Reuters reports that Walmart and Home Depot, two of the top 10 U.S. employers, have embraced a health insurance strategy that punishes drugmakers for using discount cards to keep patients from switching or stopping their medications.
Large U.S. companies have started tightly managing how employees and their family members use these popular discount, or copay, cards for everything from multiple sclerosis treatments to widely-used rheumatoid arthritis medications sold through a specialty pharmacy.
The move reflects their frustration that the coupons, which lower patient out-of-pocket spending, can be a disincentive to seeking less expensive treatments and drive up health plan costs.
For certain therapies, the insurance programs extract more money from the drugmaker or redirect the employee to a cheaper medicine, according to benefits experts.
Home Depot’s program, run by CVS Health, has a particular focus on therapies for cystic fibrosis, hepatitis C, cancer, HIV, psoriasis, pulmonary arterial hypertension and hyperlipidemia, or extremely high cholesterol, according to health plan documents provided to Reuters. The company, which has 400,000 employees, said the program affects fewer than 1 percent of its plan members. Yet those participants can have an outsized impact on spending because of how costly it is to treat their conditions.
Specialty drugs can account for more than half of a corporate health plan’s spending on medicines. Employers who use the most comprehensive program at CVS can save up to 7 percent on their total specialty medication costs, CVS told Reuters.
The programs, known as copay "accumulators" and copay "maximizers," are expected to expand in the next two years, from about 25 percent of U.S. employers to as much as 50 percent, according to the National Business Group on Health.
Drugmakers "are concerned about it because the bottom line is that it will cost them more money," said Brian Marcotte, the group’s chief executive. Drugmakers are worried about the hit to profits if many more employers sign on. They are also concerned because they cannot easily track when the programs are being used.
Eli Lilly & Co executives said last week that copay accumulator programs were having an impact on its Taltz psoriasis drug and Forteo for osteoporosis, but that it did not feel there was "significant exposure."
Pfizer and AstraZeneca executives said in recent interviews with Reuters that they are monitoring the effect of these programs.
AbbVie, maker of top-selling arthritis treatment Humira, said in April it expects moderately higher spending on copay assistance this year.
Pharmaceutical industry spending on copay cards has more than doubled to $7 billion over the past five years, mostly due to coupons offered on higher-cost specialty drugs.
A copay "accumulator" recognizes when an employee uses a drugmaker discount card and makes sure that money does not apply toward their annual out-of-pocket spending requirement. When the copay card runs out of money, a patient must either cover the full copay cost, get a new discount card, or stop filling the prescription. The program can apply to almost any drug coupon used at a pharmacy working with the pharmacy benefit manager. A copay "maximizer" is more limited in scope, but potentially as costly to the drugmaker ...
Large U.S. companies have started tightly managing how employees and their family members use these popular discount, or copay, cards for everything from multiple sclerosis treatments to widely-used rheumatoid arthritis medications sold through a specialty pharmacy.
The move reflects their frustration that the coupons, which lower patient out-of-pocket spending, can be a disincentive to seeking less expensive treatments and drive up health plan costs.
For certain therapies, the insurance programs extract more money from the drugmaker or redirect the employee to a cheaper medicine, according to benefits experts.
Home Depot’s program, run by CVS Health, has a particular focus on therapies for cystic fibrosis, hepatitis C, cancer, HIV, psoriasis, pulmonary arterial hypertension and hyperlipidemia, or extremely high cholesterol, according to health plan documents provided to Reuters. The company, which has 400,000 employees, said the program affects fewer than 1 percent of its plan members. Yet those participants can have an outsized impact on spending because of how costly it is to treat their conditions.
Specialty drugs can account for more than half of a corporate health plan’s spending on medicines. Employers who use the most comprehensive program at CVS can save up to 7 percent on their total specialty medication costs, CVS told Reuters.
The programs, known as copay "accumulators" and copay "maximizers," are expected to expand in the next two years, from about 25 percent of U.S. employers to as much as 50 percent, according to the National Business Group on Health.
Drugmakers "are concerned about it because the bottom line is that it will cost them more money," said Brian Marcotte, the group’s chief executive. Drugmakers are worried about the hit to profits if many more employers sign on. They are also concerned because they cannot easily track when the programs are being used.
Eli Lilly & Co executives said last week that copay accumulator programs were having an impact on its Taltz psoriasis drug and Forteo for osteoporosis, but that it did not feel there was "significant exposure."
Pfizer and AstraZeneca executives said in recent interviews with Reuters that they are monitoring the effect of these programs.
AbbVie, maker of top-selling arthritis treatment Humira, said in April it expects moderately higher spending on copay assistance this year.
Pharmaceutical industry spending on copay cards has more than doubled to $7 billion over the past five years, mostly due to coupons offered on higher-cost specialty drugs.
A copay "accumulator" recognizes when an employee uses a drugmaker discount card and makes sure that money does not apply toward their annual out-of-pocket spending requirement. When the copay card runs out of money, a patient must either cover the full copay cost, get a new discount card, or stop filling the prescription. The program can apply to almost any drug coupon used at a pharmacy working with the pharmacy benefit manager. A copay "maximizer" is more limited in scope, but potentially as costly to the drugmaker ...
Express Scripts announced it is introducing a novel formulary to provide employers and health plans a better opportunity to leverage changing dynamics to help lower their members' out-of-pocket costs.
The Express Scripts' National Preferred Flex Formulary provides a way for plans to cover lower list price products, such as new authorized alternatives that drug makers are bringing to the market, and reduce reliance on rebated brand products.
Drug makers set drug prices, and can lower them at any time. However, immediate list price decreases for products already on the market can pose challenges for employers and health plans that already have underwritten plan offerings and benefit designs for upcoming years based on existing economics.
By introducing authorized alternative products, through a new or additional National Drug Code (NDC) with a lower list price, we can create a competitive dynamic more similar to a generic coming to market. Cash-paying patients can have immediate access to the lower-priced medication. Meanwhile, employers and health plans can choose which product to cover that is best for their plan and their members: the lower-priced option or the original brand, which may have a rebate.
Over time, plans, pharmacies and others in the supply chain can transition to a new pricing model and the drug maker could ultimately retire their high list price product.
The National Preferred Flex Formulary is a comprehensive formulary that will mirror our industry leading National Preferred Formulary -- covering more than 3,800 brand and generic medications -- and will follow Express Scripts'clinical-first formulary decision process for all new therapies that come to market.
When a manufacturer launches a lower-cost authorized alternative to a branded medication currently on the market, Express Scripts will evaluate the product for placement on the National Preferred Flex Formulary.
If appropriate, the authorized alternative product will be added to the Flex formulary with preferred or possibly non-preferred status. The innovator brand-name product, and potentially other products in the therapy class, then will be excluded from coverage.
Members enrolled in the Flex formulary who have a high-deductible or co-insurance plan design can have immediate access to the lower-priced authorized alternative medication.
Branded innovator products will remain preferred or non-preferred on other formularies, including Express Scripts' National Preferred Formulary, while the authorized alternative product may be excluded ...
The Express Scripts' National Preferred Flex Formulary provides a way for plans to cover lower list price products, such as new authorized alternatives that drug makers are bringing to the market, and reduce reliance on rebated brand products.
Drug makers set drug prices, and can lower them at any time. However, immediate list price decreases for products already on the market can pose challenges for employers and health plans that already have underwritten plan offerings and benefit designs for upcoming years based on existing economics.
By introducing authorized alternative products, through a new or additional National Drug Code (NDC) with a lower list price, we can create a competitive dynamic more similar to a generic coming to market. Cash-paying patients can have immediate access to the lower-priced medication. Meanwhile, employers and health plans can choose which product to cover that is best for their plan and their members: the lower-priced option or the original brand, which may have a rebate.
Over time, plans, pharmacies and others in the supply chain can transition to a new pricing model and the drug maker could ultimately retire their high list price product.
The National Preferred Flex Formulary is a comprehensive formulary that will mirror our industry leading National Preferred Formulary -- covering more than 3,800 brand and generic medications -- and will follow Express Scripts'clinical-first formulary decision process for all new therapies that come to market.
When a manufacturer launches a lower-cost authorized alternative to a branded medication currently on the market, Express Scripts will evaluate the product for placement on the National Preferred Flex Formulary.
If appropriate, the authorized alternative product will be added to the Flex formulary with preferred or possibly non-preferred status. The innovator brand-name product, and potentially other products in the therapy class, then will be excluded from coverage.
Members enrolled in the Flex formulary who have a high-deductible or co-insurance plan design can have immediate access to the lower-priced authorized alternative medication.
Branded innovator products will remain preferred or non-preferred on other formularies, including Express Scripts' National Preferred Formulary, while the authorized alternative product may be excluded ...
Dr. Robert Caton, a Modesto orthopedic surgeon accepted an agreement with the prosecution in September, pleading guilty to a misdemeanor charge of false and fraudulent claims and accepting kickbacks. More than 20 felony counts and enhancements in the original criminal complaint were dismissed.
Caton was sentenced to three years probation and agreed to pay $175,270 in restitution to the scammed insurance companies. He also agreed to pay $18,000 to a victim’s witness emergency fund.
"He accepted responsibility and paid back the money he made from the arrangement with Mr. King," said Shaddi Kamiabipour, a senior prosecutor for the Orange County district attorney. She said the penalty was not unusual for someone whose involvement was less than others.
He was the first of 26 doctors, pharmacists and business owners to accept a plea deal following the massive indictments.
A similar plea deal could be offered to the other local physicians because there’s no evidence their patients were physically harmed, an Orange County prosecutor said.
Five local physicians charged with participating in a $40 million fraudulent billing and kickback scheme are set for pretrial hearings in December and January.
A total of six doctors who practice in Modesto were arraigned in April 2017 on felony counts of conspiring to commit medical insurance fraud, false and fraudulent claims and insurance fraud, following a multiagency investigation led by the California Department of Insurance.
Authorities said they were among 26 doctors, pharmacists and business owners in California charged with participating in the alleged conspiracy to maximize profits from workers compensation patients. Charged with masterminding the scheme are Tanya Moreland King and her husband Christopher King of Beverly Hills, who owned Monarch Medical Group, King Medical Management and One Source Laboratories in Southern California.
Irvine pharmacists Charles Bonner, RPh., 56, and Mervyn Miller, RPh., 66, both owners of Steven's Pharmacy, were accused of conspiring with Christopher and Tanya King by selling more than $1 million in compound creams that were not FDA approved nor have known medical benefits. The Kings purchased the creams for between $15 and $40 per tube. These products were then billed to patients' workers' compensation insurance carriers for between $250 and $700 dollars per tube. Tanya King is accused of recruiting physicians to participate in this scam by paying a flat $50 rate or a share in the profits.
Doctors John Casey, Jonathan Cohen, Mohamed Ibrahim and William Pistel of Stanislaus Orthopaedic and Sports Medicine on East Orangeburg Avenue are set for a pretrial hearing Jan. 18 in Orange County Superior Court. Another Modesto physician, Jerome Robson, has a pretrial court date Dec. 3 ...
