A bill introduced on Thursday in the US House of Representatives would make permanent some temporary changes that CMS has initiated in its telehealth coverage during the COVID-19 pandemic.
Cosponsored by members of the House Telehealth Caucus, the bipartisan legislation would eliminate most geographic and originating site restrictions on the use of telehealth in Medicare. The bill would allow telehealth visits to be conducted in a patient's home. It would also permit rural health clinics and federally qualified health clinics to furnish telehealth services.
In addition, the bill would authorize the Department of Health and Human Services to waive or modify telehealth requirements in Medicare during and for 90 days after any emergency period. It would also require HHS to submit a report to Congress on telehealth utilization within 6 months after the end of the emergency period.
Industry groups hailed the introduction of this legislation. But many other details of how Congress or CMS might regulate telehealth coverage after the pandemic is over remain unclear. Moreover, the bill affects only Medicare. States would have to pass their own legislation to make permanent the temporary changes many of them have created in their Medicaid regulations on telehealth. And commercial insurers would not be bound by the House bill, should it be adopted and signed into law.
Among the temporary waivers CMS introduced under the authority of President Trump's March 13 emergency declaration and the CARES Act, the agency:
-- Allowed patients to receive services anywhere, including at home
-- Added 135 allowable telehealth services, more than doubling the number of services it allowed before
-- Established reimbursement parity for in-person and telehealth visits
-- Allowed telephone Evaluation and Management visits to be paid at the same rate as in-person visits
-- Allowed the use of telehealth in post-acute care facilities
-- Covered telehealth in rural health clinics and federally qualified health centers
-- Expanded the types of providers who can supply telehealth services
-- Waived the collection of copays for telehealth visits
Prior to the COVID-19 crisis, CMS also expanded allowable telehealth services and introduced "virtual check-ins," which doctors can use to determine whether patients should be seen in person. In addition, it gave Medicare Advantage plans the option of offering telehealth services to their members.
CMS has already started to use the information it has collected on telehealth use in the pandemic to inform its decisions going forward. "Early CMS data have shown telehealth to be an effective way for people to access health care safely during the COVID-19 pandemic, whether it's getting a prescription refilled, managing chronic conditions, or obtaining mental health counseling," Verma writes in the blog post.
Before the public health emergency, Verma said, an average of 13,000 fee-for-service Medicare beneficiaries received telehealth services each week. In the last week of April, nearly 1.7 million beneficiaries received telehealth services. More than 9 million beneficiaries received telehealth visits from mid-March through mid-June, including audio-only visits, virtual check-ins, and e-visits via patient portals.
In rural areas, she notes, 22% of Medicare patients used telehealth; 30% used it in urban areas. Patients in the Northeast and mid-Atlantic used more telehealth than did patients elsewhere.
...
Cosponsored by members of the House Telehealth Caucus, the bipartisan legislation would eliminate most geographic and originating site restrictions on the use of telehealth in Medicare. The bill would allow telehealth visits to be conducted in a patient's home. It would also permit rural health clinics and federally qualified health clinics to furnish telehealth services.
In addition, the bill would authorize the Department of Health and Human Services to waive or modify telehealth requirements in Medicare during and for 90 days after any emergency period. It would also require HHS to submit a report to Congress on telehealth utilization within 6 months after the end of the emergency period.
Industry groups hailed the introduction of this legislation. But many other details of how Congress or CMS might regulate telehealth coverage after the pandemic is over remain unclear. Moreover, the bill affects only Medicare. States would have to pass their own legislation to make permanent the temporary changes many of them have created in their Medicaid regulations on telehealth. And commercial insurers would not be bound by the House bill, should it be adopted and signed into law.
Among the temporary waivers CMS introduced under the authority of President Trump's March 13 emergency declaration and the CARES Act, the agency:
-- Allowed patients to receive services anywhere, including at home
-- Added 135 allowable telehealth services, more than doubling the number of services it allowed before
-- Established reimbursement parity for in-person and telehealth visits
-- Allowed telephone Evaluation and Management visits to be paid at the same rate as in-person visits
-- Allowed the use of telehealth in post-acute care facilities
-- Covered telehealth in rural health clinics and federally qualified health centers
-- Expanded the types of providers who can supply telehealth services
-- Waived the collection of copays for telehealth visits
Prior to the COVID-19 crisis, CMS also expanded allowable telehealth services and introduced "virtual check-ins," which doctors can use to determine whether patients should be seen in person. In addition, it gave Medicare Advantage plans the option of offering telehealth services to their members.
CMS has already started to use the information it has collected on telehealth use in the pandemic to inform its decisions going forward. "Early CMS data have shown telehealth to be an effective way for people to access health care safely during the COVID-19 pandemic, whether it's getting a prescription refilled, managing chronic conditions, or obtaining mental health counseling," Verma writes in the blog post.
Before the public health emergency, Verma said, an average of 13,000 fee-for-service Medicare beneficiaries received telehealth services each week. In the last week of April, nearly 1.7 million beneficiaries received telehealth services. More than 9 million beneficiaries received telehealth visits from mid-March through mid-June, including audio-only visits, virtual check-ins, and e-visits via patient portals.
In rural areas, she notes, 22% of Medicare patients used telehealth; 30% used it in urban areas. Patients in the Northeast and mid-Atlantic used more telehealth than did patients elsewhere.
...
The California Attorney General issued a letter conditionally approving the sale of St. Francis Medical Center, a Verity Health System medical facility in Los Angeles County, to Prime Healthcare, Inc.
Daughters of Charity of St. Vincent de Paul, Province of the West, a religious organization, originally owned Verity. In 2015, the Daughters recapitalize the system with an investment of about $250 million. Verity was losing close to $175 million per year on a cash flow basis. In 2018 it filed for bankruptcy to help resolve a cash crunch while it found a buyer.
Under California law, any proposed sale of a non-profit health facility to a for-profit corporation must secure the approval of the state Attorney General, whose statutory charge is to consider the factors set forth in the law, including whether the transaction is in the public interest and whether the transaction affects the availability or accessibility of healthcare services to the affected community.
The Attorney General’s conditional consent represented in the letter seeks to protect access to care for the Los Angeles communities served by the hospital. If Verity and Prime close on the sale with the conditions outlined in the letter, they are consenting to comply with the conditions. The transaction must still be approved in Court where Verity has filed for bankruptcy.
The Attorney General’s conditions are based on an independent health expert’s in-depth analysis of the health and medical needs in the surrounding communities. Among other things, these conditions call for Prime, the prospective purchaser, to:
-- Keep St. Francis open for at least ten years after sale and continue operating as a Trauma II Center. St. Francis will continue to provide cancer services, cardiac services, women’s health services, neonatal intensive care, perinatal and pediatric services, psychiatric and other critical services recommended by the health expert;
-- Increase of its reach of charity care policy at St. Francis by covering care in full, serving those who earn at the 400 percent of federal poverty level ($51,040 for an individual and $86,880 for a family of three) and up to 600 percent of federal poverty for the discount payment policy;
-- Commit $10,186,173 in charity care for patients in the surrounding community, and Prime has agreed to improve its charity care policies to cover significantly more patients;
-- Increase the community benefit of St. Francis to $1,597,077 for six years exclusive of any grants received, to support the Southern California Crossroads Program, the Health Benefit Resource Center, Welcome Baby Program, Healthy Community Initiatives, American Career College access for onsite training, Paramedic Training and Education, and Patient Transportation Support;
-- Maintain admitting privileges for staff in good standing, maintain on-call coverage contracts and comparable arrangements with physicians at fair market value to maintain Level II trauma care at St. Francis;
-- Commit the necessary investments required to maintain seismic compliance at St. Francis. Prime will be required to expend at least $35 million for capital improvements, excluding seismic retrofit costs, at St. Francis Medical Center over the five-year period from the closing date, including but not limited to upgrading its electronic medical records system. The expert report identified seismic issues at St. Francis; and
-- Maintain access to women’s healthcare services for ten years, and no limitations on LGBTQ healthcare services offered at St. Francis ...
Daughters of Charity of St. Vincent de Paul, Province of the West, a religious organization, originally owned Verity. In 2015, the Daughters recapitalize the system with an investment of about $250 million. Verity was losing close to $175 million per year on a cash flow basis. In 2018 it filed for bankruptcy to help resolve a cash crunch while it found a buyer.
Under California law, any proposed sale of a non-profit health facility to a for-profit corporation must secure the approval of the state Attorney General, whose statutory charge is to consider the factors set forth in the law, including whether the transaction is in the public interest and whether the transaction affects the availability or accessibility of healthcare services to the affected community.
The Attorney General’s conditional consent represented in the letter seeks to protect access to care for the Los Angeles communities served by the hospital. If Verity and Prime close on the sale with the conditions outlined in the letter, they are consenting to comply with the conditions. The transaction must still be approved in Court where Verity has filed for bankruptcy.
The Attorney General’s conditions are based on an independent health expert’s in-depth analysis of the health and medical needs in the surrounding communities. Among other things, these conditions call for Prime, the prospective purchaser, to:
-- Keep St. Francis open for at least ten years after sale and continue operating as a Trauma II Center. St. Francis will continue to provide cancer services, cardiac services, women’s health services, neonatal intensive care, perinatal and pediatric services, psychiatric and other critical services recommended by the health expert;
-- Increase of its reach of charity care policy at St. Francis by covering care in full, serving those who earn at the 400 percent of federal poverty level ($51,040 for an individual and $86,880 for a family of three) and up to 600 percent of federal poverty for the discount payment policy;
-- Commit $10,186,173 in charity care for patients in the surrounding community, and Prime has agreed to improve its charity care policies to cover significantly more patients;
-- Increase the community benefit of St. Francis to $1,597,077 for six years exclusive of any grants received, to support the Southern California Crossroads Program, the Health Benefit Resource Center, Welcome Baby Program, Healthy Community Initiatives, American Career College access for onsite training, Paramedic Training and Education, and Patient Transportation Support;
-- Maintain admitting privileges for staff in good standing, maintain on-call coverage contracts and comparable arrangements with physicians at fair market value to maintain Level II trauma care at St. Francis;
-- Commit the necessary investments required to maintain seismic compliance at St. Francis. Prime will be required to expend at least $35 million for capital improvements, excluding seismic retrofit costs, at St. Francis Medical Center over the five-year period from the closing date, including but not limited to upgrading its electronic medical records system. The expert report identified seismic issues at St. Francis; and
-- Maintain access to women’s healthcare services for ten years, and no limitations on LGBTQ healthcare services offered at St. Francis ...
