The California Insurance Commissioner issued an Order adopting emergency workers’ compensation regulations in response to the COVID-19 pandemic.

These new regulations will mandate insurance companies to recompute premium charges for policyholders to reflect reduced risk of loss consistent with Commissioner Lara’s April 13 and May 15, 2020 Bulletins, and will result in savings for many policyholders as businesses continue to struggle financially during the COVID-19 pandemic.

The new regulations will go into effect on July 1, 2020.

Under these emergency regulations, employers are permitted to reclassify an employee if the employee’s duties have changed to a clerical classification that has reduced risk than the employee’s previous classification.

This reclassification will reduce the employer’s premiums for employees who are a lower risk because they are now working from home even though they may not have previously done so. This change would be retroactive to March 19, 2020, the first day of the Governor’s statewide stay-at-home order, and conclude 60 days after the order is lifted.

These emergency regulations also exclude from premium calculations the payments made to an employee, including sick or family leave, while the employee is not performing duties of any kind for the employer. Typically, these payments would be used as a basis for the employer’s workers’ compensation premium. This change will lower the employer’s rate by reducing the amount of payroll assessed, and the employer will not pay premium for paid workers who are otherwise being furloughed.

This new regulation will also exclude claims related to a COVID-19 diagnosis from being included in future rate calculations so that employers are not penalized with higher rates due to COVID-19 claims.

Insurers will also be required to report injuries involving a diagnosis of COVID-19 which will allow the Commissioner’s statistical agent - the WCIRB - to keep track of COVID-19 injuries, and will aid in the WCIRB’s future analyses of the workplace and market impacts ...

A joint effort by the California Department of Insurance and the Orange County District Attorney’s Office has led to charges against five defendants in connection with a fraud ring allegedly designed to traffic vulnerable substance abuse patients from outside California into treatment facilities in Orange and Riverside counties and to bilk insurance companies out of millions of dollars.

Authorities charged Jeremy Ryan, 42, of Orange, Daniel Reaman, 41, of Mount Rainier, Maryland, Richard Roberts, 61, of Stockton, Reiner Nusbaum, 54, of San Clemente, and Michael Castanon, 56, of San Juan Capistrano, with multiple felony counts including insurance fraud, money laundering, and conspiracy.

The defendants face between 12 years, 8 months and 21 years and four months in prison for their alleged involvement in a scheme that resulted in $60 million in fraudulent billing and $11.7 million in insurance losses.

Authorities allege that Ryan, Reaman, and five previously charged defendants used mass media marketing campaigns to identify addicted "clients" from across the country who were seeking treatment. The conspirators and their witting employees then falsified clients’ health care insurance applications to circumvent California residency requirements and closed enrollment periods, employed a money-laundering scheme they devised to conceal their involvement in paying clients’ insurance premiums, and trafficked their clients into Southern California treatment facilities.

The conspirators allegedly used their own nonprofit, Healthcare Relief Foundation, and exploited the unwitting non-profit, StopB4UStart, to conceal their involvement in funding their scheme.

Authorities further allege they conspired with the owners and employees of over 17 substance treatment facilities, including facilities owned by defendants Roberts, Nusbaum and Castanon, to traffic clients into these facilities in order to collect thousands of dollars on their investment in unlawful, per-client, kickbacks.

Roberts, Nusbaum, and previously charged conspirators owned and operated RNR Recovery and Diamond Recovery, both Orange and Riverside County businesses offering inpatient detox treatment and residential sober living and assistance. Castanon owned and operated Luminance Recovery Center, a San Juan Capistrano based treatment facility.

Deputy District Attorney James Bilek of the Insurance Fraud Unit at the Orange County District Attorney’s Office is prosecuting this case ...

San Francisco’s District Attorney has joined a growing chorus of California regulators and enforcement officials taking aim at gig economy companies for what they see as the misclassification of workers as contractors.

The chief prosecutor announced the filing of an employee protection action against DoorDash alleging the company has and continues to illegally misclassify its delivery workers as independent contractors when, in fact, they are employees. The action seeks restitution for workers, an injunction requiring DoorDash to properly classify its delivery workers as employees, and civil penalties.

DoorDash is a business that delivers food, beverages and other items from local restaurants and stores to nearby customers. It refers to its delivery workers as "Dashers" and employs them to pick up orders from merchants and deliver them to customers. DoorDash is headquartered in San Francisco.