Caton was sentenced to three years probation and agreed to pay $175,270 in restitution to the scammed insurance companies. He also agreed to pay $18,000 to a victim’s witness emergency fund.
"He accepted responsibility and paid back the money he made from the arrangement with Mr. King," said Shaddi Kamiabipour, a senior prosecutor for the Orange County district attorney. She said the penalty was not unusual for someone whose involvement was less than others.
He was the first of 26 doctors, pharmacists and business owners to accept a plea deal following the massive indictments.
A similar plea deal could be offered to the other local physicians because there’s no evidence their patients were physically harmed, an Orange County prosecutor said.
Five local physicians charged with participating in a $40 million fraudulent billing and kickback scheme are set for pretrial hearings in December and January.
A total of six doctors who practice in Modesto were arraigned in April 2017 on felony counts of conspiring to commit medical insurance fraud, false and fraudulent claims and insurance fraud, following a multiagency investigation led by the California Department of Insurance.
Authorities said they were among 26 doctors, pharmacists and business owners in California charged with participating in the alleged conspiracy to maximize profits from workers compensation patients. Charged with masterminding the scheme are Tanya Moreland King and her husband Christopher King of Beverly Hills, who owned Monarch Medical Group, King Medical Management and One Source Laboratories in Southern California.
Irvine pharmacists Charles Bonner, RPh., 56, and Mervyn Miller, RPh., 66, both owners of Steven's Pharmacy, were accused of conspiring with Christopher and Tanya King by selling more than $1 million in compound creams that were not FDA approved nor have known medical benefits. The Kings purchased the creams for between $15 and $40 per tube. These products were then billed to patients' workers' compensation insurance carriers for between $250 and $700 dollars per tube. Tanya King is accused of recruiting physicians to participate in this scam by paying a flat $50 rate or a share in the profits.
Doctors John Casey, Jonathan Cohen, Mohamed Ibrahim and William Pistel of Stanislaus Orthopaedic and Sports Medicine on East Orangeburg Avenue are set for a pretrial hearing Jan. 18 in Orange County Superior Court. Another Modesto physician, Jerome Robson, has a pretrial court date Dec. 3 ...
Prosecutors unsealed a 47-count Federal Indictment against two Richland, Washington based companies, Mid Columbia Research LLC and Zain Research LLC, and their owner, Sami Anwar. The Indictment charges the defendants with conspiracy to commit wire and mail fraud, fraudulently obtaining controlled substances, and furnishing false information to the U.S. Drug Enforcement Administration (DEA). The Indictment also seeks the forfeiture of at least $274,642.80 representing the proceeds of the alleged fraud.
The Indictment charges that the defendants fraudulently conducted and falsified a drug trial designed to study an experimental alternative treatment for daily opioid users who suffered from chronic pain. Prosecutors say the defendants enrolled ineligible study subjects and forged physician signatures and falsified medical records and other documentation designed to make it appear as though a licensed physician had determined that the subjects were eligible for the study.
The Indictment further charges that the defendants falsified records and study data designed to make it appear as though subjects were participating in the study and were receiving the experimental treatment when they were not, in order to falsely bill for the study and obtain over a quarter of a million dollars from the drug company that was sponsoring the study.
The Indictment charges that the defendants created false and fraudulent documentation to hide the fraud from the sponsor, monitors, and federal regulators. The Indictment also charges that the defendants fraudulently obtained controlled substances, including the narcotic opioids hydrocodone/acetaminophen (which is commonly sold as Vicodin) and morphine, by falsely representing that these drugs would be and were being used for legitimate research purposes when they were not.
Finally, the Indictment charges that the defendants submitted a false and fraudulent application to the DEA in a failed attempt to obtain Gamma Hydroxybutyrate (commonly known as "GHB" or the "date rape drug") for a separate sleep disorder study that the defendants also hoped to obtain funding for.
United States Attorney Harrington said "Investigating fraud and opioid-related crimes is a top priority for the Department of Justice. The United States Attorney’s Office for the Eastern District of Washington will continue to use all of the investigative and legal tools available to us to do so."
DEA Special Agent in Charge of the Pacific Northwest Region Keith Weis was extremely pleased with today’s announcement, stating that "Conducting legitimate research is the foundation in which modern medicine is built on. To exploit that under the false premise of conducting lifesaving research to aid those who suffer opioid dependency is appalling, illegal, and criminal." Weis further added that, "This investigative action in Eastern Washington is part of a continuing state wide strategy addressing illicit opioid access and diversion currently endangering our communities."
The conspiracy, mail, and wire fraud charges against Defendant Sami Anwar each carry a maximum penalty of a 20-year term of imprisonment; a $250,000 fine, or double the gross gain or gross loss, whichever is greater; a 3-year term of court supervision; and restitution. Following the grand jury’s return of the Indictment, United States Magistrate Judge Mary K. Dimke issued a warrant for the seizure of over $175,000 from one of Mr. Anwar’s bank accounts constituting some of the proceeds of the alleged fraud ...
The Indictment charges that the defendants fraudulently conducted and falsified a drug trial designed to study an experimental alternative treatment for daily opioid users who suffered from chronic pain. Prosecutors say the defendants enrolled ineligible study subjects and forged physician signatures and falsified medical records and other documentation designed to make it appear as though a licensed physician had determined that the subjects were eligible for the study.
The Indictment further charges that the defendants falsified records and study data designed to make it appear as though subjects were participating in the study and were receiving the experimental treatment when they were not, in order to falsely bill for the study and obtain over a quarter of a million dollars from the drug company that was sponsoring the study.
The Indictment charges that the defendants created false and fraudulent documentation to hide the fraud from the sponsor, monitors, and federal regulators. The Indictment also charges that the defendants fraudulently obtained controlled substances, including the narcotic opioids hydrocodone/acetaminophen (which is commonly sold as Vicodin) and morphine, by falsely representing that these drugs would be and were being used for legitimate research purposes when they were not.
Finally, the Indictment charges that the defendants submitted a false and fraudulent application to the DEA in a failed attempt to obtain Gamma Hydroxybutyrate (commonly known as "GHB" or the "date rape drug") for a separate sleep disorder study that the defendants also hoped to obtain funding for.
United States Attorney Harrington said "Investigating fraud and opioid-related crimes is a top priority for the Department of Justice. The United States Attorney’s Office for the Eastern District of Washington will continue to use all of the investigative and legal tools available to us to do so."
DEA Special Agent in Charge of the Pacific Northwest Region Keith Weis was extremely pleased with today’s announcement, stating that "Conducting legitimate research is the foundation in which modern medicine is built on. To exploit that under the false premise of conducting lifesaving research to aid those who suffer opioid dependency is appalling, illegal, and criminal." Weis further added that, "This investigative action in Eastern Washington is part of a continuing state wide strategy addressing illicit opioid access and diversion currently endangering our communities."
The conspiracy, mail, and wire fraud charges against Defendant Sami Anwar each carry a maximum penalty of a 20-year term of imprisonment; a $250,000 fine, or double the gross gain or gross loss, whichever is greater; a 3-year term of court supervision; and restitution. Following the grand jury’s return of the Indictment, United States Magistrate Judge Mary K. Dimke issued a warrant for the seizure of over $175,000 from one of Mr. Anwar’s bank accounts constituting some of the proceeds of the alleged fraud ...
When President Trump declared a public health emergency over the abuse of heavy-duty painkillers like oxycodone and hydrocodone, he ordered all government agencies to take action in response to the death of 70,000 Americans last year from opioid overdoses.
The FDA told Reuters it has received over 200 submissions from companies seeking a speedy approval process for their devices. These range from Stimwave’s Halo to painkilling products made by Abbott Laboratories and other industry heavyweights as an alternative to opioids.
"We’re pleased by the robust interest in this innovation challenge and the acknowledgement from developers about the unique and important role medical devices, including digital health technologies like mobile medical apps, have the potential to play in tackling the opioid crisis," FDA Commissioner Scott Gottlieb said.
The FDA has been increasingly reluctant to greenlight new opioids for market but earlier this month approved a potent opioid-based painkiller from AcelRx Pharmaceuticals Inc placing tight restrictions on its distribution and use. In a rare move, Gottlieb made a public statement at the time, explaining the decision.
The regulator’s push for alternatives to opioids has helped drive interest from venture capital funds and institutional investors this year in firms promising to develop alternatives, according to interviews with device companies, financial services firms and brokerage Cowen & Co.
For example, privately-held Virpax Pharmaceuticals, which makes an aerosol spray that delivers a non-opioid pain drug, said it had four or five banks interested in running its Series A investment round this summer versus just one in the past.
Abbott, like rivals Boston Scientific Corp and Nevro Corp, makes neuromodulation implants which stimulate the nervous system to mask pain signals before they reach the brain.
Abbott has submitted an entry for the competition in the hope it will slash waiting times, which often stretch several months just to get an initial meeting, according to Dr. Allen Burton, Abbott’s medical director of neuromodulation.
While neuromodulation is only a small part of Abbott’s large medical device business, the unit is seen as a growth engine for the company. Burton estimates between 10-to-20 percent of the growth Abbott has seen in its neuromodulation business could be tied to doctors prescribing its devices for pain after surgery or from injury to patients that are opioid averse.
Boston Scientific did not apply for the contest, but the company is investing "heavily" in its neuromodulation unit, which was its fastest-growing at nearly 23 percent in the latest quarter.
Although the FDA contest is limited to devices and app-based solutions for pain and addiction, the current regulatory climate is also conducive to companies developing opioid-alternative pharmaceuticals.
Drugmakers including Pfizer Inc, Eli Lilly and Co, Regeneron Pharmaceuticals Inc and Teva Pharmaceutical Industries Inc have been packing their pipelines with potential solutions to the crisis and there are 120 non-opioid drugs under FDA review this year, up some 650 percent since 2013, according to business intelligence firm Informa ...
The FDA told Reuters it has received over 200 submissions from companies seeking a speedy approval process for their devices. These range from Stimwave’s Halo to painkilling products made by Abbott Laboratories and other industry heavyweights as an alternative to opioids.
"We’re pleased by the robust interest in this innovation challenge and the acknowledgement from developers about the unique and important role medical devices, including digital health technologies like mobile medical apps, have the potential to play in tackling the opioid crisis," FDA Commissioner Scott Gottlieb said.
The FDA has been increasingly reluctant to greenlight new opioids for market but earlier this month approved a potent opioid-based painkiller from AcelRx Pharmaceuticals Inc placing tight restrictions on its distribution and use. In a rare move, Gottlieb made a public statement at the time, explaining the decision.
The regulator’s push for alternatives to opioids has helped drive interest from venture capital funds and institutional investors this year in firms promising to develop alternatives, according to interviews with device companies, financial services firms and brokerage Cowen & Co.
For example, privately-held Virpax Pharmaceuticals, which makes an aerosol spray that delivers a non-opioid pain drug, said it had four or five banks interested in running its Series A investment round this summer versus just one in the past.
Abbott, like rivals Boston Scientific Corp and Nevro Corp, makes neuromodulation implants which stimulate the nervous system to mask pain signals before they reach the brain.