On March 18, 2020, the Appeals Board issued its decision In Re: COVID-19 State of Emergency En Banc (Misc. No. 260) in response to the March 4, 2020 declaration of a state of emergency issued by the State of California’s Governor, Gavin Newsom,3 and pursuant to WCAB Rule 10370. (Cal. Code Regs., tit. 8, § 10370.)
The Appeals Board temporarily suspended specific WCAB Rules of Practice and Procedure in its decision including WCAB Rules 10961(a), 10962(c), 10990(f)(3)(E), and 10995(c)(3). (Cal. Code Regs., tit. 8, former §§ 10860, 10865, 10866, now §§ 10961(a), 10962(c), 10990(f)(3)(E), 10995(c)(3) (eff. Jan. 1, 2020).)
Pursuant to this suspension, workers’ compensation judges (WCJs) and arbitrators were provided with an unlimited extension of time within which to issue reports in response to petitions for reconsideration, removal or disqualification.
As of September 1, 2020, the Appeals Board in its new July 16, 2020 In Re: COVID-19 State of Emergency En Banc (Misc. No. 264) decision, rescinds its prior suspension of the following WCAB Rules:
-- 10961(a) Actions by Workers' Compensation Judge After Petition for Reconsideration is Filed.,
-- 10962(c) Report of Workers' Compensation Judge.,
-- 10990(f)(3)(E) Reconsideration of Arbitration Decisions Made Pursuant to Labor Code Sections 3201.5 and 3201.7.and
-- 10995(c)(3) Reconsideration of Arbitrator's Decisions or Awards Made Pursuant to the Mandatory or Voluntary Arbitration Provisions of Labor Code Sections 5270 Through 5275.
These Rules will become effective again with respect to petitions filed on or after September 1, 2020.
Suspension of the other Rules as outlined in the March 18, 2020 en banc decision remains in effect until further notice ...
The Appeals Board temporarily suspended specific WCAB Rules of Practice and Procedure in its decision including WCAB Rules 10961(a), 10962(c), 10990(f)(3)(E), and 10995(c)(3). (Cal. Code Regs., tit. 8, former §§ 10860, 10865, 10866, now §§ 10961(a), 10962(c), 10990(f)(3)(E), 10995(c)(3) (eff. Jan. 1, 2020).)
Pursuant to this suspension, workers’ compensation judges (WCJs) and arbitrators were provided with an unlimited extension of time within which to issue reports in response to petitions for reconsideration, removal or disqualification.
As of September 1, 2020, the Appeals Board in its new July 16, 2020 In Re: COVID-19 State of Emergency En Banc (Misc. No. 264) decision, rescinds its prior suspension of the following WCAB Rules:
-- 10961(a) Actions by Workers' Compensation Judge After Petition for Reconsideration is Filed.,
-- 10962(c) Report of Workers' Compensation Judge.,
-- 10990(f)(3)(E) Reconsideration of Arbitration Decisions Made Pursuant to Labor Code Sections 3201.5 and 3201.7.and
-- 10995(c)(3) Reconsideration of Arbitrator's Decisions or Awards Made Pursuant to the Mandatory or Voluntary Arbitration Provisions of Labor Code Sections 5270 Through 5275.
These Rules will become effective again with respect to petitions filed on or after September 1, 2020.
Suspension of the other Rules as outlined in the March 18, 2020 en banc decision remains in effect until further notice ...
The global insurance industry could be hit with losses of $203 billion this year because of the coronavirus pandemic, according to Lloyd's of London, the world's largest insurance exchange. The claims costs are on a par with some of the most catastrophic hurricanes of recent years and could rise further if the virus isn't contained, Lloyd's said.
"Once the scale and complexity of the social and economic impact of COVID-19 is fully understood, the overall cost to the global insurance non-life industry is likely to be far in excess of those historical events," Lloyd's said.
Chubb’s disclosure of second quarter 2020 global net catastrophe losses underscores the damage COVID-19 is doing to some carriers’ bottom lines. The global property/casualty insurer estimated $1.8 billion in pretax catastrophe losses for Q2. Of that number, close to $1.4 billion in pretax catastrophe losses stem from the coronavirus pandemic. Losses from severe U.S. weather events and U.S. civil unrest constitute the difference.
Coronavirus losses could be an issue for some time, Chubb Chairman and CEO Evan Greenberg suggested during his comments about 2020 first-quarter earnings earlier this year. "In this case the degree of revenue impact is simply unknowable," Greenberg said at the time.
CNA Financial Corporation announced that it expects to report net catastrophe losses in the second quarter of 2020 of $182 million related to COVID-19, $61 million related to civil unrest and $58 million related primarily to severe weather-related events, for a total catastrophe loss estimate of $301 million pretax.
The losses are substantially driven by healthcare professional liability with additional impacts from workers' compensation, management liability, commercial property, trade credit, and surety. Due to the recent timing of the event, emergence pattern of claims, and long tail nature of certain exposures the losses are substantially classified as incurred but not reported (IBNR) reserves.
W.R. Berkley Corp. cautioned that its 2020 second quarter pretax catastrophe losses will reach $145 million, with more than half of that coming from COVID-19 related costs. Out of that total, $85 million stems from COVID-19 claims, the specialty insurer and reinsurer said. Civil unrest created another $20 million in pretax catastrophe losses, and $40 million stems from severe weather-related events, W.R. Berkley said.
W.R. Berkley indicated its COVID-19 claims, due to the pandemic and resulting economic crisis, consist of losses mostly from "contingency and event cancellation policies, workers compensation, professional liability and other liability-related products, as well as commercial property-related business interruption coverages ...
"Once the scale and complexity of the social and economic impact of COVID-19 is fully understood, the overall cost to the global insurance non-life industry is likely to be far in excess of those historical events," Lloyd's said.
Chubb’s disclosure of second quarter 2020 global net catastrophe losses underscores the damage COVID-19 is doing to some carriers’ bottom lines. The global property/casualty insurer estimated $1.8 billion in pretax catastrophe losses for Q2. Of that number, close to $1.4 billion in pretax catastrophe losses stem from the coronavirus pandemic. Losses from severe U.S. weather events and U.S. civil unrest constitute the difference.
Coronavirus losses could be an issue for some time, Chubb Chairman and CEO Evan Greenberg suggested during his comments about 2020 first-quarter earnings earlier this year. "In this case the degree of revenue impact is simply unknowable," Greenberg said at the time.
CNA Financial Corporation announced that it expects to report net catastrophe losses in the second quarter of 2020 of $182 million related to COVID-19, $61 million related to civil unrest and $58 million related primarily to severe weather-related events, for a total catastrophe loss estimate of $301 million pretax.
The losses are substantially driven by healthcare professional liability with additional impacts from workers' compensation, management liability, commercial property, trade credit, and surety. Due to the recent timing of the event, emergence pattern of claims, and long tail nature of certain exposures the losses are substantially classified as incurred but not reported (IBNR) reserves.
W.R. Berkley Corp. cautioned that its 2020 second quarter pretax catastrophe losses will reach $145 million, with more than half of that coming from COVID-19 related costs. Out of that total, $85 million stems from COVID-19 claims, the specialty insurer and reinsurer said. Civil unrest created another $20 million in pretax catastrophe losses, and $40 million stems from severe weather-related events, W.R. Berkley said.
W.R. Berkley indicated its COVID-19 claims, due to the pandemic and resulting economic crisis, consist of losses mostly from "contingency and event cancellation policies, workers compensation, professional liability and other liability-related products, as well as commercial property-related business interruption coverages ...
Governors and public health officials across the country have implemented stringent measures to help contain the spread of COVID-19, such as safer at home and face covering mandates. Some jurisdictions also require employers to screen the health of employees, often as they begin a shift. These health screening steps, including temperature checks, are becoming more common as states further reopen their economies.
A a recent post by Littler covers statewide laws and orders across the country, that require employers to take employees’ temperatures and/or conduct other employee health screening procedures, such as asking employees about any COVID-19-consistent symptoms using a questionnaire or checklist.
In California, currently there is no state requirement for temperature screenings. However, some California localities have provisions concerning employee temperature screenings. California does require employers to train employees on how to limit the spread of COVID-19, including how to screen themselves for symptoms and stay home if they have them. Some California localities have provisions concerning employee health screenings.
The post does not address other significant issues related to employer screenings of employee health, including potential wage and hour, discrimination, and privacy concerns. As a result, employers should consult with counsel for details on additional orders that may apply to their operations and for guidance on related legal questions.
Last month, Littler released the results of its COVID-19 Return to Work Survey Report, completed by 1,010 in-house counsel, human resources professionals and C-suite executives.
Employers are moving forward with caution, as only 18 percent plan to bring employees back immediately after stay-at-home orders expire. Another 33 percent will wait a few weeks and 42 percent plan to take a "wait and see" approach to gauge the outcome of other business’ reopening efforts.
Employers are also taking numerous steps to maintain employees’ safety, including increased cleaning (90 percent), limiting employee contact in common areas (87 percent), providing and/or encouraging the use of face coverings or other protective gear (86 percent) and modifying workspaces to maintain safe distances (78 percent).
More than half (58 percent) of respondents also plan to conduct testing or health screenings on employees, with most referring to temperature checks (89 percent) and symptom screenings (72 percent) and a small number selecting antibody (8 percent) and antigen (7 percent) tests.
Yet while the U.S. Equal Employment Opportunity Commission has released some guidance about screening employees for COVID-19, uncertainty remains around implementation, privacy matters and litigation risks.
Employers interested in further information may wish to consult Littler articles identifying face covering guidance and return to work protocols, as well as its interactive reopening map ...