According to the complaint, misclassification is a major issue negatively impacting California workers. The California Supreme Court has discussed that misclassification is a "very serious problem" that was depriving "millions of workers of the labor law protections to which they are entitled."

The California Legislature has stated that misclassification contributes to the rise in income inequality and the shrinking of the middle class.

Additionally, the San Francisco Board of Supervisors recently adopted a Resolution urging "City Attorney Dennis Herrera and District Attorney Chesa Boudin to seek immediate injunctive relief to prevent the misclassification of San Francisco workers as they seek to access basic workplace rights like paid sick leave, unemployment insurance, and benefits provided under the San Francisco Health Care Security Ordinance."

Under California’s protective labor laws, workers are presumed to be employees and it is the employer’s burden to justify classifying workers as independent contractors.

The District Attorney also claims that "properly classifying employees is especially important during the ongoing COVID-19 pandemic. Dashers were already performing dangerous work, forced to navigate traffic conditions as quickly as possible to make their deliveries or risk being suspended or terminated by DoorDash. The job of a Dasher became substantially more perilous during this pandemic. Dashers have been deemed essential workers yet DoorDash does not even provide them with workers’ compensation insurance and prevents them from having access to paid sick and disability leave under state laws."
...

The first wave of COVID-19 came slowly to San Joaquin County in the heart of California’s breadbasket, but the much-feared second surge is roaring through, sickening as many people in the two weeks since Memorial Day as in March and April combined.

In San Joaquin County, Health Officer Maggie Park attributes the rise in cases to two cherry packing plants where people are working in close proximity, and to families and friends gathering without wearing masks or physical distancing, along with recent moves to re-open the economy.

Hospitalizations have spiked by 40%, and the county is one of ten in the most populous U.S. state put on a watch list of places that might be ordered to lock down their economies again after weeks of careful reopening.

But Reuters reports that when Michael Tubbs, mayor of the county seat of Stockton, submitted an ordinance requiring residents to wear masks when they are in public, he did not get a single vote from the six other members of the city council.

It is "a political hazard to act in the interest of public health," complained Tubbs, a liberal whose city has several conservatives on the council.

The pushback Tubbs experienced - and the spike in cases the county’s health director says was exacerbated when people celebrated Mothers Day and Memorial Day without following physical distancing rules - offers a glimpse into the complicated politics around lifting coronavirus restrictions.

Last week, the chief health officer for Orange County in Southern California resigned amid protests and personal attacks after she issued an order to wear masks in public. Four other health officers in California have resigned or retired in the last two months, as have two public health department directors, local media have reported as cases and deaths continue to rise in the state.

On Tuesday, the state reported nearly 160,000 confirmed COVID-19 cases and over 5,200 deaths.

Health directors and the U.S. Centers for Disease Control and Prevention say wearing face coverings in public is essential to slow the spread of the virus.

Public health restrictions run against the grain of individualism in American culture, and often generate resistance, said U.C. Berkeley epidemiologist Arthur Reingold. Chafing under rules requiring masks in public is reminiscent of prior health care emergencies, such as the uproar that followed efforts to close gay bath houses during the HIV epidemic, Reingold said.

Throughout the country, resistance to public health measures has also taken on a partisan tinge. A Reuters/Ipsos survey conducted last month found that just one-third of Republicans were "very concerned" about the virus, compared to nearly half of Democrats. Trump eschews wearing a mask in public, while his Democratic opponent in November, Joe Biden, generally wears one.

In California, Governor Gavin Newsom has loosened the state’s shutdown even as cases in some areas continue to rise. Stockton, which also has a number of conservative members of the county Board of Supervisors, is emblematic of places where wearing a mask has become politicized ...

Strong responses to the opioid epidemic have led to decreased opioid use over the past five years. However, has the decline been consistent across industries?

A new article published by the National Council on Compensation Insurance (NCCI) explores the difference in opioid use between industry groups by looking at data-driven trends underlying opioid prescribing patterns in workers compensation - with a special focus on the contracting industry.

Studies have shown that certain industry groups have been more prone to opioid use and abuse than others. Further, NCCI data shows that the treatment of injured workers in certain industry groups is significantly more likely to include opioids. For example, in the contracting industry, the quantity of opioids prescribed to injured workers is more than double the average number prescribed to those in all other industry groups.

The share of claims receiving an opioid is greater for the contracting industry group (20%) when compared with all other industry groups combined (14%).