Abbott has submitted an entry for the competition in the hope it will slash waiting times, which often stretch several months just to get an initial meeting, according to Dr. Allen Burton, Abbott’s medical director of neuromodulation.
While neuromodulation is only a small part of Abbott’s large medical device business, the unit is seen as a growth engine for the company. Burton estimates between 10-to-20 percent of the growth Abbott has seen in its neuromodulation business could be tied to doctors prescribing its devices for pain after surgery or from injury to patients that are opioid averse.
Boston Scientific did not apply for the contest, but the company is investing "heavily" in its neuromodulation unit, which was its fastest-growing at nearly 23 percent in the latest quarter.
Although the FDA contest is limited to devices and app-based solutions for pain and addiction, the current regulatory climate is also conducive to companies developing opioid-alternative pharmaceuticals.
Drugmakers including Pfizer Inc, Eli Lilly and Co, Regeneron Pharmaceuticals Inc and Teva Pharmaceutical Industries Inc have been packing their pipelines with potential solutions to the crisis and there are 120 non-opioid drugs under FDA review this year, up some 650 percent since 2013, according to business intelligence firm Informa ...
The Bureau of Labor Statistics is a unit of the United States Department of Labor. It is the principal fact-finding agency for the U.S. government in the broad field of labor economics and statistics and serves as a principal agency of the U.S. Federal Statistical System.
This week it published the first in a series of two news releases from BLS covering occupational safety and health statistics for the 2017 calendar year.
A second release in December will provide results from the Census of Fatal Occupational Injuries (CFOI) of all fatal work injuries occurring in the U.S. during the calendar year. The CFOI uses diverse state, federal, and independent data sources to identify, verify, and describe fatal work injuries to ensure that counts are as complete and accurate as possible.
According to its report, there were approximately 2.8 million nonfatal workplace injuries and illnesses reported by private industry employers in 2017, which occurred at a rate of 2.8 cases per 100 full-time equivalent (FTE) workers.
Private industry employers reported nearly 45,800 fewer nonfatal injury and illness cases in 2017 compared to a year earlier, according to estimates from the Survey of Occupational Injuries and Illnesses (SOII).
The 2017 rate of total recordable cases (TRC) fell 0.1 cases per 100 FTE workers to continue a pattern of declines that, apart from 2012, occurred annually since 2004.
- The rates for different types of cases - days away from work (DAFW), days of job transfer or restriction only (DJTR), and other recordable cases (ORC) - were unchanged from a year earlier.
- The rate for DJTR cases has remained at 0.7 cases per 100 FTE workers since 2011.
- Nearly one-third of nonfatal occupational injuries and illnesses resulted in days away from work.
- Among the 19 private industry sectors, only manufacturing and finance and insurance experienced statistically significant changes in their overall rates of nonfatal injuries and illnesses in 2017 - each declined by 0.1 cases per 100 FTE workers compared to 2016.
There were 882,730 occupational injuries and illnesses in 2017 that resulted in days away from work in private industry, essentially unchanged from 2016. The private industry incidence rate for DAFW cases was 89.4 cases per 10,000 full-time equivalent (FTE) workers in 2017.
The median days away from work—a key measure of the severity of cases - was 8 in 2017, unchanged from 2016 ...
This week it published the first in a series of two news releases from BLS covering occupational safety and health statistics for the 2017 calendar year.
A second release in December will provide results from the Census of Fatal Occupational Injuries (CFOI) of all fatal work injuries occurring in the U.S. during the calendar year. The CFOI uses diverse state, federal, and independent data sources to identify, verify, and describe fatal work injuries to ensure that counts are as complete and accurate as possible.
According to its report, there were approximately 2.8 million nonfatal workplace injuries and illnesses reported by private industry employers in 2017, which occurred at a rate of 2.8 cases per 100 full-time equivalent (FTE) workers.
Private industry employers reported nearly 45,800 fewer nonfatal injury and illness cases in 2017 compared to a year earlier, according to estimates from the Survey of Occupational Injuries and Illnesses (SOII).
The 2017 rate of total recordable cases (TRC) fell 0.1 cases per 100 FTE workers to continue a pattern of declines that, apart from 2012, occurred annually since 2004.
- The rates for different types of cases - days away from work (DAFW), days of job transfer or restriction only (DJTR), and other recordable cases (ORC) - were unchanged from a year earlier.
- The rate for DJTR cases has remained at 0.7 cases per 100 FTE workers since 2011.
- Nearly one-third of nonfatal occupational injuries and illnesses resulted in days away from work.
- Among the 19 private industry sectors, only manufacturing and finance and insurance experienced statistically significant changes in their overall rates of nonfatal injuries and illnesses in 2017 - each declined by 0.1 cases per 100 FTE workers compared to 2016.
There were 882,730 occupational injuries and illnesses in 2017 that resulted in days away from work in private industry, essentially unchanged from 2016. The private industry incidence rate for DAFW cases was 89.4 cases per 10,000 full-time equivalent (FTE) workers in 2017.
The median days away from work—a key measure of the severity of cases - was 8 in 2017, unchanged from 2016 ...
With numbers still coming in and some important races still too close to call, Ricardo Lara, a Democratic California state senator known for his "health for all" legislation, is likely the winner of the race for California insurance commissioner post.. The California Secretary of State reports that as of 8:36 am on November 8, 100% of the precincts have reported, and Lara has the lead over Steve Poisner by 50.8% to 49.2%
Lara, has represented California’s 33rd District in the state Senate since 2012. He has a narrow lead over Steve Poizner, a former California insurance commissioner who ran as an independent. Lara supports universal, comprehensive health coverage for all Californians.
As a state senator, Lara wrote the Health4All Kids Act. The act extended the state’s Medicaid program, Medi-Cal, to cover about 250,000 California children in families that have trouble documenting the children’s immigration status.
Lara later co-introduced S.B. 562, a bill that could create a single-payer health care system for California. The bill would prohibit insurers from offering traditional major medical coverage in competition with the universal health coverage program, according to a copy of the bill text. Because the proposed program would cover dental care, vision care, chiropractic care, home health care and acupuncture, the bill might also ban the sale of some kinds of supplemental health insurance products, such as dental insurance, vision insurance, alternative health care insurance, and long-term care insurance that covers home health care.
Members of the California state Senate passed S.B. 562 by a 23-14 vote on June 1, 2017. California Assembly Speaker Anthony Rendon declined to have the Assembly act on the bill. Rendon said the bill was incomplete, according to a statement Rendon released in June 2017.
Lara is expected to work with the incoming governor, Gavin Newsom, and the state legislature on health care. Health care came up as a top issue in polling.
Lara - who was endorsed by outgoing California Gov. Jerry Brown, as well as by the Union of Health Care Professionals and the United Farm Workers of America - has also been talking about the possible effects of wildfires and climate-caused events on Californians’ health.
Lara has pledged in his campaign materials to support consumers, patients, working families and vulnerable populations. His platform also includes efforts to improve infrastructure and education.
In an official ballot statement, Lara notes that his father was a factory worker. He says his parents believed in the value of having insurance to protect their modest property. He states that, as his parents aged, "they sacrificed a little more to buy life insurance. They did it because they knew they were one accident, one fire, one burglary, one serious illness away from losing everything they had worked for." ...
Lara, has represented California’s 33rd District in the state Senate since 2012. He has a narrow lead over Steve Poizner, a former California insurance commissioner who ran as an independent. Lara supports universal, comprehensive health coverage for all Californians.
As a state senator, Lara wrote the Health4All Kids Act. The act extended the state’s Medicaid program, Medi-Cal, to cover about 250,000 California children in families that have trouble documenting the children’s immigration status.
Lara later co-introduced S.B. 562, a bill that could create a single-payer health care system for California. The bill would prohibit insurers from offering traditional major medical coverage in competition with the universal health coverage program, according to a copy of the bill text. Because the proposed program would cover dental care, vision care, chiropractic care, home health care and acupuncture, the bill might also ban the sale of some kinds of supplemental health insurance products, such as dental insurance, vision insurance, alternative health care insurance, and long-term care insurance that covers home health care.
Members of the California state Senate passed S.B. 562 by a 23-14 vote on June 1, 2017. California Assembly Speaker Anthony Rendon declined to have the Assembly act on the bill. Rendon said the bill was incomplete, according to a statement Rendon released in June 2017.
Lara is expected to work with the incoming governor, Gavin Newsom, and the state legislature on health care. Health care came up as a top issue in polling.
Lara - who was endorsed by outgoing California Gov. Jerry Brown, as well as by the Union of Health Care Professionals and the United Farm Workers of America - has also been talking about the possible effects of wildfires and climate-caused events on Californians’ health.
Lara has pledged in his campaign materials to support consumers, patients, working families and vulnerable populations. His platform also includes efforts to improve infrastructure and education.
In an official ballot statement, Lara notes that his father was a factory worker. He says his parents believed in the value of having insurance to protect their modest property. He states that, as his parents aged, "they sacrificed a little more to buy life insurance. They did it because they knew they were one accident, one fire, one burglary, one serious illness away from losing everything they had worked for." ...
The California Insurance Commissioner adopted and issued a revised advisory pure premium rate, lowering the benchmark to $1.63 per $100 of payroll for workers’ compensation insurance, effective January 1, 2019. Commissioner Jones has reduced the advisory pure premium rate by about 42 percent since January 2015 when the Commissioner approved an average pure premium rate that was $2.81 per $100 of payroll.
With an average filed pure premium rate of $2.13 per $100 of payroll as of July 1, 2018, insurers were on average applying pure premium rates that were approximately 19.7 percent more than the corresponding average advisory pure premium rate of $1.78 approved by the commissioner as of that date.
The indicated advisory pure premium rate level of $1.63 approved by the Commissioner today is about 23.5 percent lower than the industry filed average pure premium rate of $2.13 as of July 1, 2018.
"Savings for workers’ compensation insurers continue and all of those savings ought to be shared with employers," said Insurance Commissioner Dave Jones. "Cost savings in the workers' compensation system have helped insurers and employers deserve to share in the cost savings through lower premiums. I renew my call on workers’ compensation insurers to pass along savings to employers."
Commissioner Jones’ decision results in an advisory pure premium rate that is below the $1.70 average rate recommended by the Workers’ Compensation Insurance Rating Bureau (WCIRB) in its filing. Jones issued the advisory rate after a public hearing and careful review of the testimony and evidence submitted by stakeholders. The pure premium rate is only advisory, as the Legislature has not given the commissioner rate authority over workers’ compensation rates.
The WCIRB’s pure premium advisory rate filing demonstrated continued decreases in costs in California’s workers’ compensation insurance market. The pure premium advisory rate reduction is based on insurers' cost data through June 30 of this year. Insurers' net costs in the workers' compensation system continue to decline as a result of SB 863, SB 1160, and AB 1244 enacted by the Legislature and Governor Jerry Brown. The WCIRB notes continued favorable medical loss development including acceleration in claim settlement.
...
With an average filed pure premium rate of $2.13 per $100 of payroll as of July 1, 2018, insurers were on average applying pure premium rates that were approximately 19.7 percent more than the corresponding average advisory pure premium rate of $1.78 approved by the commissioner as of that date.