A a recent post by Littler covers statewide laws and orders across the country, that require employers to take employees’ temperatures and/or conduct other employee health screening procedures, such as asking employees about any COVID-19-consistent symptoms using a questionnaire or checklist.
In California, currently there is no state requirement for temperature screenings. However, some California localities have provisions concerning employee temperature screenings. California does require employers to train employees on how to limit the spread of COVID-19, including how to screen themselves for symptoms and stay home if they have them. Some California localities have provisions concerning employee health screenings.
The post does not address other significant issues related to employer screenings of employee health, including potential wage and hour, discrimination, and privacy concerns. As a result, employers should consult with counsel for details on additional orders that may apply to their operations and for guidance on related legal questions.
Last month, Littler released the results of its COVID-19 Return to Work Survey Report, completed by 1,010 in-house counsel, human resources professionals and C-suite executives.
Employers are moving forward with caution, as only 18 percent plan to bring employees back immediately after stay-at-home orders expire. Another 33 percent will wait a few weeks and 42 percent plan to take a "wait and see" approach to gauge the outcome of other business’ reopening efforts.
Employers are also taking numerous steps to maintain employees’ safety, including increased cleaning (90 percent), limiting employee contact in common areas (87 percent), providing and/or encouraging the use of face coverings or other protective gear (86 percent) and modifying workspaces to maintain safe distances (78 percent).
More than half (58 percent) of respondents also plan to conduct testing or health screenings on employees, with most referring to temperature checks (89 percent) and symptom screenings (72 percent) and a small number selecting antibody (8 percent) and antigen (7 percent) tests.
Yet while the U.S. Equal Employment Opportunity Commission has released some guidance about screening employees for COVID-19, uncertainty remains around implementation, privacy matters and litigation risks.
Employers interested in further information may wish to consult Littler articles identifying face covering guidance and return to work protocols, as well as its interactive reopening map ...
The WCIRB estimates about 30,000 COVID-19 claims will be filed in California, generating about $1.2 billion in costs. About 15,000 have been filed so far. Medical research on causative and risk factors are in the process of being created and published. This research will be critical evidence as causation and apportionment issues are litigated in these claims.
COVID-19 morbidity and mortality reports in the U.S. have not included findings specific to young adults. The Centers for Disease Control and Prevention provides a list of conditions and associated behaviors, including smoking, conferring risk of severe COVID-19 illness regardless of age.
A new University of California San Francisco study published this month in the Journal of Adolescent Health, examined young adults' medical vulnerability to severe COVID-19 illness, focusing on smoking-related behavior.
A young adult subsample (aged 18-25 years) was developed from the National Health Interview Survey, a nationally representative data set, pooling years 2016-2108. The medical vulnerability measure (yes vs. no) was developed, guided by the Centers for Disease Control and Prevention risk indicators. The estimates of medical vulnerability were developed for the full sample, the nonsmoking sample, and the individual risk indicators. Logistic regressions were conducted to examine differences by sex, race/ethnicity, income, and insurance.
Smoking was the most common risk factor for severe COVID-19 complications among otherwise largely healthy young people. For young men, smoking or vaping may more than double the potential of being hospitalized, needing intensive care or even dying from the virus. For young women, it could increase the possibility 1½ times.
The findings from this analysis indicate that nearly one in three young adults are medically vulnerable to severe COVID-19 illness (32%).
In contrast, in the nonsmoking young adult group, only about one in six is medically vulnerable to severe COVID-19 illness (16%).
This difference between estimates is driven largely by the sizable portion of young adults who reported that they engaged in past 30-day smoking (1 in 10) and past 30-day e-cigarette use (1 in 14).
By contrast, relatively fewer young adults reported medical conditions identified by the CDC as conferring severe illness risk ...
COVID-19 morbidity and mortality reports in the U.S. have not included findings specific to young adults. The Centers for Disease Control and Prevention provides a list of conditions and associated behaviors, including smoking, conferring risk of severe COVID-19 illness regardless of age.
A new University of California San Francisco study published this month in the Journal of Adolescent Health, examined young adults' medical vulnerability to severe COVID-19 illness, focusing on smoking-related behavior.
A young adult subsample (aged 18-25 years) was developed from the National Health Interview Survey, a nationally representative data set, pooling years 2016-2108. The medical vulnerability measure (yes vs. no) was developed, guided by the Centers for Disease Control and Prevention risk indicators. The estimates of medical vulnerability were developed for the full sample, the nonsmoking sample, and the individual risk indicators. Logistic regressions were conducted to examine differences by sex, race/ethnicity, income, and insurance.
Smoking was the most common risk factor for severe COVID-19 complications among otherwise largely healthy young people. For young men, smoking or vaping may more than double the potential of being hospitalized, needing intensive care or even dying from the virus. For young women, it could increase the possibility 1½ times.
The findings from this analysis indicate that nearly one in three young adults are medically vulnerable to severe COVID-19 illness (32%).
In contrast, in the nonsmoking young adult group, only about one in six is medically vulnerable to severe COVID-19 illness (16%).
This difference between estimates is driven largely by the sizable portion of young adults who reported that they engaged in past 30-day smoking (1 in 10) and past 30-day e-cigarette use (1 in 14).
By contrast, relatively fewer young adults reported medical conditions identified by the CDC as conferring severe illness risk ...
The Workers’ Compensation Insurance Rating Bureau of California released its 2020 State of the System report highlighting key metrics of the California workers’ compensation system. While much of the historical data in the report predates the COVID-19 pandemic, the pandemic and resultant stay-at-home orders will likely impact premium levels, claim frequency and claim severity in 2020 and beyond.
WCIRB Chief Actuary David Bellusci and the Vice President, Actuarial Services Tony Milano discussed the State of the System report in a webinar that you are able to view. Here are some of the highlights of the Report and the webinar.
The sharp decrease in employment projected for 2020 combined with continued decreases in insurer rates will contribute to a large decrease in premium for 2020. The WCIRB is expecting a roughly $3.5 billion decline in written premium in 2020, from $15.9 billion in 2019 to $12.5 billion this year.
California had the highest rates in the country until 2018, when rate declines moved it from the top spot. The highest rates are now found in New York.
Average insurer rates are down almost 40% since 2015. Current charged rates are at the lowest level in approximately 50 years, as over the long term declining claim frequency and increasing wage levels have offset rising medical costs and increases in indemnity benefits.
The average charged rates per $100 of payroll fell to $1.96 in 2019 from a peak of $2.97 in 2014. The rate is expected to dip to $1.81 in 2020.
However, average insurer manual rates are significantly above the rates charged to employers, indicating that insurers are, on average, applying significant pricing discounts to their filed rates.
The report also examined Gov. Gavin Newsom’s order during the height of the pandemic regarding a rebuttable assumption of compensability for all workers directed by their employer to work outside their home. "We estimate about 30,000 claims arising during this period generating about $1.2 billion in costs," Bellusci said in his webinar discussing the report.
In the WCIRB’s evaluation of the Governor’s Executive Order, the low-range estimate was $0.6 billion, the mid-range estimate $1.2 billion and the high-range estimate $2.0 billion. These estimates are lower than those in an earlier WCIRB estimate.
According to Bellusci, recent data from the Division of Workers’ Compensation shows about 15,000 COVID-19 claims so far. As expected, the vast majority of COVID-19 claims reported to the Division of Workers’ Compensation are in the health care and government/public administration sectors. It is likely as California’s economy begins to re-open that the industry mix of COVID-19 claims will be more dispersed.
The report shows pre-pandemic cost trends were generally stable with modest frequency and severity growth, continued high levels of frictional costs and significant regional differentials, while 2020 claim frequency could be impacted by the economic downturn and surges of COVID-19 and post-termination claims ...
WCIRB Chief Actuary David Bellusci and the Vice President, Actuarial Services Tony Milano discussed the State of the System report in a webinar that you are able to view. Here are some of the highlights of the Report and the webinar.
The sharp decrease in employment projected for 2020 combined with continued decreases in insurer rates will contribute to a large decrease in premium for 2020. The WCIRB is expecting a roughly $3.5 billion decline in written premium in 2020, from $15.9 billion in 2019 to $12.5 billion this year.
California had the highest rates in the country until 2018, when rate declines moved it from the top spot. The highest rates are now found in New York.
Average insurer rates are down almost 40% since 2015. Current charged rates are at the lowest level in approximately 50 years, as over the long term declining claim frequency and increasing wage levels have offset rising medical costs and increases in indemnity benefits.
The average charged rates per $100 of payroll fell to $1.96 in 2019 from a peak of $2.97 in 2014. The rate is expected to dip to $1.81 in 2020.
However, average insurer manual rates are significantly above the rates charged to employers, indicating that insurers are, on average, applying significant pricing discounts to their filed rates.
The report also examined Gov. Gavin Newsom’s order during the height of the pandemic regarding a rebuttable assumption of compensability for all workers directed by their employer to work outside their home. "We estimate about 30,000 claims arising during this period generating about $1.2 billion in costs," Bellusci said in his webinar discussing the report.
In the WCIRB’s evaluation of the Governor’s Executive Order, the low-range estimate was $0.6 billion, the mid-range estimate $1.2 billion and the high-range estimate $2.0 billion. These estimates are lower than those in an earlier WCIRB estimate.
According to Bellusci, recent data from the Division of Workers’ Compensation shows about 15,000 COVID-19 claims so far. As expected, the vast majority of COVID-19 claims reported to the Division of Workers’ Compensation are in the health care and government/public administration sectors. It is likely as California’s economy begins to re-open that the industry mix of COVID-19 claims will be more dispersed.
The report shows pre-pandemic cost trends were generally stable with modest frequency and severity growth, continued high levels of frictional costs and significant regional differentials, while 2020 claim frequency could be impacted by the economic downturn and surges of COVID-19 and post-termination claims ...
Dr. Marco Antonio Chavez was sentenced to 21 months in custody and ordered to pay restitution of $783,764.37 for defrauding TRICARE, the health care benefits program for military service members and their dependents.
