrival of the Delta variant.

Researchers found that a fresh inoculation with the Pfizer-BioNTech vaccine protected just as well against an infection with the Delta variant as it did against infection with other versions of the coronavirus.

Second, the vaccine’s ability to keep vaccinated people out of the hospital remained high across a span of time when the Delta variant gained ground in Southern California.

And third, breakthrough infections were more closely linked to the amount of time that had lapsed since vaccination than they were to the particular viral variant involved.

By showing that waning immunity, not the Delta variant, was the likely reason for the rise in breakthrough infections, the study suggests it may not be necessary to reformulate a Pfizer-BioNTech booster that specifically targets Delta. For now, at least, a third shot identical to the first two would probably extend the vaccine’s early record of protection against all strains, including Delta.

The protection provided by the Pfizer vaccine beyond six months has been an open question, hinted at only by Israeli studies that suggest COVID-19 hospitalization rates rise in those above 60 years of age.

In another recent study, researchers from Emory University and Stanford found that six months after being inoculated with the Pfizer vaccine, roughly half of 56 young and middle-aged adults had no detectable neutralizing antibodies against the SARS-CoV-2 virus. The reduced immunity was particularly dramatic against the coronavirus variants Delta, Beta and Mu.

That study was posted last week on BioRXiv, a site where researchers share preliminary work before it has been peer-reviewed. But its findings of “a substantial waning of antibody responses” – as well as a drop in the immunity provided by T cells – suggest that a third booster immunization “might be warranted,” its authors wrote.

Our ability to sense heat, cold and touch is essential for survival and underpins our interaction with the world around us. In our daily lives we take these sensations for granted, but how are nerve impulses initiated so that temperature and pressure can be perceived? This question has been solved by this year’s Nobel Prize laureates.

The laureates identified critical missing links in our understanding of the complex interplay between our senses and the environment.

University of California, San Francisco David Julius utilized capsaicin, a pungent compound from chili peppers that induces a burning sensation, to identify a sensor in the nerve endings of the skin that responds to heat. Scripps Research in La Jolla, California scientist Ardem Patapoutian used pressure-sensitive cells to discover a novel class of sensors that respond to mechanical stimuli in the skin and internal organs. These breakthrough discoveries launched intense research activities leading to a rapid increase in our understanding of how our nervous system senses heat, cold, and mechanical stimuli.

Prior to the discoveries of David Julius and Ardem Patapoutian, the understanding of how the nervous system senses and interprets our environment still contained a fundamental unsolved question: how are temperature and mechanical stimuli converted into electrical impulses in the nervous system?

In the latter part of the 1990’s, David Julius saw the possibility for major advances by analyzing how the chemical compound capsaicin causes the burning sensation we feel when we come into contact with chili peppers. Capsaicin was already known to activate nerve cells causing pain sensations, but how this chemical actually exerted this function was an unsolved riddle.

After a laborious search, a single gene was identified that was able to make cells capsaicin sensitive. The gene for capsaicin sensing had been found! Further experiments revealed that the identified gene encoded a novel ion channel protein and this newly discovered capsaicin receptor was later named TRPV1. When Julius investigated the protein’s ability to respond to heat, he realized that he had discovered a heat-sensing receptor that is activated at temperatures perceived as painful.

While the mechanisms for temperature sensation were unfolding, it remained unclear how mechanical stimuli could be converted into our senses of touch and pressure. Researchers had previously found mechanical sensors in bacteria, but the mechanisms underlying touch in vertebrates remained unknown. Ardem Patapoutian, wished to identify the elusive receptors that are activated by mechanical stimuli.

The breakthrough by Patapoutian led to a series of papers from his and other groups, demonstrating that the Piezo2 ion channel is essential for the sense of touch. Moreover, Piezo2 was shown to play a key role in the critically important sensing of body position and motion, known as proprioception. In further work, Piezo1 and Piezo2 channels have been shown to regulate additional important physiological processes including blood pressure, respiration and urinary bladder control.