The indicated advisory pure premium rate level of $1.63 approved by the Commissioner today is about 23.5 percent lower than the industry filed average pure premium rate of $2.13 as of July 1, 2018.
"Savings for workers’ compensation insurers continue and all of those savings ought to be shared with employers," said Insurance Commissioner Dave Jones. "Cost savings in the workers' compensation system have helped insurers and employers deserve to share in the cost savings through lower premiums. I renew my call on workers’ compensation insurers to pass along savings to employers."
Commissioner Jones’ decision results in an advisory pure premium rate that is below the $1.70 average rate recommended by the Workers’ Compensation Insurance Rating Bureau (WCIRB) in its filing. Jones issued the advisory rate after a public hearing and careful review of the testimony and evidence submitted by stakeholders. The pure premium rate is only advisory, as the Legislature has not given the commissioner rate authority over workers’ compensation rates.
The WCIRB’s pure premium advisory rate filing demonstrated continued decreases in costs in California’s workers’ compensation insurance market. The pure premium advisory rate reduction is based on insurers' cost data through June 30 of this year. Insurers' net costs in the workers' compensation system continue to decline as a result of SB 863, SB 1160, and AB 1244 enacted by the Legislature and Governor Jerry Brown. The WCIRB notes continued favorable medical loss development including acceleration in claim settlement.
...
The WCIRB has released the California Workers’ Compensation Aggregate Medical Payment Trends report comparing medical payment information from 2015 to 2017. The WCIRB analysis is based on medical payment data representing 92% of the California workers’ compensation insurance market.
Overall, there was a cumulative 8% reduction in medical payments per claim from CY2015 through CY2017, comparable to the cumulative two-year reduction (10%) from CY2014 to CY2016 (Table 1). The decline in paid per claim was largely driven by the declines in utilization (e.g., paid transactions per claim declined by 8%).
The downward trend reflects a continuation of the savings generated by the reforms to the medical care delivery enacted by Senate Bill No. SB 863 in 2012, anti-fraud efforts and the continued sharp decline in pharmaceutical costs.
There were sharp declines in the average paid per transaction for pharmaceuticals (24%), pharmacies (28%) and pharmacists (27%) since 2015. This continues to be a result of reductions in the prescribing of controlled substances, reduced physician office dispensing, implementation of the Federal Upper Limits on prescription drug prices, as well as the continued shift from brand to generic drugs. (These reductions pre-date the implementation of the new drug formulary implemented in January 2018 pursuant to Assembly Bill No. 1124).
There were sharp decreases in the share of workers’ compensation claims with any opioid prescription from 18.2% in 2015 to 11.6% in 2017. The medical payments on the claims with at least one opioid prescription were, on average, more than three times higher than those on the claims without opioid prescriptions.
Common non-opiate analgesics and topicals, Topical Corticosteroids, and other medications sometimes used to relieve pain such as Anticonvulsants and Central Muscle Relaxants experienced a combined increase of 4.8%. On the other hand, Opioid Agonists, Opioid Partial Agonists and Opioid Combinations totaled a 2.8% decrease in their share of pharmaceutical payments from CY2016 to CY2017.
There was a significant change in the mix of Medical-Legal (ML) services in 2017. The share of ML104 (the most comprehensive and expensive service) transactions declined by 22.7%, while that for ML102 (the most basic ML evaluation) increased by 42.6%. This resulted in an 8% decline in the average cost of a medical-legal report in 2017 following a number of years of increases.
The procedure code set related to Physical Medicine and Rehabilitation was the greatest gainer between CY2016 and CY2017 and received the second largest amount of payments (21.7%). The Office or Other Outpatient Services continued to grow, and received the largest amount of payments (33.5%).
The full report is available in the Research section of the WCIRB website, California Workers’ Compensation Aggregate Medical Payment Trends - Updated through Calendar Year 2017 ...
Overall, there was a cumulative 8% reduction in medical payments per claim from CY2015 through CY2017, comparable to the cumulative two-year reduction (10%) from CY2014 to CY2016 (Table 1). The decline in paid per claim was largely driven by the declines in utilization (e.g., paid transactions per claim declined by 8%).
The downward trend reflects a continuation of the savings generated by the reforms to the medical care delivery enacted by Senate Bill No. SB 863 in 2012, anti-fraud efforts and the continued sharp decline in pharmaceutical costs.
There were sharp declines in the average paid per transaction for pharmaceuticals (24%), pharmacies (28%) and pharmacists (27%) since 2015. This continues to be a result of reductions in the prescribing of controlled substances, reduced physician office dispensing, implementation of the Federal Upper Limits on prescription drug prices, as well as the continued shift from brand to generic drugs. (These reductions pre-date the implementation of the new drug formulary implemented in January 2018 pursuant to Assembly Bill No. 1124).
There were sharp decreases in the share of workers’ compensation claims with any opioid prescription from 18.2% in 2015 to 11.6% in 2017. The medical payments on the claims with at least one opioid prescription were, on average, more than three times higher than those on the claims without opioid prescriptions.
Common non-opiate analgesics and topicals, Topical Corticosteroids, and other medications sometimes used to relieve pain such as Anticonvulsants and Central Muscle Relaxants experienced a combined increase of 4.8%. On the other hand, Opioid Agonists, Opioid Partial Agonists and Opioid Combinations totaled a 2.8% decrease in their share of pharmaceutical payments from CY2016 to CY2017.
There was a significant change in the mix of Medical-Legal (ML) services in 2017. The share of ML104 (the most comprehensive and expensive service) transactions declined by 22.7%, while that for ML102 (the most basic ML evaluation) increased by 42.6%. This resulted in an 8% decline in the average cost of a medical-legal report in 2017 following a number of years of increases.
The procedure code set related to Physical Medicine and Rehabilitation was the greatest gainer between CY2016 and CY2017 and received the second largest amount of payments (21.7%). The Office or Other Outpatient Services continued to grow, and received the largest amount of payments (33.5%).
The full report is available in the Research section of the WCIRB website, California Workers’ Compensation Aggregate Medical Payment Trends - Updated through Calendar Year 2017 ...
Governor Brown signed AB 2334 into law last summer. The new law requires that, as part of occupational injury and illness reporting, employers additionally file specified injury and illness forms electronically with Cal/OSHA no later than February 1 of each year.
And requires Cal/OSHA to develop a searchable database for one of those forms relating to summary information on its web site by a date specified and further requires Cal/OSHA to post those forms on the database within 90 days of receipt. "While posting of injury information at each worksite is important, specific workplace injury and illness information is not accessible to the public and prospective employees in an easily accessible database on the Internet."
The new law seems to have been triggered by federal initiatives to reduce employer reporting requirements.
The federal Occupational Safety and Health Administration (OSHA) adopted the Improve Tracking of Workplace Injuries and Illnesses rule in 2016. This rule requires electronic submission of certain occupational injury and illness reports by covered employers with at least 250 employees and by smaller employers in high-risk industries. In the fall of 2017,
However, OSHA issued a Notice of Proposed Rulemaking to potentially relax these workplace injury and illness reporting requirements.
In response to the federal initiative to reduce employer reporting requirements, California decided to pass a new law that went the other way - Increase employer reporting requirements. To quickly implement AB 2334, Cal/OSHA’s emergency regulations requiring certain employers in California to electronically submit each year their Form 300A summaries of work-related injuries and illnesses to federal OSHA have been approved by the Office of Administrative Law (OAL).
The following employers must submit online the Form 300A covering calendar year 2017 by December 31, 2018:
- All employers with 250 or more employees, unless specifically exempted by section 14300.2 of Title 8 of the California Code of Regulations.
- Employers with 20 to 249 employees in the specific industries listed in Appendix H of the emergency regulations. There are approximately 67 industries on this list. Examples include construction, manufacturing, wholesale trade, grocery and specialty food stores, and similar industries. .
Employers described above that are now required to submit their 300A summaries online each year should follow the instructions on federal OSHA’s Injury Tracking Application webpage.
Cal/OSHA will proceed with the formal rulemaking process to make the emergency regulations permanent by submitting the required documentation to OAL. The rulemaking process will include a public comment period and public hearing. The dates for the comment period and public hearing will be posted on Cal/OSHA’s proposed regulation page.
The California Division of Occupational Safety and Health, or Cal/OSHA, is the division within the Department of Industrial Relations (DIR) that helps protect California’s workers from health and safety hazards on the job in almost every workplace ...
And requires Cal/OSHA to develop a searchable database for one of those forms relating to summary information on its web site by a date specified and further requires Cal/OSHA to post those forms on the database within 90 days of receipt. "While posting of injury information at each worksite is important, specific workplace injury and illness information is not accessible to the public and prospective employees in an easily accessible database on the Internet."
The new law seems to have been triggered by federal initiatives to reduce employer reporting requirements.
The federal Occupational Safety and Health Administration (OSHA) adopted the Improve Tracking of Workplace Injuries and Illnesses rule in 2016. This rule requires electronic submission of certain occupational injury and illness reports by covered employers with at least 250 employees and by smaller employers in high-risk industries. In the fall of 2017,
However, OSHA issued a Notice of Proposed Rulemaking to potentially relax these workplace injury and illness reporting requirements.
In response to the federal initiative to reduce employer reporting requirements, California decided to pass a new law that went the other way - Increase employer reporting requirements. To quickly implement AB 2334, Cal/OSHA’s emergency regulations requiring certain employers in California to electronically submit each year their Form 300A summaries of work-related injuries and illnesses to federal OSHA have been approved by the Office of Administrative Law (OAL).
The following employers must submit online the Form 300A covering calendar year 2017 by December 31, 2018:
- All employers with 250 or more employees, unless specifically exempted by section 14300.2 of Title 8 of the California Code of Regulations.
- Employers with 20 to 249 employees in the specific industries listed in Appendix H of the emergency regulations. There are approximately 67 industries on this list. Examples include construction, manufacturing, wholesale trade, grocery and specialty food stores, and similar industries. .
Employers described above that are now required to submit their 300A summaries online each year should follow the instructions on federal OSHA’s Injury Tracking Application webpage.
Cal/OSHA will proceed with the formal rulemaking process to make the emergency regulations permanent by submitting the required documentation to OAL. The rulemaking process will include a public comment period and public hearing. The dates for the comment period and public hearing will be posted on Cal/OSHA’s proposed regulation page.
The California Division of Occupational Safety and Health, or Cal/OSHA, is the division within the Department of Industrial Relations (DIR) that helps protect California’s workers from health and safety hazards on the job in almost every workplace ...
Spyros Panos M.D., was an orthopedic surgeon practicing in New York. For years, he seemed like a successful orthopedic surgeon, seeing dozens of patients a day and bringing in millions of dollars in fees for his suburban New York medical group.
Behind the scenes, however, he was inflating charges and billing for surgeries he didn’t perform, perpetrating a years-long fraud that culminated in a guilty plea on a single count in federal court in 2013. In 2013, he surrendered his license to practice medicine following his conviction for health care fraud.
In 2014, Panos began serving a 54-month sentence, and was released in 2016 to a halfway house and then, about a month later, to home confinement. He also faced more than 250 malpractice lawsuits, including some claiming that he botched surgeries.