Chavez was a physician licensed by the State of California who provided psychiatry services, including therapy and prescription medications for children and adults diagnosed with ADHD and depression, for San Diego patients. He is a 2006 graduate of the University of Texas Medical School.
Chavez defrauded TRICARE by using the personal information of these patients to create and submit false and fraudulent claims for nonexistent appointments when he did not actually treat those patients. And he routinely selected the billing code for the highest-level (and highest-reimbursement) patient visit for these fabricated appointments, to maximize the fraudulent reimbursements he received from TRICARE.
Chavez became a network provider for TRICARE in 2013 under contract with United Health Care Military & Veterans, West. That August, Chavez became eligible to submit claims directly to TRICARE through XPressClaim ("XPC"), a web-based system. Chavez used that access to help his scheme to defraud TRICARE, using his unique personal security key code to avoid review by other billing staff. He then caused the payments to be electronically transferred into an account that was in his name, which he controlled.
Chavez tried to deflect attention and avoid detection of his fraudulent billing through a variety of deceptive means. For example, he notified patients that they might see entries on their Explanation of Benefit ("EOB") forms from TRICARE that they would not recognize. This was an attempt to prevent patients from complaining to TRICARE and drawing attention to the false bills. In reality, Chavez knew that the reason the patients would not recognize the entries on their EOBs was because they had not actually occurred - Chavez had simply made them up.
When the TRICARE contractor conducted an audit and requested certain of Chavez’s patient files, Chavez falsely claimed that he had already sent the files, when he knew those files did not exist and could not have been sent. Chavez also misrepresented that a member of the office staff had stolen his TRICARE checks and deposited them without his permission.
Over the course of his scheme, Chavez submitted approximately $928,800 in false and fraudulent claims to TRICARE via XPC, and was paid $783,764.37 on those claims by TRICARE.
Separately, records of the State of California reflect that Chavez’s medical license was suspended in May 2018, upon the finding of an administrative judge that Chavez had treated patients while under the influence of a narcotic or alcohol ...
Chavez was a physician licensed by the State of California who provided psychiatry services, including therapy and prescription medications for children and adults diagnosed with ADHD and depression, for San Diego patients. He is a 2006 graduate of the University of Texas Medical School.
Chavez defrauded TRICARE by using the personal information of these patients to create and submit false and fraudulent claims for nonexistent appointments when he did not actually treat those patients. And he routinely selected the billing code for the highest-level (and highest-reimbursement) patient visit for these fabricated appointments, to maximize the fraudulent reimbursements he received from TRICARE.
Chavez became a network provider for TRICARE in 2013 under contract with United Health Care Military & Veterans, West. That August, Chavez became eligible to submit claims directly to TRICARE through XPressClaim ("XPC"), a web-based system. Chavez used that access to help his scheme to defraud TRICARE, using his unique personal security key code to avoid review by other billing staff. He then caused the payments to be electronically transferred into an account that was in his name, which he controlled.
Chavez tried to deflect attention and avoid detection of his fraudulent billing through a variety of deceptive means. For example, he notified patients that they might see entries on their Explanation of Benefit ("EOB") forms from TRICARE that they would not recognize. This was an attempt to prevent patients from complaining to TRICARE and drawing attention to the false bills. In reality, Chavez knew that the reason the patients would not recognize the entries on their EOBs was because they had not actually occurred - Chavez had simply made them up.
When the TRICARE contractor conducted an audit and requested certain of Chavez’s patient files, Chavez falsely claimed that he had already sent the files, when he knew those files did not exist and could not have been sent. Chavez also misrepresented that a member of the office staff had stolen his TRICARE checks and deposited them without his permission.
Over the course of his scheme, Chavez submitted approximately $928,800 in false and fraudulent claims to TRICARE via XPC, and was paid $783,764.37 on those claims by TRICARE.
Separately, records of the State of California reflect that Chavez’s medical license was suspended in May 2018, upon the finding of an administrative judge that Chavez had treated patients while under the influence of a narcotic or alcohol ...
The Labor Commissioner’s Office has filed a lawsuit against a gig-economy car wash company in Southern California for violating labor laws by misclassifying employees as independent contractors. Mobile Wash, Inc. of Bellflower misclassified at least 100 workers, harming both the workers and law-abiding businesses in the car washing industry, the lawsuit says.
This is the first lawsuit filed by the Labor Commissioner’s Office to enforce Assembly Bill 5, the 2019 law that requires the application of the "ABC test" to determine if workers in California are employees or independent contractors. Under the ABC test, a worker is considered an employee unless they are free from control from the hiring entity, perform work outside of the hiring entity’s usual business, and engage in an accepted independent trade or occupation.
Mobile Wash uses a phone app to offer car washing and detailing services to customers throughout Southern California and a few locations in Northern California. The company requires its workers to use their own cars and buy their own uniforms, insurance, cleaning equipment, supplies and gas. Mobile Wash does not reimburse the workers for these business expenses or travel time in violation of the requirement to pay for all hours worked at no less than the minimum wage. It also unlawfully charges workers a $2 "transaction fee" for every tip left on a credit card.
An analysis by the Labor Commissioner’s Office found that a Mobile Wash employee working for 10 hours a day, 6 days a week is entitled to $1,521 per week for unpaid wages including minimum wage and overtime violation, liquidated damages, rest period violations, reimbursements of business expenses and recovery of stolen tips, and other violations including but not limited to failure to provide paid sick leave. Mobile Wash had over 100 car washers at any given time.
The lawsuit, filed in Los Angeles Superior Court, asks the court to order Mobile Wash, Inc. to stop misclassifying its employees and to halt its operations using employee labor until it meets California’s car wash registration and bond requirements, as it has never been licensed with the Labor Commissioner’s Office. The suit also seeks the recovery of unpaid wages, penalties and interest on behalf of workers going back to April of 2017 as well as civil penalties and any costs and reasonable attorneys’ fees incurred by the Labor Commissioner’s Office.
Also named in the lawsuit is Mobile Wash’s president and CEO, Alfred Davtyan, who faces liability under provisions in the Labor Code that hold business owners, directors, officers, and managing agents jointly liable, along with the business entity, for the types of violations that were committed by Mobile Wash, as a consequence of the adoption of a business plan founded upon unlawful misclassification.
The Community Labor Environmental Action Network (CLEAN), a nonprofit that assists car wash workers, assisted the Labor Commissioner’s Office with this case.
...
This is the first lawsuit filed by the Labor Commissioner’s Office to enforce Assembly Bill 5, the 2019 law that requires the application of the "ABC test" to determine if workers in California are employees or independent contractors. Under the ABC test, a worker is considered an employee unless they are free from control from the hiring entity, perform work outside of the hiring entity’s usual business, and engage in an accepted independent trade or occupation.
Mobile Wash uses a phone app to offer car washing and detailing services to customers throughout Southern California and a few locations in Northern California. The company requires its workers to use their own cars and buy their own uniforms, insurance, cleaning equipment, supplies and gas. Mobile Wash does not reimburse the workers for these business expenses or travel time in violation of the requirement to pay for all hours worked at no less than the minimum wage. It also unlawfully charges workers a $2 "transaction fee" for every tip left on a credit card.
An analysis by the Labor Commissioner’s Office found that a Mobile Wash employee working for 10 hours a day, 6 days a week is entitled to $1,521 per week for unpaid wages including minimum wage and overtime violation, liquidated damages, rest period violations, reimbursements of business expenses and recovery of stolen tips, and other violations including but not limited to failure to provide paid sick leave. Mobile Wash had over 100 car washers at any given time.
The lawsuit, filed in Los Angeles Superior Court, asks the court to order Mobile Wash, Inc. to stop misclassifying its employees and to halt its operations using employee labor until it meets California’s car wash registration and bond requirements, as it has never been licensed with the Labor Commissioner’s Office. The suit also seeks the recovery of unpaid wages, penalties and interest on behalf of workers going back to April of 2017 as well as civil penalties and any costs and reasonable attorneys’ fees incurred by the Labor Commissioner’s Office.
Also named in the lawsuit is Mobile Wash’s president and CEO, Alfred Davtyan, who faces liability under provisions in the Labor Code that hold business owners, directors, officers, and managing agents jointly liable, along with the business entity, for the types of violations that were committed by Mobile Wash, as a consequence of the adoption of a business plan founded upon unlawful misclassification.
The Community Labor Environmental Action Network (CLEAN), a nonprofit that assists car wash workers, assisted the Labor Commissioner’s Office with this case.
...
Longwood Management Corporation and 27 affiliated skilled nursing facilities have agreed to resolve allegations that they violated the False Claims Act by submitting false claims to Medicare for rehabilitation therapy services that were not reasonable or necessary, the Department of Justice announced today. Longwood is headquartered in Los Angeles, and the 27 skilled nursing facilities are located in Southern California.
The settlement covers conduct that occurred from May 1, 2008 through August 1, 2012 at six facilities: Alameda Care Center in Burbank, Burbank Rehabilitation Center, Magnolia Gardens Convalescent Hospital in Granada Hills, Montrose Healthcare Center, Sherman Oaks Health & Rehab Center, and West Hills Health & Rehab Center.
The settlement also covers conduct that occurred from January 1, 2006 through October 10, 2014 at 21 facilities: Burlington Convalescent Hospital in the Westlake District of Los Angeles, Chino Valley Rehabilitation Center LLC, Colonial Care Center in Long Beach, Covina Rehabilitation Center, Crenshaw Nursing Home, Green Acres Lodge in Rosemead, Imperial Care Center in Studio City, Imperial Crest Health Care Center in Hawthorne, Laurel Convalescent Hospital in Fontana, Live Oak Rehabilitation Center in San Gabriel, Longwood Manor Convalescent Hospital in the Mid-City District of Los Angeles, Monterey Care Center in Rosemead, Intercommunity Healthcare Center in Norwalk, Park Anaheim Healthcare Center, Pico Rivera Healthcare Center, San Gabriel Convalescent Center, Whittier Pacific Care Center, Studio City Rehabilitation Center, Sunnyview Care Center in the Pico Union District of Los Angeles, View Park Convalescent Center in Baldwin Hills, and Western Convalescent Hospital in the Jefferson Park District of Los Angeles.