This means that, on average, one out of every five contracting claims involves at least one opioid prescription. In addition, these contracting industry group claimants, on average, receive both 20% more opioid prescriptions and opioid prescriptions that are 20% stronger.

One factor contributing to the higher opioid usage in the contracting industry group is the greater likelihood for serious injuries to occur. Higher medical costs are typically associated with more serious injuries-claims that may be more likely to require pain management efforts, including the potential use of opioids.

For accidents occurring in 2017, the average medical cost per claim, including prescription costs, in the contracting industry group was approximately 2.3 times greater than that for all other industry groups combined.

Opioid usage has experienced decreases in recent years, including among the contracting industry. Between 2012 and 2017, overall, per-claim opioid usage fell by 49% in the contracting industry group.

Decreased opioid usage in the contracting industry group can be primarily explained by a combination of two factors: fewer claimants receiving an opioid prescription, and a reduced number of opioid prescriptions for those who do receive them ...

The Workers Compensation Research Institute (WCRI) released a new report that gathers in one place the numerous state regulations affecting drugs prescribed to workers with injuries in all 50 states and the District of Columbia.

"Across the country, states have implemented an array of different regulatory strategies, overseen by different agencies, to address prescribing of medicine," said Ramona Tanabe, WCRI’s executive vice president and counsel.

"This report provides policymakers and system stakeholders with a basic understanding of the different strategies adopted by states, with references to the regulations for those seeking more detail."

The report, Workers’ Compensation Prescription Drug Regulations: A National Inventory, 2020, also provides information on some of the most prominent prescription drug issues stakeholders are concerned about today, such as the following:

-- Rules for Limiting and Monitoring Opioid Prescriptions
-- Medical Marijuana Regulations
-- Workers’ Compensation Drug Formularies
-- Prescription Drug Monitoring Programs
-- Price Regulations for Pharmacy- and Physician-Dispensed Drugs
-- Drug Testing Regulations

The tables in this report were compiled from completed surveys of two agencies for each of the 50 states and the District of Columbia as of January 1, 2020.

For more information or to purchase, visit its website ...

Analysts predict the Global Insurance Fraud Detections market to show a compound annual growth rate of 21.66% from 3.7 billion in 2019 to reach 12 billion by 2026.

The major factors contributing to the growth of the market are the need to manage huge volumes of identities by organizations productively, increasing operational efficiency and improving the customer experience, growing adoption of advanced analytics techniques, and stringent regulatory compliance requirements.

The global Insurance Fraud Detection Market is bifurcated into Fraud Analytics, Authentications, Governance Risk and Compliance, and others.

Fraud analytics is expected to constitute the largest market share. Such systems track and analyze data from multiple data sources, identify anomalies and suspicious and irregular activity across all channels, and provide real-time control mechanisms to prevent fraudulent practices. Hence, leading to the growth of the segment.

The emergence of advanced solutions such as the use of automated business rules, self-learning models, text mining, image screening, network analysis, predictive analytics, and device identification is estimated to deliver actionable insights to advance claims processes.

As a result, insurance organizations are adopting fraud detection solutions that not only recognize the genuine claims process but also decrease the number of false positives.

Various factors, such as a rise in the sophistication level of cyber-attacks and enormous monetary losses due to these attacks in the insurance sector, are anticipated to drive the market. An increase in the generation of enterprise data and its intricacy, high industry-specific requirements, and an increase in the incidence of fraud further supplement the fraud detection market growth.

With the growing awareness of criminals and sophisticated crimes, fraud prevention and detection capabilities are increasing. Global concerns about the constantly increasing cases of insurance fraud, coupled with sophisticated organized crime, have signaled the need for all insurance companies to act consistently.

Different factors, such as an exponential rise in cyber-attack sophistication and substantial monetary losses due to these assaults in the insurance sector, are expected to drive the market ...

The Division of Workers’ Compensation has posted draft revisions to the Official Medical Fee Schedule regulations that govern the maximum reasonable fee for pharmaceuticals dispensed to injured workers.

Under the California Labor Code, the fee schedule for dispensed pharmaceuticals is based primarily upon the Medi-Cal pharmacy payment system. Medi-Cal has implemented a revised payment methodology approved by the Centers for Medicare and Medicaid Services (CMS) utilizing "National Average Drug Acquisition Cost" (NADAC) based upon survey data compiled by CMS instead of the "average wholesale price" (AWP).