Since March 2017, he has been serving a two-year term of supervised release. It did not take him long to get into trouble again. But even as he was waiting to be sentenced, federal prosecutors say, Panos was beginning a new criminal scheme that would go undetected for years until he was arrested again in April 2018.
In April 2018, he was charged with wire fraud, health care fraud, and aggravated identity theft, in connection with a scheme in which he assumed the identity of a licensed orthopedic surgeon and obtained over $860,000 in payments for reviewing patient files in Workers Compensation cases.
In about December 2013, after Panos pled guilty on October 31, 2013, and before he surrendered to serve his sentence on April 2, 2014, a company called Excel O LLC was formed. The registered agent for Excel O is a Panos family member and is not a licensed physician. Panos allegedly used this company to hide his identity, and assume the stolen identity of another physician, to dupe utilization review companies who evaluated cases nationwide.
In the latest criminal case, prosecutors say Panos defrauded six utilization review companies for $876,000, using a fake Google email address, a shell company registered in the name of a family member to a Brooklyn address and the credentials of another physician. He is charged with infiltrating an obscure but essential piece of the American health-care business: a $4 billion industry that provides independent doctors to render expert opinions on which treatments are appropriate. He has plead not guilty to the charges.
Over the past five months, thousands of patients have received notices from several insurance companies that Panos had posed as another doctor in order to review their medical records in coverage disputes. At least 2,500 people nationwide were affected, according to data compiled by Bloomberg, but the full reach of the alleged fraud hasn’t been made public.
Prosecutors did not name the six independent review companies that Panos worked for, but disclosure letters identify some of them: Advanced Medical Reviews and Network Medical Review are both subsidiaries of a company called ExamWorks, which was acquired by the private equity firm Leonard Green & Partners LP for $2 billion in 2016.
At least one company, Gallagher Bassett, a subsidiary of insurance brokerage Arthur J. Gallagher, told California authorities last August, that 1,294 workers’ compensation claims in the state may have been affected through vendors who hired Panos ...
Behind the scenes, however, he was inflating charges and billing for surgeries he didn’t perform, perpetrating a years-long fraud that culminated in a guilty plea on a single count in federal court in 2013. In 2013, he surrendered his license to practice medicine following his conviction for health care fraud.
In 2014, Panos began serving a 54-month sentence, and was released in 2016 to a halfway house and then, about a month later, to home confinement. He also faced more than 250 malpractice lawsuits, including some claiming that he botched surgeries.
Since March 2017, he has been serving a two-year term of supervised release. It did not take him long to get into trouble again. But even as he was waiting to be sentenced, federal prosecutors say, Panos was beginning a new criminal scheme that would go undetected for years until he was arrested again in April 2018.
In April 2018, he was charged with wire fraud, health care fraud, and aggravated identity theft, in connection with a scheme in which he assumed the identity of a licensed orthopedic surgeon and obtained over $860,000 in payments for reviewing patient files in Workers Compensation cases.
In about December 2013, after Panos pled guilty on October 31, 2013, and before he surrendered to serve his sentence on April 2, 2014, a company called Excel O LLC was formed. The registered agent for Excel O is a Panos family member and is not a licensed physician. Panos allegedly used this company to hide his identity, and assume the stolen identity of another physician, to dupe utilization review companies who evaluated cases nationwide.
In the latest criminal case, prosecutors say Panos defrauded six utilization review companies for $876,000, using a fake Google email address, a shell company registered in the name of a family member to a Brooklyn address and the credentials of another physician. He is charged with infiltrating an obscure but essential piece of the American health-care business: a $4 billion industry that provides independent doctors to render expert opinions on which treatments are appropriate. He has plead not guilty to the charges.
Over the past five months, thousands of patients have received notices from several insurance companies that Panos had posed as another doctor in order to review their medical records in coverage disputes. At least 2,500 people nationwide were affected, according to data compiled by Bloomberg, but the full reach of the alleged fraud hasn’t been made public.
Prosecutors did not name the six independent review companies that Panos worked for, but disclosure letters identify some of them: Advanced Medical Reviews and Network Medical Review are both subsidiaries of a company called ExamWorks, which was acquired by the private equity firm Leonard Green & Partners LP for $2 billion in 2016.
At least one company, Gallagher Bassett, a subsidiary of insurance brokerage Arthur J. Gallagher, told California authorities last August, that 1,294 workers’ compensation claims in the state may have been affected through vendors who hired Panos ...
The California Division of Workers’ Compensation announced that registration for its 26th annual educational conference is now open.
The conference will take place February 11-12, 2019 at the Los Angeles Airport Marriott and February 28-March 1, 2019 at the Oakland Marriott City Center Hotel.
Attendee, exhibitor and sponsor registration forms may be downloaded from the conference website.
Registration flyers were recently mailed to the names on our conference mailing list. These forms are also available at this website and at DWC district offices.
This annual event is the largest workers’ compensation training in the state and allows claims administrators, attorneys, medical providers, return-to-work specialists, employers, human resources and others to learn firsthand about the most recent developments in the system. Attendees will be interested in learning about current topics from a variety of workers’ compensation experts from DWC, other state and public agencies, and the private sector.
DWC has applied for continuing educational credits by attorney, rehabilitation counselor, case manager, disability management, human resource and qualified medical examiner certifying organizations among others.
Organizations who would like to become sponsors of the DWC conference can do so by going to the website.
The 2018 conference had 1,772 attendees and 128 exhibitors, so early registration is encouraged ...
The conference will take place February 11-12, 2019 at the Los Angeles Airport Marriott and February 28-March 1, 2019 at the Oakland Marriott City Center Hotel.
Attendee, exhibitor and sponsor registration forms may be downloaded from the conference website.
Registration flyers were recently mailed to the names on our conference mailing list. These forms are also available at this website and at DWC district offices.
This annual event is the largest workers’ compensation training in the state and allows claims administrators, attorneys, medical providers, return-to-work specialists, employers, human resources and others to learn firsthand about the most recent developments in the system. Attendees will be interested in learning about current topics from a variety of workers’ compensation experts from DWC, other state and public agencies, and the private sector.
DWC has applied for continuing educational credits by attorney, rehabilitation counselor, case manager, disability management, human resource and qualified medical examiner certifying organizations among others.
Organizations who would like to become sponsors of the DWC conference can do so by going to the website.
The 2018 conference had 1,772 attendees and 128 exhibitors, so early registration is encouraged ...
Perry Roy Segal M.D., License No. C 39242, is a 1976 graduate of Johns Hopkins University School of Medicine, and is certified by the American Board of Psychiatry and Neurology. He was licensed as a California Physician and Surgeon in June 1980. He is listed as a QME in psychiatry with an office at 250 Blossom Hill Road, in Los Gatos California.
The DWC Disciplined Physicians List shows that his QME certification has been revoked with revocation stayed. He was placed on probation from 10/18/2018 through 10/18/2019 concurrent with Medical Board probation and discipline order..
The Accusation filed against Dr. Segal in July 2015 claimed he engaged in "unprofessional conduct amounting to gross negligence and/or repeated negligent acts and/or incompetence in the care and treatment of Patient T.D." He had been treating this patient for depression and anxiety, allegedly stemming in part from a possible work-related injury since March, 1999.
On August 6, 2013, the Medical Board received a complaint from a pharmacist, Dr. R. W., at the Fox Army Health Center in Redstone Arsenal, Alabama, regarding Dr. Segal's prescriptions of pain medication to Patient T.D.
In an interview with the Medical Board, Dr. R. W . detailed that Patient T.D. was receiving prescriptions for Percocet from the Respondent which she filled in Alabama, but that Patient T.D. also filled other pain medication prescriptions in California. Dr. R. W .also reported that it appeared that Respondent, a psychiatrist, was prescribing pain medications and performing pain management without conducting proper physical examinations.
Dr. R. W. reported that she tried repeatedly to discuss the situation with Respondent, who would not contact her. Eventually, Dr. R. W. reached Respondent, who was uncooperative and evasive, telling her that Patient T . D . was a family friend. Ultimately, the Fox Army Health Center refused to fill additional prescriptions for Patient T.D.
Pharmacy and medical records show that during a sample three-year period, Dr. Segal prescribed Patient T.D. various doses and quantities of Demerol, Percocet, Valium, Ambien, Dilaudid, Soma, and Xanax. During this time, Patient T.D. also received pain medications from at least four other doctors.
During his interview with the Board, Segal admitted that he had prescribed pain medications to Patient T.D .for at least a decade, and that he did so as a stop-gap measure to support her during a time when he believed that she had difficulty receiving pain medications from her other health care providers. He stated that he prescribed several dangerous drugs and narcotics to Patient T.D. because she asked for them by name.
During his interview with the Board, Dr. Segal admitted that in the more than ten years of prescribing her pain medication, he had never checked with Patient T. D. s other doctors to ensure that she was not receiving pain medication from multiple providers. He also admitted that he had never checked the Control led Substance Utilization Review and Evaluation System (CURES) to verify her claims that she could not get pain medication from other providers. During his interview with the Board, he admitted that he did not know that CURES existed.
Had he checked CURES or with Patient T. D .'s other health care providers, he would have learned that she was receiving pain medication from at least four other doctors.
In May 2016, Dr. Segal and his attorney signed a Stipulated Settlement with the California Medical Board ...
The DWC Disciplined Physicians List shows that his QME certification has been revoked with revocation stayed. He was placed on probation from 10/18/2018 through 10/18/2019 concurrent with Medical Board probation and discipline order..
The Accusation filed against Dr. Segal in July 2015 claimed he engaged in "unprofessional conduct amounting to gross negligence and/or repeated negligent acts and/or incompetence in the care and treatment of Patient T.D." He had been treating this patient for depression and anxiety, allegedly stemming in part from a possible work-related injury since March, 1999.
On August 6, 2013, the Medical Board received a complaint from a pharmacist, Dr. R. W., at the Fox Army Health Center in Redstone Arsenal, Alabama, regarding Dr. Segal's prescriptions of pain medication to Patient T.D.
In an interview with the Medical Board, Dr. R. W . detailed that Patient T.D. was receiving prescriptions for Percocet from the Respondent which she filled in Alabama, but that Patient T.D. also filled other pain medication prescriptions in California. Dr. R. W .also reported that it appeared that Respondent, a psychiatrist, was prescribing pain medications and performing pain management without conducting proper physical examinations.
Dr. R. W. reported that she tried repeatedly to discuss the situation with Respondent, who would not contact her. Eventually, Dr. R. W. reached Respondent, who was uncooperative and evasive, telling her that Patient T . D . was a family friend. Ultimately, the Fox Army Health Center refused to fill additional prescriptions for Patient T.D.
Pharmacy and medical records show that during a sample three-year period, Dr. Segal prescribed Patient T.D. various doses and quantities of Demerol, Percocet, Valium, Ambien, Dilaudid, Soma, and Xanax. During this time, Patient T.D. also received pain medications from at least four other doctors.