Longwood allegedly submitted false and fraudulent claims to Medicare for medically unreasonable and unnecessary Ultra High levels of rehabilitation therapy for Medicare Part A residents. Specifically, Longwood allegedly pressured therapists to increase the amount of therapy provided to patients to meet pre-planned targets for Medicare revenue. These targets were alleged to have been set without regard to patients’ individual therapy needs and could only be achieved by billing for a high percentage of patients at the Ultra High level.
The settlement partially resolves allegations brought in two lawsuits filed by whistleblowers under the qui tam provisions of the False Claims Act, which allows private parties to bring suit on behalf of the government and to share in any recovery. The whistleblowers - Judy Boyce, Benjamin Monsod and Keith Pennetti - will collectively receive $3,006,000 of the settlement proceeds.
...
The settlement covers conduct that occurred from May 1, 2008 through August 1, 2012 at six facilities: Alameda Care Center in Burbank, Burbank Rehabilitation Center, Magnolia Gardens Convalescent Hospital in Granada Hills, Montrose Healthcare Center, Sherman Oaks Health & Rehab Center, and West Hills Health & Rehab Center.
The settlement also covers conduct that occurred from January 1, 2006 through October 10, 2014 at 21 facilities: Burlington Convalescent Hospital in the Westlake District of Los Angeles, Chino Valley Rehabilitation Center LLC, Colonial Care Center in Long Beach, Covina Rehabilitation Center, Crenshaw Nursing Home, Green Acres Lodge in Rosemead, Imperial Care Center in Studio City, Imperial Crest Health Care Center in Hawthorne, Laurel Convalescent Hospital in Fontana, Live Oak Rehabilitation Center in San Gabriel, Longwood Manor Convalescent Hospital in the Mid-City District of Los Angeles, Monterey Care Center in Rosemead, Intercommunity Healthcare Center in Norwalk, Park Anaheim Healthcare Center, Pico Rivera Healthcare Center, San Gabriel Convalescent Center, Whittier Pacific Care Center, Studio City Rehabilitation Center, Sunnyview Care Center in the Pico Union District of Los Angeles, View Park Convalescent Center in Baldwin Hills, and Western Convalescent Hospital in the Jefferson Park District of Los Angeles.
Longwood allegedly submitted false and fraudulent claims to Medicare for medically unreasonable and unnecessary Ultra High levels of rehabilitation therapy for Medicare Part A residents. Specifically, Longwood allegedly pressured therapists to increase the amount of therapy provided to patients to meet pre-planned targets for Medicare revenue. These targets were alleged to have been set without regard to patients’ individual therapy needs and could only be achieved by billing for a high percentage of patients at the Ultra High level.
The settlement partially resolves allegations brought in two lawsuits filed by whistleblowers under the qui tam provisions of the False Claims Act, which allows private parties to bring suit on behalf of the government and to share in any recovery. The whistleblowers - Judy Boyce, Benjamin Monsod and Keith Pennetti - will collectively receive $3,006,000 of the settlement proceeds.
...
Disc herniation is a common cause of stenosis and the back and limb pain that it leads to. It occurs when disc nuclear material pushes through a tear in the annulus.
Lumbar discectomy is a common procedure used to remove the disc material that is pressing on nerves or the spinal cord. But reherniation is the most common failure mode for these procedures due to the weakened state of the disc annulus.
A study published in April 2020 in the journal Expert Review of Medical Devices (Expert review with meta-analysis of randomized and nonrandomized controlled studies of Barricaid annular closure in patients at high risk for lumbar disc reherniation") found that symptomatic reherniation rates after lumbar discectomy with Barricaid were 50% lower than lumbar discectomy without Barricaid.
The market and impact for the device is quite large, with Barricaid’s manufacturer, Intrinsic Therapeutics, estimating 400,000 total lumbar discectomy procedures performed in the U.S. annually, 120,000 of which involve a large defect, which is most likely to herniate and benefit from the use of the Barricaid Annular Closure device.
Intrinsic Therapeutics, Inc. of Woburn, Massachusetts, received FDA approval for Barricaid Annular Closure device in 2019.
The device consists of a metallic anchor connected to a polyester plug that the company refers to as the occlusion component. The anchor is affixed to the vertebral body closest to the annular defect and the occlusion component is inserted into the defect. The device is designed to withstand up to 330psi, which allows for normal anatomical movement.
The Centers for Medicare and Medicaid Services (CMS) listed a new billing code for annular closure (C9757) for which the Barricaid Annular Closure device is the only one that is FDA-approved. The new code went into effect on January 1, 2020.
Additionally, the International Journal of Spine Surgery issued guidance supporting both coding and coverage of the device.
CEO and President of Intrinsic Therapeutics, Cary Hagan said in a recent press release, "We appreciate all the progress that is being made on patient access to Barricaid by leading surgeons and spine specialty societies. With more than 20 insurers now covering Barricaid, together with the support of surgeons and specialty societies, and more than 50 peer reviewed manuscripts, we are confident in our ability to continue delivering needed and cost-effective care for lumbar discectomy patients with large annular defects." ...
Lumbar discectomy is a common procedure used to remove the disc material that is pressing on nerves or the spinal cord. But reherniation is the most common failure mode for these procedures due to the weakened state of the disc annulus.
A study published in April 2020 in the journal Expert Review of Medical Devices (Expert review with meta-analysis of randomized and nonrandomized controlled studies of Barricaid annular closure in patients at high risk for lumbar disc reherniation") found that symptomatic reherniation rates after lumbar discectomy with Barricaid were 50% lower than lumbar discectomy without Barricaid.
The market and impact for the device is quite large, with Barricaid’s manufacturer, Intrinsic Therapeutics, estimating 400,000 total lumbar discectomy procedures performed in the U.S. annually, 120,000 of which involve a large defect, which is most likely to herniate and benefit from the use of the Barricaid Annular Closure device.
Intrinsic Therapeutics, Inc. of Woburn, Massachusetts, received FDA approval for Barricaid Annular Closure device in 2019.
The device consists of a metallic anchor connected to a polyester plug that the company refers to as the occlusion component. The anchor is affixed to the vertebral body closest to the annular defect and the occlusion component is inserted into the defect. The device is designed to withstand up to 330psi, which allows for normal anatomical movement.
The Centers for Medicare and Medicaid Services (CMS) listed a new billing code for annular closure (C9757) for which the Barricaid Annular Closure device is the only one that is FDA-approved. The new code went into effect on January 1, 2020.
Additionally, the International Journal of Spine Surgery issued guidance supporting both coding and coverage of the device.
CEO and President of Intrinsic Therapeutics, Cary Hagan said in a recent press release, "We appreciate all the progress that is being made on patient access to Barricaid by leading surgeons and spine specialty societies. With more than 20 insurers now covering Barricaid, together with the support of surgeons and specialty societies, and more than 50 peer reviewed manuscripts, we are confident in our ability to continue delivering needed and cost-effective care for lumbar discectomy patients with large annular defects." ...
From the moment news of COVID-19 started spreading, insurance carriers knew there would be a significant business impact. Exactly what the impact would be was not immediately clear, and still leaves some room for guessing.
First, claims saw a sharp decline as the Coronavirus started hitting worldwide. For the most part, this came as no surprise. With fewer cars on the road, fewer accidents result in damage claims. There are fewer ways for people to hurt themselves if they never leave their homes. Workers’ comp claims decline when the workplace is nearly empty. This was an anticipated and completely logical result.
As the world started to come alive after 3 months and "life as normal" began to resume, claims volume started trending back toward normal. This regional trend was steady as municipalities loosened restrictions.
Friss, a Dutch tech company that provides fraud-detection software to 180 insurers, suggests that now a fraud storm is well underway.
The company said in a blog post last week that it has seen a strong uptick in the volume of fraud investigations tracked by its detection software, even though total claims volume is down. In other words, even though there are fewer claims, a higher proportion of them look suspicious.
A graphic that showed a declining volume of claims starting when coronavirus lockdowns began in March and leveling off as lockdowns eased in June. A corresponding line showed the share of claims investigated rising sharply, easing and then rising again. Exact percentages were not revealed.
"We’ve seen this before in economic downturns and other times of hardship, and sadly we predicted this at the onset of the pandemic."
Inflated COVID-related cleaning charges, fake testing locations and non-existent telemedicine visits are just a few of the emerging fraud schemes the company is seeing. Unethical customers are aware of what they can get away with. They are also adept at coming up with new schemes - quickly. When the opportunity is available, it will be taken advantage of.
The take away from this trend is "that carriers who wish to weather the storm must remain diligent on treating their customers well. Policies must be easy to obtain at a competitive price, and claims handling must become more efficient and customer-centric. Modern carriers must adapt quickly and provide the service their customers demand." ...
First, claims saw a sharp decline as the Coronavirus started hitting worldwide. For the most part, this came as no surprise. With fewer cars on the road, fewer accidents result in damage claims. There are fewer ways for people to hurt themselves if they never leave their homes. Workers’ comp claims decline when the workplace is nearly empty. This was an anticipated and completely logical result.
As the world started to come alive after 3 months and "life as normal" began to resume, claims volume started trending back toward normal. This regional trend was steady as municipalities loosened restrictions.
Friss, a Dutch tech company that provides fraud-detection software to 180 insurers, suggests that now a fraud storm is well underway.
The company said in a blog post last week that it has seen a strong uptick in the volume of fraud investigations tracked by its detection software, even though total claims volume is down. In other words, even though there are fewer claims, a higher proportion of them look suspicious.
A graphic that showed a declining volume of claims starting when coronavirus lockdowns began in March and leveling off as lockdowns eased in June. A corresponding line showed the share of claims investigated rising sharply, easing and then rising again. Exact percentages were not revealed.
"We’ve seen this before in economic downturns and other times of hardship, and sadly we predicted this at the onset of the pandemic."
Inflated COVID-related cleaning charges, fake testing locations and non-existent telemedicine visits are just a few of the emerging fraud schemes the company is seeing. Unethical customers are aware of what they can get away with. They are also adept at coming up with new schemes - quickly. When the opportunity is available, it will be taken advantage of.