The new Medi-Cal methodology also revises the pharmacy dispensing fee value and structure by updating the dispensing fee from $7.25 to a two-tier dispensing fee of $10.05 or $13.20, depending on the volume of pharmacy claims processed.

DWC proposes to amend the workers’ compensation pharmaceutical fee schedule in accordance with the provisions of Labor Code section 5307.1, and in light of the Medi-Cal payment system changes.

The proposed regulations set forth separate provisions for pharmacy-dispensed and physician-dispensed pharmaceuticals in order to implement statutory provisions with additional fee caps for some physician-dispensed pharmaceuticals.

The regulation draft would:

-- Amend existing regulations in the Physician Fee Schedule (Sections 9789.12.1, 9789.13.2, 9789.13.3) that cross reference to the pharmaceutical fee schedule
-- Amend existing Pharmacy Fee Schedule regulation (Section 9789.40)
-- Adopt new Pharmaceutical Fee Schedule regulations and structure; separate provisions for pharmacy-dispensed pharmaceuticals (Sections 9789.40.1, 9789.40.2, 9789.40.3) and physician-dispensed (Sections 9789.40.4, 9789.40.5) pharmaceuticals
-- Amend Official Medical Fee Schedule section 9789.111 which sets forth effective dates

The draft regulations, a sample excerpt of the fee data file, a sample excerpt of the dispensing fee file and background information on the Medi-Cal fee methodology changes are available on the DWC Forum webpage under "current forums." Comments will be accepted on the forum until 5 p.m. on Friday, July 3, 2020 ...

ReadyLink Healthcare is a nurse staffing company based in Thousand Palms, California. It contracts with registered nurses and other healthcare providers throughout the United States, and places them at hospitals, on a short-term basis.

SCIF and ReadyLink have been engaged in a multiyear, multijurisdictional dispute over the final amount of workers' compensation insurance premium that ReadyLink owes to SCIF for the 2005 policy year, based on an audit of ReadyLink's payroll for that year performed by SCIF. During the audit, SCIF determined that certain payments made by ReadyLink to its nurses, which ReadyLink characterized as per diem payments, should instead be considered to be payroll under the relevant workers' compensation regulations. SCIF's audit resulted in a significant increase in ReadyLink's premium.

After 15 years of litigation attempting to collect additional premium from its insured, the State Compensation Insurance Fund was sent back essentially to square one to a trial court in Riverside. The convoluted litigation history is enough to give anyone a headache.

ReadyLink first challenged SCIF's application of the regulations by filing an appeal of the audit to the Insurance Commissioner. The Commissioner approved SCIF's application of the relevant regulation.

A trial court then rejected ReadyLink's petition for a writ of administrative mandamus to prohibit the Insurance Commissioner from enforcing its decision, and an appellate court affirmed the trial court's judgment.

While ReadyLink's appeal from the trial court's denial of its petition for a peremptory writ of administrative mandamus was pending, ReadyLink filed a putative class action lawsuit in federal district court against SCIF and the Insurance Commissioner. (ReadyLink Healthcare, Inc. v. State Compensation Ins. Fund (9th Cir. 2014) 754 F.3d 754, 757).

The federal district court dismissed the case concluding that it was appropriate to decline to exercise supplemental jurisdiction over the remaining state-law claims. While ReadyLink's federal appeal was pending, California's Second District Court of Appeal issued its opinion in ReadyLink Healthcare affirming the trial courts ruling.

SCIF then filed the action underlying this current appeal in Riverside County Superior Court on January 13, 2015. SCIF alleged causes of action against ReadyLink for breach of contract, money due on an open book, and common count. The trial court ultimately granted SCIF's motion for judgment on the pleadings, finding that the amount owed was precisely what was determined in the underlying administrative decision and appeals, the amount of $555,327.53, plus prejudgment interest of $571,606.99.

ReadyLink appealed the money judgment in favor of SCIF. The Court of Appeal reversed in the new published opinion of SCIF v ReadyLink Healthcare inc.

A review of ReadyLink Healthcare, supra, 210 Cal.App.4th 1166, demonstrated that the issues that remain to be decided in this collection action were not previously considered, let alone decided, in the appellate review from the writ proceeding.

The single issue before the ALJ was whether SCIF's inclusion as payroll those amounts that ReadyLink paid to its employee nurses as per diems for the 2005 policy year complied with the California Workers' Compensation Uniform Statistical Reporting Plan.