During his interview with the Board, Segal admitted that he had prescribed pain medications to Patient T.D .for at least a decade, and that he did so as a stop-gap measure to support her during a time when he believed that she had difficulty receiving pain medications from her other health care providers. He stated that he prescribed several dangerous drugs and narcotics to Patient T.D. because she asked for them by name.
During his interview with the Board, Dr. Segal admitted that in the more than ten years of prescribing her pain medication, he had never checked with Patient T. D. s other doctors to ensure that she was not receiving pain medication from multiple providers. He also admitted that he had never checked the Control led Substance Utilization Review and Evaluation System (CURES) to verify her claims that she could not get pain medication from other providers. During his interview with the Board, he admitted that he did not know that CURES existed.
Had he checked CURES or with Patient T. D .'s other health care providers, he would have learned that she was receiving pain medication from at least four other doctors.
In May 2016, Dr. Segal and his attorney signed a Stipulated Settlement with the California Medical Board ...
Gilbane Building Company has been a part of the San Francisco Bay Area since 1995. It was founded in 1873 and still a privately held, family-owned company, Gilbane has 46 office locations worldwide. Gilbane has built some of the most complex and celebrated construction projects in the nation and has been recognized for excellence in safety by the Construction Users Roundtable (CURT) and the Associated General Contractors of America (AGC).
Triax Technologies, Inc. is a Norwalk, Connecticut-based technology company that develops and delivers IoT solutions for the construction industry. Its flagship Spot-r system connects workers, equipment and managers through a proprietary, minimal infrastructure network, sensors and a cloud-based dashboard. By providing real-time, data-driven visibility into daily site operations and safety incidents, Spot-r is changing the way construction companies manage resources, information and risk. Triax develops intelligent, actionable solutions that address the complexities of an active job site, and it helps firms streamline processes and build safer and smarter.
The Travelers Companies, Inc. announced a collaboration with Gilbane and Triax Technologies to explore the potential safety benefits of wearable devices.
"Work-related injuries remain a significant source of exposure for contractors, and it’s a priority for us to find new ways to help them manage risk and keep workers out of harm’s way," said Rick Keegan, President of Construction at Travelers. "This project will help us gain valuable data-driven insight, and we look forward to working with Gilbane and Triax to identify the best uses for wearable technology to help improve outcomes and employee safety."
Travelers will review data collected from a variety of Triax’s Spot-r IoT devices, including those being used at a 60,000-square-foot, six-floor Gilbane construction site in New York City over 20 months. More than 130 employees will use the Spot-r ClipTM, an unobtrusive device worn on the worker’s waist belt. The Spot-r Clip enables faster response times to possible injuries by automatically detecting worker falls and providing supervisors with real-time notification of worker location and other safety incident details. The IoT device also includes a feature that allows workers to easily report hazards or incidents. On-site machinery will be fitted with the Spot-r EquipTagTM, which monitors equipment location and usage. Additionally, the site will have Spot-r EvacTagsTM, which allow managers to trigger high-decibel, highly visible emergency alarms to workers via a dashboard.
In 2016, Travelers created the Early Severity PredictorSM, an industry-first predictive model that identifies the likelihood of an injured employee developing chronic pain so that he or she can reduce the need for opioids or other painkillers during recovery.
The following year, the company launched ZoneCheckSM, a first-of-its-kind online tool to help contractors identify areas surrounding a job site that could be affected by vibrations from heavy equipment. Most recently, the company introduced a digital self-service tool, MyTravelers® for Injured Employees, which streamlines the workers compensation claim process ...
Triax Technologies, Inc. is a Norwalk, Connecticut-based technology company that develops and delivers IoT solutions for the construction industry. Its flagship Spot-r system connects workers, equipment and managers through a proprietary, minimal infrastructure network, sensors and a cloud-based dashboard. By providing real-time, data-driven visibility into daily site operations and safety incidents, Spot-r is changing the way construction companies manage resources, information and risk. Triax develops intelligent, actionable solutions that address the complexities of an active job site, and it helps firms streamline processes and build safer and smarter.
The Travelers Companies, Inc. announced a collaboration with Gilbane and Triax Technologies to explore the potential safety benefits of wearable devices.
"Work-related injuries remain a significant source of exposure for contractors, and it’s a priority for us to find new ways to help them manage risk and keep workers out of harm’s way," said Rick Keegan, President of Construction at Travelers. "This project will help us gain valuable data-driven insight, and we look forward to working with Gilbane and Triax to identify the best uses for wearable technology to help improve outcomes and employee safety."
Travelers will review data collected from a variety of Triax’s Spot-r IoT devices, including those being used at a 60,000-square-foot, six-floor Gilbane construction site in New York City over 20 months. More than 130 employees will use the Spot-r ClipTM, an unobtrusive device worn on the worker’s waist belt. The Spot-r Clip enables faster response times to possible injuries by automatically detecting worker falls and providing supervisors with real-time notification of worker location and other safety incident details. The IoT device also includes a feature that allows workers to easily report hazards or incidents. On-site machinery will be fitted with the Spot-r EquipTagTM, which monitors equipment location and usage. Additionally, the site will have Spot-r EvacTagsTM, which allow managers to trigger high-decibel, highly visible emergency alarms to workers via a dashboard.
In 2016, Travelers created the Early Severity PredictorSM, an industry-first predictive model that identifies the likelihood of an injured employee developing chronic pain so that he or she can reduce the need for opioids or other painkillers during recovery.
The following year, the company launched ZoneCheckSM, a first-of-its-kind online tool to help contractors identify areas surrounding a job site that could be affected by vibrations from heavy equipment. Most recently, the company introduced a digital self-service tool, MyTravelers® for Injured Employees, which streamlines the workers compensation claim process ...
Four chiropractors and a capper were charged this week with insurance fraud in a massive multi-million dollar workers’ compensation insurance referral scheme that exploited persons in predominantly Spanish-speaking communities.
Last year, 10 attorneys and six cappers were charged as part of the same investigation. This is the second phase of filing resulting from a 4-year insurance fraud investigation by the Orange County District Attorney’s Office Bureau of Investigation, Insurance Fraud Unit.
Three defendants charged in Phase I of this investigation have pleaded guilty to participating in the unlawful referral scheme, with one pleading to multiple counts of insurance fraud. In 2014, the OCDA received a tip from a major insurance carrier and initiated an investigation in conjunction with CDI, which ultimately involved more than 20 insurance carriers and self-insured entities conducting business in California.
In 2005, Carlos Arguello III formed Centro Legal Internacional, an "advertising" company, and secured unlawful referral contracts with 20 to 40 workers' compensation insurance and personal injury attorneys. Arguello required all participating attorneys to sign annual contracts entitled "joint advertising agreement." Based on the contracts, the attorneys paid Arguello a specified monthly fee for procuring and delivering a minimum number of retained clients per month. Arguello used several names for his referral scheme, including Centro Legal Int’l, Justicia Legal Int’l, and Centro de Abogados Int’l.
He had websites created to advertise these legal services, including iwantmylawyernow.com, instantlawyeraccess.com, centrodeabogadosinternacional.com, uniondeabogadoslatinos.com, and unitedinjuryattorneys.com. Each website and advertisement offered a "free consultation" via an online consultation form or a toll-free number. The toll-free numbers for Centro Legal Int’l, Justicia Legal Int’l, and Centro de Abogados were all directed to a call center in Tijuana, Mexico.
Arguello also owned or was affiliated with other companies that he had the attorneys refer business to, including C & E Technology, Professional Document Management, and Providence Scheduling.
Edgar Gonzalez, another charged defendant in Phase I, is accused of paying attorneys for referral of business to his copy service company, called USA Photocopy, and billing the work to workers’ compensation insurance carriers.
The new Phase II involves Arguello’s call center operators and sign-up agents who were required to stress to the callers the importance of medical treatment to their workers’ compensation or personal injury case, encouraging them to show up to all appointments.
Once the caller agreed to become represented by an attorney from Arguello’s scheme, the "client" was then sold to Providence Scheduling, a service Fermin Iglesias is accused of owning and operating. Iglesias is accused of having arrangements with several chiropractors, including defendants Afsoun Naderi, Bahar Danesh Gharib, Bryan Aun, and John Larson, who are accused of paying Providence Scheduling for patients under the guise of a "Promotion and Scheduling Services Agreement."
Iglesias is accused of directing these chiropractors to also prescribe durable medical equipment (DME) to their patients through his several DME companies, including Meridian Rehab, Bright Rehab Solutions, Prime Medical Resources, and Prime Orthopedics, all of which he billed to workers’ compensation insurance carriers.
Iglesias is further accused of requiring the chiropractors to refer all diagnostic imaging tests, such as MRI’s, through a scheduling company owned by Iglesias and Arguello called Medex Solutions.
The diagnostic facility owners are accused of paying Iglesias and Medex Solutions kickbacks disguised as "scheduling service" fees for each completed scan. All diagnostic services were billed to workers’ compensation insurance carriers ...
Last year, 10 attorneys and six cappers were charged as part of the same investigation. This is the second phase of filing resulting from a 4-year insurance fraud investigation by the Orange County District Attorney’s Office Bureau of Investigation, Insurance Fraud Unit.
Three defendants charged in Phase I of this investigation have pleaded guilty to participating in the unlawful referral scheme, with one pleading to multiple counts of insurance fraud. In 2014, the OCDA received a tip from a major insurance carrier and initiated an investigation in conjunction with CDI, which ultimately involved more than 20 insurance carriers and self-insured entities conducting business in California.
In 2005, Carlos Arguello III formed Centro Legal Internacional, an "advertising" company, and secured unlawful referral contracts with 20 to 40 workers' compensation insurance and personal injury attorneys. Arguello required all participating attorneys to sign annual contracts entitled "joint advertising agreement." Based on the contracts, the attorneys paid Arguello a specified monthly fee for procuring and delivering a minimum number of retained clients per month. Arguello used several names for his referral scheme, including Centro Legal Int’l, Justicia Legal Int’l, and Centro de Abogados Int’l.
He had websites created to advertise these legal services, including iwantmylawyernow.com, instantlawyeraccess.com, centrodeabogadosinternacional.com, uniondeabogadoslatinos.com, and unitedinjuryattorneys.com. Each website and advertisement offered a "free consultation" via an online consultation form or a toll-free number. The toll-free numbers for Centro Legal Int’l, Justicia Legal Int’l, and Centro de Abogados were all directed to a call center in Tijuana, Mexico.
Arguello also owned or was affiliated with other companies that he had the attorneys refer business to, including C & E Technology, Professional Document Management, and Providence Scheduling.
Edgar Gonzalez, another charged defendant in Phase I, is accused of paying attorneys for referral of business to his copy service company, called USA Photocopy, and billing the work to workers’ compensation insurance carriers.
The new Phase II involves Arguello’s call center operators and sign-up agents who were required to stress to the callers the importance of medical treatment to their workers’ compensation or personal injury case, encouraging them to show up to all appointments.
Once the caller agreed to become represented by an attorney from Arguello’s scheme, the "client" was then sold to Providence Scheduling, a service Fermin Iglesias is accused of owning and operating. Iglesias is accused of having arrangements with several chiropractors, including defendants Afsoun Naderi, Bahar Danesh Gharib, Bryan Aun, and John Larson, who are accused of paying Providence Scheduling for patients under the guise of a "Promotion and Scheduling Services Agreement."