The take away from this trend is "that carriers who wish to weather the storm must remain diligent on treating their customers well. Policies must be easy to obtain at a competitive price, and claims handling must become more efficient and customer-centric. Modern carriers must adapt quickly and provide the service their customers demand." ...
A judge for the U.S. District Court for the Northern District of California ruled that Amazon.com Inc.’s injury data is not confidential information.
The Center for Investigative Reporting, a journalism nonprofit based in Berkeley, California, filed Freedom of Information Act requests between with the U.S. Occupational Safety and Health Administration, seeking annual data on Amazon’s injuries, illnesses and fatalities at certain warehouses.
OSHA requires employers with more than 10 workers to annually submit data on workplace injuries and illnesses using its Form 300. The log includes the name and title of workers who are injured or contract an occupational illness, along with a description of the injury or illness, and the result of the injury or illness. Employers are required to provide copies of these records to current and former employees and their representatives upon request, and employers must retain the records for five years.
OSHA’s final rule on record keeping also stipulates that an "employer may not require an employee, former employee or designated employee representative to agree to limit the use of the records as a condition for viewing or obtaining copies of records."
Although OSHA noted in 2016 that public access of this data could encourage employers to abate hazards and prevent injuries and illnesses, in August 2019, OSHA stated that it considered the Form 300 data to be confidential commercial information.
The DOL argued that the Form 300 logs fall under the FOIA exemption that shields from mandatory disclosure any "commercial or financial information obtained from a person."
Judge Kim, however, disagreed in her 28 page July 6, 2020 Order, holding that Amazon itself had not customarily treated its Form 300 data as confidential, and noted that OSHA regulations require employers, including Amazon, to post such information at its facilities for a three-month period.
Although the DOL also argued that the data could be "misused," Judge Kim dismissed this argument, noting that employees’ personal and medical information does not appear on the form, and that Amazon’s broad disclosures required under the regulations to all current employees, former employees, and employees’ representatives - with no restrictions on their further disclosures - defeats the DOL’s effort to demonstrate confidentiality.
Kim’s ruling comes just one month after another federal judge in Oakland, California, ruled against the Department of Labor in a similar lawsuit brought by the Center for Investigative Reporting. In that case, U.S. District Judge Donna Ryu ordered the department to release 237,000 workplace injury logs submitted by various employers from Aug. 1, 2017, through Feb. 6, 2018. Like Kim, Ryu also found the companies were already warned the information could be posted on a public website in 2016 ...
The Center for Investigative Reporting, a journalism nonprofit based in Berkeley, California, filed Freedom of Information Act requests between with the U.S. Occupational Safety and Health Administration, seeking annual data on Amazon’s injuries, illnesses and fatalities at certain warehouses.
OSHA requires employers with more than 10 workers to annually submit data on workplace injuries and illnesses using its Form 300. The log includes the name and title of workers who are injured or contract an occupational illness, along with a description of the injury or illness, and the result of the injury or illness. Employers are required to provide copies of these records to current and former employees and their representatives upon request, and employers must retain the records for five years.
OSHA’s final rule on record keeping also stipulates that an "employer may not require an employee, former employee or designated employee representative to agree to limit the use of the records as a condition for viewing or obtaining copies of records."
Although OSHA noted in 2016 that public access of this data could encourage employers to abate hazards and prevent injuries and illnesses, in August 2019, OSHA stated that it considered the Form 300 data to be confidential commercial information.
The DOL argued that the Form 300 logs fall under the FOIA exemption that shields from mandatory disclosure any "commercial or financial information obtained from a person."
Judge Kim, however, disagreed in her 28 page July 6, 2020 Order, holding that Amazon itself had not customarily treated its Form 300 data as confidential, and noted that OSHA regulations require employers, including Amazon, to post such information at its facilities for a three-month period.
Although the DOL also argued that the data could be "misused," Judge Kim dismissed this argument, noting that employees’ personal and medical information does not appear on the form, and that Amazon’s broad disclosures required under the regulations to all current employees, former employees, and employees’ representatives - with no restrictions on their further disclosures - defeats the DOL’s effort to demonstrate confidentiality.
Kim’s ruling comes just one month after another federal judge in Oakland, California, ruled against the Department of Labor in a similar lawsuit brought by the Center for Investigative Reporting. In that case, U.S. District Judge Donna Ryu ordered the department to release 237,000 workplace injury logs submitted by various employers from Aug. 1, 2017, through Feb. 6, 2018. Like Kim, Ryu also found the companies were already warned the information could be posted on a public website in 2016 ...
Monterey County District Attorney announced that Monica Herrera, a 43-year-old resident of Newman, California and former owner of a licensed, Monterey County cannabis company, pled no contest on July 7, 2020 to felony payroll tax fraud and not having workers’ compensation insurance, a misdemeanor.
Herrera owned and operated Holistic Farms, LLC, pursuant to a California Temporary Cannabis Cultivation License and a Monterey County permit. The licensing and permits authorized Herrera to run her business at 2242 Alisal Road in Salinas, California.
During the course of a search warrant served on June 26, 2018 in an unrelated investigation, Monterey County District Attorney investigators discovered that Herrera had violated her license and permit conditions by relocating her cannabis processing operations to 2348 Alisal Road.
During that search, investigators interviewed multiple individuals who verified that they worked for Herrera as cannabis processors and that Herrera paid their wages in cash. Though Herrera had employees, investigators confirmed with public agencies that Herrera had never paid payroll taxes on employee wages to the California Employment Development Department and she did not have workers’ compensation insurance.
Herrera will be sentenced on August 25, 2020. The Court is expected to place Herrera on probation, order her to pay fines of as much as $30,000 and perform 300 hours of community service.
The Monterey County District Attorney also just announced that John Bresciani, a 65-year-old Salinas resident and owner of Pacific Coast Battery Service, Inc. ("PCBS"), pled no contest to defrauding his insurance carrier.
In September 2018, while investigating an insurance claim, Mr. Bresciani’s insurer determined that an injured worker had not been identified in prior policy years. In an ensuing investigation by the Monterey County District Attorney’s Workers’ Compensation Fraud Unit, Mr. Bresciani conceded that he had not truthfully reported the worker’s employment and had kept the employee "off book" by paying cash wages.
Felony criminal charges for insurance premium fraud were filed on December 11, 2019. Mr. Bresciani cooperated with the investigation and paid restitution to his insurance carrier for the $2,943.44 premium that should have been paid. He pled guilty to a misdemeanor charge and Judge Andrew Liu accepted the plea on July 8, 2020. Mr. Bresciani was placed on 3 years’ probation and ordered to pay a $5,000 fine.
...
Herrera owned and operated Holistic Farms, LLC, pursuant to a California Temporary Cannabis Cultivation License and a Monterey County permit. The licensing and permits authorized Herrera to run her business at 2242 Alisal Road in Salinas, California.
During the course of a search warrant served on June 26, 2018 in an unrelated investigation, Monterey County District Attorney investigators discovered that Herrera had violated her license and permit conditions by relocating her cannabis processing operations to 2348 Alisal Road.
During that search, investigators interviewed multiple individuals who verified that they worked for Herrera as cannabis processors and that Herrera paid their wages in cash. Though Herrera had employees, investigators confirmed with public agencies that Herrera had never paid payroll taxes on employee wages to the California Employment Development Department and she did not have workers’ compensation insurance.
Herrera will be sentenced on August 25, 2020. The Court is expected to place Herrera on probation, order her to pay fines of as much as $30,000 and perform 300 hours of community service.
The Monterey County District Attorney also just announced that John Bresciani, a 65-year-old Salinas resident and owner of Pacific Coast Battery Service, Inc. ("PCBS"), pled no contest to defrauding his insurance carrier.
In September 2018, while investigating an insurance claim, Mr. Bresciani’s insurer determined that an injured worker had not been identified in prior policy years. In an ensuing investigation by the Monterey County District Attorney’s Workers’ Compensation Fraud Unit, Mr. Bresciani conceded that he had not truthfully reported the worker’s employment and had kept the employee "off book" by paying cash wages.
Felony criminal charges for insurance premium fraud were filed on December 11, 2019. Mr. Bresciani cooperated with the investigation and paid restitution to his insurance carrier for the $2,943.44 premium that should have been paid. He pled guilty to a misdemeanor charge and Judge Andrew Liu accepted the plea on July 8, 2020. Mr. Bresciani was placed on 3 years’ probation and ordered to pay a $5,000 fine.
...
Novartis Pharmaceuticals Corporation has agreed to pay $51.25 million to resolve allegations that it violated the False Claims Act by illegally paying the Medicare co-pays for its own drugs.
When a Medicare beneficiary obtains a prescription drug covered by Medicare Part B or Part D, the beneficiary may be required to make a partial payment, which may take the form of a co-payment, co-insurance, or deductible. Congress included co-pay requirements in these programs, in part, to encourage market forces to serve as a check on health care costs, including the prices that pharmaceutical manufacturers can demand for their drugs.
The Anti-Kickback Statute prohibits pharmaceutical companies from offering or paying, directly or indirectly, any remuneration - which includes money or any other thing of value - to induce Medicare patients to purchase the companies’ drugs.
Officials say Novartis coordinated with three co-pay foundations to funnel money through the foundations to patients taking Novartis’ own drugs, As a result, the Novartis’ conduct was not ‘charitable,’ but rather functioned as a kickback scheme that undermined the structure of the Medicare program and illegally subsidized the high costs of Novartis’ drugs at the expense of American taxpayers.
Novartis used The Assistance Fund as a conduit to pay kickbacks to Medicare patients taking Gilenya, a Novartis drug for multiple sclerosis, and used the National Organization for Rare Disorders and Chronic Disease Fund as conduits to pay kickbacks to Medicare patients taking Afinitor, a Novartis drug for renal cell carcinoma and progressive neuroendocrine tumors of pancreatic origin.
In October 2012, Novartis learned from Express Scripts, which then was managing Novartis’ free drug program for Gilenya, that Novartis was providing free Gilenya to 364 patients who would become eligible for Medicare the following year.
Novartis and Express Scripts transitioned these patients to Medicare Part D so that, in the future, Novartis would obtain revenue from Medicare when the patients filled their prescriptions for Gilenya.
Knowing that these patients could not afford co-pays for Gilenya, Novartis developed a plan for it to cover their co-pays through The Assistance Fund, which operated a fund that, ostensibly, offered to cover co-pays for any MS patient who met its financial eligibility criteria, regardless of which MS drug the patient was taking.
Novartis entered into a five-year corporate integrity agreement as part of this settlement. Novartis will be required to implement measures, controls, and monitoring designed to promote independence from any patient assistance programs that it finances. In addition, Novartis agreed to implement risk assessment programs and to obtain compliance-related certifications from company executives and Board members.
To date, the Department of Justice has collected over $900 million from ten pharmaceutical companies (United Therapeutics, Pfizer, Actelion, Jazz, Lundbeck, Alexion, Astellas, Amgen, Sanofi, and Novartis) that allegedly used third-party foundations as kickback vehicles. The Department also has reached settlements with four foundations (Patient Access Network Foundation, Chronic Disease Fund, The Assistance Fund, and Patient Services, Inc.) that allegedly conspired or coordinated with these pharmaceutical companies ...
When a Medicare beneficiary obtains a prescription drug covered by Medicare Part B or Part D, the beneficiary may be required to make a partial payment, which may take the form of a co-payment, co-insurance, or deductible. Congress included co-pay requirements in these programs, in part, to encourage market forces to serve as a check on health care costs, including the prices that pharmaceutical manufacturers can demand for their drugs.
The Anti-Kickback Statute prohibits pharmaceutical companies from offering or paying, directly or indirectly, any remuneration - which includes money or any other thing of value - to induce Medicare patients to purchase the companies’ drugs.
Officials say Novartis coordinated with three co-pay foundations to funnel money through the foundations to patients taking Novartis’ own drugs, As a result, the Novartis’ conduct was not ‘charitable,’ but rather functioned as a kickback scheme that undermined the structure of the Medicare program and illegally subsidized the high costs of Novartis’ drugs at the expense of American taxpayers.
Novartis used The Assistance Fund as a conduit to pay kickbacks to Medicare patients taking Gilenya, a Novartis drug for multiple sclerosis, and used the National Organization for Rare Disorders and Chronic Disease Fund as conduits to pay kickbacks to Medicare patients taking Afinitor, a Novartis drug for renal cell carcinoma and progressive neuroendocrine tumors of pancreatic origin.
In October 2012, Novartis learned from Express Scripts, which then was managing Novartis’ free drug program for Gilenya, that Novartis was providing free Gilenya to 364 patients who would become eligible for Medicare the following year.
Novartis and Express Scripts transitioned these patients to Medicare Part D so that, in the future, Novartis would obtain revenue from Medicare when the patients filled their prescriptions for Gilenya.
Knowing that these patients could not afford co-pays for Gilenya, Novartis developed a plan for it to cover their co-pays through The Assistance Fund, which operated a fund that, ostensibly, offered to cover co-pays for any MS patient who met its financial eligibility criteria, regardless of which MS drug the patient was taking.
Novartis entered into a five-year corporate integrity agreement as part of this settlement. Novartis will be required to implement measures, controls, and monitoring designed to promote independence from any patient assistance programs that it finances. In addition, Novartis agreed to implement risk assessment programs and to obtain compliance-related certifications from company executives and Board members.
To date, the Department of Justice has collected over $900 million from ten pharmaceutical companies (United Therapeutics, Pfizer, Actelion, Jazz, Lundbeck, Alexion, Astellas, Amgen, Sanofi, and Novartis) that allegedly used third-party foundations as kickback vehicles. The Department also has reached settlements with four foundations (Patient Access Network Foundation, Chronic Disease Fund, The Assistance Fund, and Patient Services, Inc.) that allegedly conspired or coordinated with these pharmaceutical companies ...
The California Self-Insurers' Security Fund supports businesses by helping lower their workers' compensation costs and freeing up their working capital.
The program provides a financial backstop to replace security deposits required to collateralize self-insured workers' compensation liabilities.
The CASISF Board of Trustees has approved and implemented the 2020/21 Alternative Security Program, which frees $6.5 billion in working capital and provides California self-insured businesses greater financial flexibility. Moreover, there has been no increase in the Security Fund's general assessment from last year.
These continuing savings make the program and costs even more competitive for California self-insured businesses. "The Fund's historically sound and rigorous credit monitoring practices have positioned the Fund to address the economic impacts of the coronavirus pandemic," said Dan Sovocool, a partner at Nixon Peabody LLP and the Security Fund's outside General Counsel. "The Fund continues to be a strong resource and partner for California's self-insured employers."
All employers in California are required to have workers' compensation insurance to cover their employees in the event of work-related injuries or illnesses. Employers may satisfy this requirement by obtaining an insurance policy or gaining authority from the DIR's Office of Self Insurance Plans (OSIP) to self-insure the businesses' workers' compensation liabilities.
Self-insured employers maintain a deposit equal to their estimated liabilities. Employers may post the deposit in cash, letters of credit, surety bonds, or securities. The use of these instruments limits the employer's ability to use their cash or credit line. In contrast, the Security Fund's ASP allows employer members to free up their cash or line of credit, allowing them to reinvest this capital back into their businesses. The ASP provides the member with a low-cost substitute for collateral with no balance sheet impact.
California currently has more than 3,500 private employers protecting more than 2.2 million workers representing a total payroll of nearly $113 billion through self-insurance workers' compensation plans.
A self-insurance plan protects one of every eight California workers. Self-insured private employers in California represent large and midsized private companies and industry groups.
The California Self-Insurers' Security Fund (CASISF) has been serving its members for 36 years since its founding on July 6, 1994. It is a member-driven non-profit organization with leadership by a volunteer Board of Trustees representing members serving members. The Security Fund is a strategic partner supporting California self-insured workers' compensation programs ...
The program provides a financial backstop to replace security deposits required to collateralize self-insured workers' compensation liabilities.
The CASISF Board of Trustees has approved and implemented the 2020/21 Alternative Security Program, which frees $6.5 billion in working capital and provides California self-insured businesses greater financial flexibility. Moreover, there has been no increase in the Security Fund's general assessment from last year.
These continuing savings make the program and costs even more competitive for California self-insured businesses. "The Fund's historically sound and rigorous credit monitoring practices have positioned the Fund to address the economic impacts of the coronavirus pandemic," said Dan Sovocool, a partner at Nixon Peabody LLP and the Security Fund's outside General Counsel. "The Fund continues to be a strong resource and partner for California's self-insured employers."
All employers in California are required to have workers' compensation insurance to cover their employees in the event of work-related injuries or illnesses. Employers may satisfy this requirement by obtaining an insurance policy or gaining authority from the DIR's Office of Self Insurance Plans (OSIP) to self-insure the businesses' workers' compensation liabilities.
Self-insured employers maintain a deposit equal to their estimated liabilities. Employers may post the deposit in cash, letters of credit, surety bonds, or securities. The use of these instruments limits the employer's ability to use their cash or credit line. In contrast, the Security Fund's ASP allows employer members to free up their cash or line of credit, allowing them to reinvest this capital back into their businesses. The ASP provides the member with a low-cost substitute for collateral with no balance sheet impact.
California currently has more than 3,500 private employers protecting more than 2.2 million workers representing a total payroll of nearly $113 billion through self-insurance workers' compensation plans.
A self-insurance plan protects one of every eight California workers. Self-insured private employers in California represent large and midsized private companies and industry groups.
The California Self-Insurers' Security Fund (CASISF) has been serving its members for 36 years since its founding on July 6, 1994. It is a member-driven non-profit organization with leadership by a volunteer Board of Trustees representing members serving members. The Security Fund is a strategic partner supporting California self-insured workers' compensation programs ...
68 year old Linda Nguyen of Union City, was sentenced to two years in prison for her role in a multi-million dollar mail fraud conspiracy involving California State Disability Indemnity (SDI) benefits. Nguyen pleaded guilty to the charge on July 17, 2019.
The SDI program is designed to provide partial wage replacement benefits to eligible California workers who are unable to work due to a non-work-related illness, injury, or pregnancy. To receive SDI benefits, a claimant must file a claim for benefits supported by a Physician/Practitioner Certification attesting to the claimant’s disability.
Nguyen admitted that from January 2013 until January 2019, she agreed with a licensed physician and others to commit mail fraud by defrauding California’s SDI program.
Specifically, Nguyen admitted she helped non-disabled persons prepare and submit fraudulent applications and certifications for SDI benefits. In exchange for her services, Nguyen charged the non-disabled SDI applicants a fee equal to 10% of the SDI benefits that they received. In addition, she paid the physician for each certification he completed for the fraudulent application.
Nguyen’s plea agreement contains four examples of individuals for whom she completed fraudulent applications.
The agreement further describes how Nguyen paid a physician to complete and sign the practitioner disability certifications even though the applicants were never treated by the physician. Nguyen acknowledged in the agreement that the total loss attributable to the fraudulent scheme in which she participated is estimated to be between $3,500,000 and $9,500,000.
A federal grand jury indicted Nguyen on January 29, 2019, charging her with one count of conspiracy to commit mail fraud, in violation of 18 U.S.C. § 1349, and one count of substantive mail fraud, in violation of 18 U.S.C. § 1341. Nguyen pleaded guilty to the conspiracy count and the substantive mail fraud count was dismissed at sentencing.
In addition to the prison term, Nguyen was ordered to serve a three year term of supervised release, to begin at the end of the prison term, and to pay restitution.
...
The SDI program is designed to provide partial wage replacement benefits to eligible California workers who are unable to work due to a non-work-related illness, injury, or pregnancy. To receive SDI benefits, a claimant must file a claim for benefits supported by a Physician/Practitioner Certification attesting to the claimant’s disability.
Nguyen admitted that from January 2013 until January 2019, she agreed with a licensed physician and others to commit mail fraud by defrauding California’s SDI program.