Iglesias is accused of directing these chiropractors to also prescribe durable medical equipment (DME) to their patients through his several DME companies, including Meridian Rehab, Bright Rehab Solutions, Prime Medical Resources, and Prime Orthopedics, all of which he billed to workers’ compensation insurance carriers.
Iglesias is further accused of requiring the chiropractors to refer all diagnostic imaging tests, such as MRI’s, through a scheduling company owned by Iglesias and Arguello called Medex Solutions.
The diagnostic facility owners are accused of paying Iglesias and Medex Solutions kickbacks disguised as "scheduling service" fees for each completed scan. All diagnostic services were billed to workers’ compensation insurance carriers ...
The school groundskeeper who won a jury trial against Bayer AG’s Monsanto unit over allegations that the company’s glyphosate-containing weed-killers caused his cancer, accepted a court-mandated reduced punitive damages award on Wednesday.
The decision by Dewayne Johnson, who sued Monsanto in 2016, brings the total award to $78 million, down from the jury’s verdict on Aug. 10 of $289 million - $39 million in compensatory and $250 million in punitive damages.
Johnson’s law firm said in a statement that he accepted the reduction "to hopefully achieve a final resolution within his lifetime."
Judge Suzanne Bolanos of San Francisco’s Superior Court of California, who oversaw the trial, earlier this month affirmed the liability portion of the verdict, but ordered punitive damages to be slashed to concur with California and federal law.
Bayer denies allegations that glyphosate can cause cancer and said it will appeal the decision as the verdict was not supported by the evidence presented at trial.
The verdict, which marked the first such decision against Monsanto, wiped 10 percent off the value of the company and shares have since dropped nearly 30 percent from their pre-verdict value.
The company, which faces more than 8,700 U.S. lawsuits over glyphosate, says decades of scientific studies and real-world use have shown glyphosate to be safe for human use. It is likely that the workers' compensation industry will end up with some of thee claims.
Regulators around the world, including the U.S. Environmental Protection Agency, have found glyphosate was not a likely carcinogen to humans and approved the chemical, but the cancer unit of the World Health Organization in 2015 classified glyphosate as "probably carcinogenic to humans."
The jury found the company’s glyphosate-containing RoundUp and Ranger Pro products responsible for causing Johnson’s non-Hodgkin’s lymphoma and said the company had failed to warn him and other consumers of the risks.
Johnson could decide whether to accept the reduction or face a new trial on the punitive damages portion.
His lawyers on Wednesday said they would challenge the amount of damages during Bayer’s appeal ...
The decision by Dewayne Johnson, who sued Monsanto in 2016, brings the total award to $78 million, down from the jury’s verdict on Aug. 10 of $289 million - $39 million in compensatory and $250 million in punitive damages.
Johnson’s law firm said in a statement that he accepted the reduction "to hopefully achieve a final resolution within his lifetime."
Judge Suzanne Bolanos of San Francisco’s Superior Court of California, who oversaw the trial, earlier this month affirmed the liability portion of the verdict, but ordered punitive damages to be slashed to concur with California and federal law.
Bayer denies allegations that glyphosate can cause cancer and said it will appeal the decision as the verdict was not supported by the evidence presented at trial.
The verdict, which marked the first such decision against Monsanto, wiped 10 percent off the value of the company and shares have since dropped nearly 30 percent from their pre-verdict value.
The company, which faces more than 8,700 U.S. lawsuits over glyphosate, says decades of scientific studies and real-world use have shown glyphosate to be safe for human use. It is likely that the workers' compensation industry will end up with some of thee claims.
Regulators around the world, including the U.S. Environmental Protection Agency, have found glyphosate was not a likely carcinogen to humans and approved the chemical, but the cancer unit of the World Health Organization in 2015 classified glyphosate as "probably carcinogenic to humans."
The jury found the company’s glyphosate-containing RoundUp and Ranger Pro products responsible for causing Johnson’s non-Hodgkin’s lymphoma and said the company had failed to warn him and other consumers of the risks.
Johnson could decide whether to accept the reduction or face a new trial on the punitive damages portion.
His lawyers on Wednesday said they would challenge the amount of damages during Bayer’s appeal ...
While some medical theorists claim cannabis can help you. others might say instead that it hurts you. New research published this month may support the latter theory. Marijuana, it seems, is not a performance-enhancing drug. That is, at least, not among young people, and not when the activity is learning.
A study published in the Journal of Clinical Psychiatry finds that when adolescents stop using marijuana - even for just one week - their verbal learning and memory improve. The study contributes to growing evidence that marijuana use in adolescents is associated with reduced neurocognitive functioning.
More than 14 percent of students in middle school and high school reported using marijuana within the past month, finds a National Institutes of Health survey conducted in 2017. And marijuana use has increased among high-schoolers over the past 10 years, according to the U.S. Department of Health & Human Services.
At the same time, the percentage of teens who believe that regular marijuana use poses a great risk to their health has dropped sharply since the mid-2000s. And legalization of marijuana may play a part in shaping how young people think about the drug. One study noted that after 2012, when marijuana was legalized in Washington state, the number of eighth-graders there that believed marijuana posed risks to their health dropped by 14 percent.
Researchers are particularly concerned with marijuana use among the young because THC, the active ingredient in marijuana, most sharply affects the parts of the brain that develop during adolescence.
"The adolescent brain is undergoing significant neurodevelopment well into the 20s, and the regions that are last to develop are those regions that are most populated by cannabis receptors and are also very critical to cognitive functioning," says Randi Schuster. Schuster is the director of neuropsychology at Massachusetts General Hospital's Center for Addiction Medicine and the study's lead author.
Schuster and the team of researchers set out to determine if cognitive functions that are potentially harmed by marijuana use in adolescents - particularly attention and memory - improve when they abstain from marijuana.
They recruited 88 pot-using teens and young adults, ages 16 to 25, and got some of them to agree to stop consuming marijuana for the month.
The researchers randomly assigned the volunteers into an abstaining group and a nonabstaining group. They delivered the bad news to those chosen to be abstainers at the end of their first visit, and Schuster says, they took it surprisingly well.
Also at each visit, the participants completed a variety of tasks testing their attention and memory through the Cambridge Neuropsychological Test Automated Battery, a validated cognitive assessment tool.
Interestingly, most of the memory improvement for the abstinent group happened during the first week of the study, which leaves the researchers feeling hopeful.
The researchers found that after four weeks, there was no noticeable difference in attention scores between the marijuana users and the nonusers. But, the memory scores of the nonusers improved, whereas the users' memories mostly stayed the same.
While this study didn't prove that abstaining from cannabis improves adolescents' attention, other studies have found that marijuana users fare worse in attention tests than nonusers. Schuster hypothesizes it might take more than four weeks of abstinence for attention levels to improve.
"We were pleasantly surprised to see that at least some of the deficits that we think may be caused by cannabis appear to be reversible, and at least some of them are quickly reversible, which is good news," Schuster says ...
A study published in the Journal of Clinical Psychiatry finds that when adolescents stop using marijuana - even for just one week - their verbal learning and memory improve. The study contributes to growing evidence that marijuana use in adolescents is associated with reduced neurocognitive functioning.
More than 14 percent of students in middle school and high school reported using marijuana within the past month, finds a National Institutes of Health survey conducted in 2017. And marijuana use has increased among high-schoolers over the past 10 years, according to the U.S. Department of Health & Human Services.
At the same time, the percentage of teens who believe that regular marijuana use poses a great risk to their health has dropped sharply since the mid-2000s. And legalization of marijuana may play a part in shaping how young people think about the drug. One study noted that after 2012, when marijuana was legalized in Washington state, the number of eighth-graders there that believed marijuana posed risks to their health dropped by 14 percent.
Researchers are particularly concerned with marijuana use among the young because THC, the active ingredient in marijuana, most sharply affects the parts of the brain that develop during adolescence.
"The adolescent brain is undergoing significant neurodevelopment well into the 20s, and the regions that are last to develop are those regions that are most populated by cannabis receptors and are also very critical to cognitive functioning," says Randi Schuster. Schuster is the director of neuropsychology at Massachusetts General Hospital's Center for Addiction Medicine and the study's lead author.
Schuster and the team of researchers set out to determine if cognitive functions that are potentially harmed by marijuana use in adolescents - particularly attention and memory - improve when they abstain from marijuana.
They recruited 88 pot-using teens and young adults, ages 16 to 25, and got some of them to agree to stop consuming marijuana for the month.
The researchers randomly assigned the volunteers into an abstaining group and a nonabstaining group. They delivered the bad news to those chosen to be abstainers at the end of their first visit, and Schuster says, they took it surprisingly well.
Also at each visit, the participants completed a variety of tasks testing their attention and memory through the Cambridge Neuropsychological Test Automated Battery, a validated cognitive assessment tool.
Interestingly, most of the memory improvement for the abstinent group happened during the first week of the study, which leaves the researchers feeling hopeful.
The researchers found that after four weeks, there was no noticeable difference in attention scores between the marijuana users and the nonusers. But, the memory scores of the nonusers improved, whereas the users' memories mostly stayed the same.
While this study didn't prove that abstaining from cannabis improves adolescents' attention, other studies have found that marijuana users fare worse in attention tests than nonusers. Schuster hypothesizes it might take more than four weeks of abstinence for attention levels to improve.
"We were pleasantly surprised to see that at least some of the deficits that we think may be caused by cannabis appear to be reversible, and at least some of them are quickly reversible, which is good news," Schuster says ...
Workers' compensation treatment guidelines, as well as guidelines used in other systems are based on published scientific outcomes research. Most assume that if the study occurred at reputable institutions, and was peer reviewed in reputable journals, it would be rock solid science. More and more, this assumption is proving to be fallacious.
Harvard Medical School and Brigham and Women’s Hospital have recommended that 31 papers from a former lab director be retracted from medical journals.
The papers from the lab of Dr. Piero Anversa, who studied cardiac stem cells, "included falsified and/or fabricated data," according to a statement to Retraction Watch and STAT from the two institutions.
Last year, the hospital agreed to a $10 million settlement with the U.S. government over allegations Anversa and two colleagues’ work had been used to fraudulently obtain federal funding.
Anversa and Dr. Annarosa Leri - who have had at least one paper already retracted, and one subject to an expression of concern - had at one point sued Harvard and the Brigham unsuccessfully for alerting journals to problems in their work back in 2014. Anversa’s lab closed in 2015; Anversa, Leri, and their colleague Dr. Jan Kajstura no longer work at the hospital.
While the Brigham settled with the U.S. Department of Justice, the U.S. Office of Research Integrity, which oversees research misconduct investigations involving National Institutes of Health funding, has not made a finding in the case. The university and the hospital have not said which journals the 31 papers appeared in, but the journal Circulation retracted a paper by Anversa and colleagues in 2014, and The Lancet issued an expression of concern about another in the same year.
"Following a review of research conducted in the former lab of Piero Anversa, we determined that 31 publications included falsified and/or fabricated data, and we have notified all relevant journals," Harvard and the Brigham told STAT and Retraction Watch.