Specifically, Nguyen admitted she helped non-disabled persons prepare and submit fraudulent applications and certifications for SDI benefits. In exchange for her services, Nguyen charged the non-disabled SDI applicants a fee equal to 10% of the SDI benefits that they received. In addition, she paid the physician for each certification he completed for the fraudulent application.
Nguyen’s plea agreement contains four examples of individuals for whom she completed fraudulent applications.
The agreement further describes how Nguyen paid a physician to complete and sign the practitioner disability certifications even though the applicants were never treated by the physician. Nguyen acknowledged in the agreement that the total loss attributable to the fraudulent scheme in which she participated is estimated to be between $3,500,000 and $9,500,000.
A federal grand jury indicted Nguyen on January 29, 2019, charging her with one count of conspiracy to commit mail fraud, in violation of 18 U.S.C. § 1349, and one count of substantive mail fraud, in violation of 18 U.S.C. § 1341. Nguyen pleaded guilty to the conspiracy count and the substantive mail fraud count was dismissed at sentencing.
In addition to the prison term, Nguyen was ordered to serve a three year term of supervised release, to begin at the end of the prison term, and to pay restitution.
...
The Department of Industrial Relations’ Office of Self-Insurance Plans (OSIP) has promulgated regulations that require public self-insured employers to submit reports with the information needed to evaluate the administrative cost, workers’ compensation expenditures, solvency and performance of public self-insured employer workers’ compensation programs.
These regulations became effective on July 1 and include the addition of the following new reporting forms:
-- Joint Powers Authority Self-Insurer’s Profile and Financial Summary Report (Form J-1)
-- Self-Insurer’s Profile and Financial Summary Report (Form P-1)
-- Aggregate Claims Information (Form AR-2 Addendum)
The reporting forms for public self-insured employers are posted online. They must be submitted with the 2019-2020 annual report, which is due on October 1, 2020 and annually thereafter.
Employers who require additional time to comply with the regulations this year should contact OSIP Chief Lyn Asio Booz at LAsioBooz@dir.ca.gov to request an extension. Deferrals of up to 60 days may be granted to employers who can demonstrate that they may not be able to comply with their reporting requirement ...
These regulations became effective on July 1 and include the addition of the following new reporting forms:
-- Joint Powers Authority Self-Insurer’s Profile and Financial Summary Report (Form J-1)
-- Self-Insurer’s Profile and Financial Summary Report (Form P-1)
-- Aggregate Claims Information (Form AR-2 Addendum)
The reporting forms for public self-insured employers are posted online. They must be submitted with the 2019-2020 annual report, which is due on October 1, 2020 and annually thereafter.
Employers who require additional time to comply with the regulations this year should contact OSIP Chief Lyn Asio Booz at LAsioBooz@dir.ca.gov to request an extension. Deferrals of up to 60 days may be granted to employers who can demonstrate that they may not be able to comply with their reporting requirement ...
With the likelihood of workers' compensation COVID-19 claims on the horizon, and with presumptions supporting them, opportunities for apportionment of permanent disability may be more important than ever in claims management.
Researchers who just published a new study, report that a person's blood type may affect their risk for COVID-19, the disease caused by the new corona virus.
The findings appear on the website medRxiv, where health researchers publish studies before they undergo the peer review process required by journals.
Researchers used observational healthcare data on 1559 individuals tested for SARS-CoV-2 (682 COV+) with known blood type in the New York Presbyterian (NYP) hospital system to assess the association between ABO+Rh blood type and SARS-CoV-2 infection status, intubation, and death.
They found a higher proportion of blood group A and a lower proportion of blood group O among COV+ patients compared to COV-, though in both cases the result is significant only in Rh positive blood types.
The effect of blood type is not explained by risk factors they considered (age, sex, hypertension, diabetes mellitus, overweight status, and chronic cardiovascular and lung disorders).
In a meta-analysis of NYP data with previously-reported data from China, they found enrichment for A and B and depletion of O blood groups among COVID-19 patients compared to the general population. They also found new evidence of associations between B, AB, and Rh blood groups and COVID-19 and further evidence of recently-discovered associations between A and O blood groups and COVID-19.
The China study was limited because of its small size and it didn't offer an explanation for its findings, Gao Yingdai, a researcher from the State Key Laboratory of Experimental Hematology in Tianjin, told the South China Morning Post.
The finding that blood type may affect COVID-19 risk could be important for healthcare workers treating COVID-19 patients, because those with A blood types" "might need particularly strengthened personal protection to reduce the chance of infection."
Also, people with A blood types might require "more vigilant surveillance and aggressive treatment," and identifying a person's blood type as a routine part of treating COVID-19 and other coronavirus infections might be helpful, according to the researchers, Newsweek reported.
...
Researchers who just published a new study, report that a person's blood type may affect their risk for COVID-19, the disease caused by the new corona virus.
The findings appear on the website medRxiv, where health researchers publish studies before they undergo the peer review process required by journals.
Researchers used observational healthcare data on 1559 individuals tested for SARS-CoV-2 (682 COV+) with known blood type in the New York Presbyterian (NYP) hospital system to assess the association between ABO+Rh blood type and SARS-CoV-2 infection status, intubation, and death.
They found a higher proportion of blood group A and a lower proportion of blood group O among COV+ patients compared to COV-, though in both cases the result is significant only in Rh positive blood types.
The effect of blood type is not explained by risk factors they considered (age, sex, hypertension, diabetes mellitus, overweight status, and chronic cardiovascular and lung disorders).
In a meta-analysis of NYP data with previously-reported data from China, they found enrichment for A and B and depletion of O blood groups among COVID-19 patients compared to the general population. They also found new evidence of associations between B, AB, and Rh blood groups and COVID-19 and further evidence of recently-discovered associations between A and O blood groups and COVID-19.
The China study was limited because of its small size and it didn't offer an explanation for its findings, Gao Yingdai, a researcher from the State Key Laboratory of Experimental Hematology in Tianjin, told the South China Morning Post.
The finding that blood type may affect COVID-19 risk could be important for healthcare workers treating COVID-19 patients, because those with A blood types" "might need particularly strengthened personal protection to reduce the chance of infection."
Also, people with A blood types might require "more vigilant surveillance and aggressive treatment," and identifying a person's blood type as a routine part of treating COVID-19 and other coronavirus infections might be helpful, according to the researchers, Newsweek reported.
...
Daniel Brodie Howard suffered major injuries in an automobile accident while acting within the scope of his employment with Agra Tech, Inc. Hartford was Agra Tech, Inc.’s workers’ compensation carrier. He was hospitalized and in a coma. Thus the probate court appointed his brother, David Howard as conservator of his person and estate.
A civil tort action was filed against multiple parties to recover for the injuries. Hartford filed a complaint in intervention seeking to recover the workers’ compensation benefits it had paid as a result of conservatee’s accident.
In 2012, a WCJ found conservatee to be totally and permanently disabled and awarded permanent disability, medical care for life, and attorney fees.
On October 30, 2013, conservatee, Hartford, and Toyota, one of the tort defendants, signed a mediation agreement that called for Toyota to pay a specified sum to conservatee. In 2014, the probate court signed an order approving the compromise of the disputed claim against the other driver and Toyota and directed payments from the settlement proceeds for attorney fees and expenses, to Hartford (for medical and like expenses it had paid), and conservatee (for the balance of the settlement).
Numerous disputes arose between the parties over the distribution of funds, each of which were subsequently resolved.
Then, in 2016, conservatee filed a motion in the probate court to assess attorney fees, asking the probate court to order Hartford to "reimburse Conservatee $150,934.76 in costs and $179,605.48 in attorney’s fees as Hartford’s pro rata share of Conservatee’s costs and attorney’s fees in creating the Toyota settlement." Conservatee stated the authority for the motion was labor code sections 3856, subdivision (b), and 3860, subdivision (e), and the "common fund" doctrine.
The probate court concluded that it lacked jurisdiction to consider conservatee’s claims because the underlying civil case had been dismissed with prejudice upon conservatee’s request. The court of appeal agreed and affirmed the order in the unpublished case of Conservatorship of Howard.
Conservatee’s motion to assess attorney fees did not revive the civil action or overcome the effect of the voluntary dismissal of that action. Upon dismissal of the civil action, the probate court no longer had jurisdiction to enter any further order distributing the settlement proceeds from the civil action ...
A civil tort action was filed against multiple parties to recover for the injuries. Hartford filed a complaint in intervention seeking to recover the workers’ compensation benefits it had paid as a result of conservatee’s accident.
In 2012, a WCJ found conservatee to be totally and permanently disabled and awarded permanent disability, medical care for life, and attorney fees.
On October 30, 2013, conservatee, Hartford, and Toyota, one of the tort defendants, signed a mediation agreement that called for Toyota to pay a specified sum to conservatee. In 2014, the probate court signed an order approving the compromise of the disputed claim against the other driver and Toyota and directed payments from the settlement proceeds for attorney fees and expenses, to Hartford (for medical and like expenses it had paid), and conservatee (for the balance of the settlement).
Numerous disputes arose between the parties over the distribution of funds, each of which were subsequently resolved.
Then, in 2016, conservatee filed a motion in the probate court to assess attorney fees, asking the probate court to order Hartford to "reimburse Conservatee $150,934.76 in costs and $179,605.48 in attorney’s fees as Hartford’s pro rata share of Conservatee’s costs and attorney’s fees in creating the Toyota settlement." Conservatee stated the authority for the motion was labor code sections 3856, subdivision (b), and 3860, subdivision (e), and the "common fund" doctrine.
The probate court concluded that it lacked jurisdiction to consider conservatee’s claims because the underlying civil case had been dismissed with prejudice upon conservatee’s request. The court of appeal agreed and affirmed the order in the unpublished case of Conservatorship of Howard.
Conservatee’s motion to assess attorney fees did not revive the civil action or overcome the effect of the voluntary dismissal of that action. Upon dismissal of the civil action, the probate court no longer had jurisdiction to enter any further order distributing the settlement proceeds from the civil action ...