Anversa has previously corrected eight of his papers, many for failures to disclose conflicts of interest. He "practically invented the field of cardiac stem cell therapy when he first reported that cardiac cells were capable of regeneration," Cardiobrief and MedPage Today wrote about him last year.
Anversa’s work was based on the idea that the heart contains stem cells that could regenerate cardiac muscle. He and his colleagues claimed that they had identified such cells, known as c-kit cells. When various research teams tried to reproduce the results, however, they failed. Still, some scientists have tried to inject c-kit cells into damaged hearts, with mixed results at best.
"We are committed to upholding the highest ethical standards and to rigorously maintaining the integrity of our research," Harvard and the Brigham said. "Any concerns brought to our attention are reviewed in accordance with institutional policies and applicable regulations."
Anversa was born in Parma, Italy, in 1940 and received his medical degree from the University of Parma in 1965. He gained prominence as a stem-cell researcher at New York Medical College in Valhalla, N.Y., where he worked before moving to Harvard Medical School and the Brigham in 2007. Anversa became a full professor in 2010 ...
Harvard Medical School and Brigham and Women’s Hospital have recommended that 31 papers from a former lab director be retracted from medical journals.
The papers from the lab of Dr. Piero Anversa, who studied cardiac stem cells, "included falsified and/or fabricated data," according to a statement to Retraction Watch and STAT from the two institutions.
Last year, the hospital agreed to a $10 million settlement with the U.S. government over allegations Anversa and two colleagues’ work had been used to fraudulently obtain federal funding.
Anversa and Dr. Annarosa Leri - who have had at least one paper already retracted, and one subject to an expression of concern - had at one point sued Harvard and the Brigham unsuccessfully for alerting journals to problems in their work back in 2014. Anversa’s lab closed in 2015; Anversa, Leri, and their colleague Dr. Jan Kajstura no longer work at the hospital.
While the Brigham settled with the U.S. Department of Justice, the U.S. Office of Research Integrity, which oversees research misconduct investigations involving National Institutes of Health funding, has not made a finding in the case. The university and the hospital have not said which journals the 31 papers appeared in, but the journal Circulation retracted a paper by Anversa and colleagues in 2014, and The Lancet issued an expression of concern about another in the same year.
"Following a review of research conducted in the former lab of Piero Anversa, we determined that 31 publications included falsified and/or fabricated data, and we have notified all relevant journals," Harvard and the Brigham told STAT and Retraction Watch.
Anversa has previously corrected eight of his papers, many for failures to disclose conflicts of interest. He "practically invented the field of cardiac stem cell therapy when he first reported that cardiac cells were capable of regeneration," Cardiobrief and MedPage Today wrote about him last year.
Anversa’s work was based on the idea that the heart contains stem cells that could regenerate cardiac muscle. He and his colleagues claimed that they had identified such cells, known as c-kit cells. When various research teams tried to reproduce the results, however, they failed. Still, some scientists have tried to inject c-kit cells into damaged hearts, with mixed results at best.
"We are committed to upholding the highest ethical standards and to rigorously maintaining the integrity of our research," Harvard and the Brigham said. "Any concerns brought to our attention are reviewed in accordance with institutional policies and applicable regulations."
Anversa was born in Parma, Italy, in 1940 and received his medical degree from the University of Parma in 1965. He gained prominence as a stem-cell researcher at New York Medical College in Valhalla, N.Y., where he worked before moving to Harvard Medical School and the Brigham in 2007. Anversa became a full professor in 2010 ...
The Los Angeles County District Attorney’s Office reports that a brother and sister who run a construction company in Paramount have been charged with fraud that allegedly resulted in at least $6 million in losses to the State Compensation Insurance Fund and with underpaying employees.
Enrique Vera (dob 2/14/70) of Tarzana, who owns Ultimate, Inc., faces four felony counts of workers’ compensation fraud and three felony counts of grand theft of labor.
Gloria Vera (dob 11/16/60), who is the company’s office manager, is charged with five counts of workers’ compensation fraud, three counts of insurance fraud and three counts of grand theft of labor, all felonies.
The charges include an allegation of fraud and embezzlement that resulted in a loss of more than $500,000 to the SCIF.
Case BA472360 was filed for arrest warrant on Oct. 24. Enrique Vera was arraigned in Department 30 of the Foltz Criminal Justice Center. Gloria Vera will be arraigned at a later time. The prosecutor requested bail be set at $505,000 for Gloria Vera and $430,000 for Enrique Vera.
According to Deputy District Attorney Christopher Hartman of the Healthcare Fraud Division, the siblings allegedly submitted altered payroll records to the SCIF in order to pay a reduced premium on the construction company’s workers’ compensation insurance. They are accused of making false and fraudulent statements with the intent to discourage injured workers from claiming workers’ compensation benefits or pursuing claims.
Gloria Vera also allegedly failed to disclose and concealed employees’ on-the-job injuries that entitled them to workers’ compensation.
The siblings allegedly also underpaid employees the prevailing wage that the company was required to as a contractor for a student housing renovation project at UCLA, the prosecutor said.
Gloria Vera faces a possible maximum penalty of 19 years in state prison if convicted as charged. Enrique Vera faces up to 15 years in prison if convicted.
The case remains under investigation by the District Attorney’s Office’s Bureau of Investigation ...
Enrique Vera (dob 2/14/70) of Tarzana, who owns Ultimate, Inc., faces four felony counts of workers’ compensation fraud and three felony counts of grand theft of labor.
Gloria Vera (dob 11/16/60), who is the company’s office manager, is charged with five counts of workers’ compensation fraud, three counts of insurance fraud and three counts of grand theft of labor, all felonies.
The charges include an allegation of fraud and embezzlement that resulted in a loss of more than $500,000 to the SCIF.
Case BA472360 was filed for arrest warrant on Oct. 24. Enrique Vera was arraigned in Department 30 of the Foltz Criminal Justice Center. Gloria Vera will be arraigned at a later time. The prosecutor requested bail be set at $505,000 for Gloria Vera and $430,000 for Enrique Vera.
According to Deputy District Attorney Christopher Hartman of the Healthcare Fraud Division, the siblings allegedly submitted altered payroll records to the SCIF in order to pay a reduced premium on the construction company’s workers’ compensation insurance. They are accused of making false and fraudulent statements with the intent to discourage injured workers from claiming workers’ compensation benefits or pursuing claims.
Gloria Vera also allegedly failed to disclose and concealed employees’ on-the-job injuries that entitled them to workers’ compensation.
The siblings allegedly also underpaid employees the prevailing wage that the company was required to as a contractor for a student housing renovation project at UCLA, the prosecutor said.
Gloria Vera faces a possible maximum penalty of 19 years in state prison if convicted as charged. Enrique Vera faces up to 15 years in prison if convicted.
The case remains under investigation by the District Attorney’s Office’s Bureau of Investigation ...
Cal/OSHA has issued citations to Circle M Contractors, Inc. for willful violations of nail gun safety regulations after a carpenter was seriously injured at a residential construction site. An investigation found that the employer failed to train and instruct employees on the proper use of pressure-powered nailing tools.
On April 17, a carpenter was using an air pressure-powered nail gun to frame wood at a construction site in Lake Forest. The worker was carrying the nail gun in his right hand with his finger on the trigger when a nail was unintentionally discharged into his left arm. Cal/OSHA’s investigation found that Circle M Contractors employees did not receive hands-on training for operating nailing tools safely and that the Rancho Santa Margarita-based employer did not ensure workers carry nail guns only by the handle and not with their finger on the trigger.
Cal/OSHA issued two willful-serious accident-related citations with a total of $225,500 in proposed penalties for Circle M Contractors’ failure to train workers on nail guns and failure to ensure safe operation of these tools. Cal/OSHA’s review of the employer’s injury log showed 34 instances of nail gun injuries suffered by employees since 2016.
"Employers must effectively train workers to safely operate dangerous tools such as nail guns," said Cal/OSHA Chief Juliann Sum. "The employer knew these tools are hazardous and did not take the necessary measures to protect their workers from injury."
In 2015, Cal/OSHA investigated after a Circle M Contractors worker installing hanger brackets slipped and discharged a nail into his knee. Cal/OSHA cited the employer for failing to ensure workers carry nail guns only by the handle. It was one of three investigations of Circle M Contractors that year following accidents in San Diego and Irvine. One worker fell nine feet while setting roof trusses and another worker fell from the second floor while removing guardrails.
Cal/OSHA has conducted over 570 inspections of framing contractors since 2015. This industry has appeared on Cal/OSHA’s High Hazard Industry List each year from 2015 to the present. The list is compiled yearly based on injury rates so that Cal/OSHA may target employers in high hazardous industries with the highest incidence of preventable workplace injuries and illnesses.
Cal/OSHA offers a guide to developing an Injury and Illness Prevention Program and model programs for employers in both high hazard and non-high hazard industries. Cal/OSHA’s Consultation Services Branch provides free and voluntary assistance to employers to improve their safety and health programs. Employers should call (800) 963-9424 for assistance from Cal/OSHA Consultation Services ...
On April 17, a carpenter was using an air pressure-powered nail gun to frame wood at a construction site in Lake Forest. The worker was carrying the nail gun in his right hand with his finger on the trigger when a nail was unintentionally discharged into his left arm. Cal/OSHA’s investigation found that Circle M Contractors employees did not receive hands-on training for operating nailing tools safely and that the Rancho Santa Margarita-based employer did not ensure workers carry nail guns only by the handle and not with their finger on the trigger.
Cal/OSHA issued two willful-serious accident-related citations with a total of $225,500 in proposed penalties for Circle M Contractors’ failure to train workers on nail guns and failure to ensure safe operation of these tools. Cal/OSHA’s review of the employer’s injury log showed 34 instances of nail gun injuries suffered by employees since 2016.
"Employers must effectively train workers to safely operate dangerous tools such as nail guns," said Cal/OSHA Chief Juliann Sum. "The employer knew these tools are hazardous and did not take the necessary measures to protect their workers from injury."
In 2015, Cal/OSHA investigated after a Circle M Contractors worker installing hanger brackets slipped and discharged a nail into his knee. Cal/OSHA cited the employer for failing to ensure workers carry nail guns only by the handle. It was one of three investigations of Circle M Contractors that year following accidents in San Diego and Irvine. One worker fell nine feet while setting roof trusses and another worker fell from the second floor while removing guardrails.
Cal/OSHA has conducted over 570 inspections of framing contractors since 2015. This industry has appeared on Cal/OSHA’s High Hazard Industry List each year from 2015 to the present. The list is compiled yearly based on injury rates so that Cal/OSHA may target employers in high hazardous industries with the highest incidence of preventable workplace injuries and illnesses.
Cal/OSHA offers a guide to developing an Injury and Illness Prevention Program and model programs for employers in both high hazard and non-high hazard industries. Cal/OSHA’s Consultation Services Branch provides free and voluntary assistance to employers to improve their safety and health programs. Employers should call (800) 963-9424 for assistance from Cal/OSHA Consultation Services ...