In its ruling on ReadyLink's petition for a writ of administrative mandamus, the trial court did not suggest that the dispute involved other questions, such as the total amount of the premium owed by ReadyLink, or whether SCIF's past conduct in relation to ReadyLink might provide a legal basis for ReadyLink to avoid having to pay the premium for the 2005 policy year as determined by SCIF.

The trial and appellate courts in the federal action did not consider, much less decide, the question of the amount of premium actually owed by ReadyLink for workers compensation insurance for the 2005 policy year.

Thus, the Court of Appeal's review of the collateral proceedings between ReadyLink and SCIF makes clear that the trial court erred in concluding that the issues raised by SCIF's collection action and by ReadyLink's affirmative defenses to that action had been litigated and decided in a prior action.

The judgment of the trial court was reversed. The trial court's order denying ReadyLink's motions to compel further discovery was also reversed ...

A new study published in the Journal of Occupational and Environmental Medicine concluded that employers can make a business case for expanding access to pharmacotherapy treatment for Opioid Use Disorder (OUD) based on its finding that receipt of pharmacotherapy significantly reduces overall health care costs.

Prior research has measured the impact of employee opioid use disorder (OUD) on employer costs. One study found that employees who are dependent on opioids but have not been diagnosed with OUD have lower at-work productivity, which costs employers approximately $16 million a year.

Another study using 2006 to 2012 data reported that individuals with OUD had seven more medically related absenteeism days annually relative to matched controls.

A third study found that US adults who misuse prescription pain relievers have higher work absenteeism than do employees who do not.

Studies focusing on health care costs have found that individuals who misuse opioids have more than $10,000 more in annual expenditures.

However, employers do not have a recent or full picture of costs related to OUD. Employees who have a spouse or dependent with an OUD may have additional lost productivity days and days absent because of family member health concerns. Employees may have to help their family member navigate health care benefits during business hours, including identifying appropriate and available providers for substance use disorder (SUD).

Employees also may assume a caregiving role, particularly during relapse or potential relapse. A cross-sectional study of caregivers of individuals with advanced cancer found a 23% drop in average productivity. Another study that looked at caregivers of patients with poststroke spasticity found that lost-productivity cost per employed caregiver was $835 per month, with 72% attributable to presenteeism.

To update this information, ACOEM researchers conducted a cross-sectional analysis of 2016 to 2017 commercial enrollment, health care, and pharmacy claims and health risk assessment data using the IBM® MarketScan® Databases (Ann Arbor, MI).

The results of the new study were consistent with previous research that found that employers incur significant costs from OUD. The findings add to the literature by providing evidence that employers would benefit financially from expanding access to pharmacotherapy for their employees with OUD.

Employers should work with other payers to tackle important barriers to treatment for OUD by supporting efforts to expand provider education and licensure requirements to include MAT and increasing insurance coverage for these treatments ...

3M's legal battle to keep price gougers from profiting on sales of its N95 face masks during the coronavirus pandemic grew on new fronts.

The Star Tribune reports that on Monday, 3M targeted a third-party seller on Amazon.com for using its trademark to sell $350,000 worth of masks at up to 20 times list prices.

KM Brothers Inc., a California company trading under several different business names, "claimed to be reselling authentic N95 respirators, while actually selling damaged and fake goods at highly inflated prices," 3M said.

After customer complaints, Amazon pulled the KM Brothers ads from its online shopping forum.

3M's federal court lawsuit against Mao Yu, the owner and operator of KM Brothers, explains a strategy that uses multiple business names to carry on selling if a single business gets taken down.

3M said that on Feb. 20, various business under KM Brothers control began selling "what were purported to be 3M-branded N95 respirators across three connected accounts on Amazon.com."

The company also "maintained at least 45 different Amazon Standard Identification Numbers."

The new lawsuits offer a glimpse into the depth and breadth of attempts to profit from a national shortage of N95 masks, said to be among the most effective in blocking airborne COVID-19 molecules.

The new legal actions bring to 14 the number of suits 3M has filed since January to try to control price gouging for its product by what the company calls "pandemic profiteers."

3M said it "has won five temporary restraining orders and three preliminary injunction orders from courts across the country that put a stop to other defendants' unlawful and unethical profiteering from the pandemic."

It has shut down more than 3,000 websites and 4,000 social media posts that try to expropriate the 3M brand for profit, the company explained.

3M asks the court to shut down KM Brothers' mask-selling operations and to force the company to repay any profits derived from by claiming the resale of 3M masks when it was instead "selling counterfeit, damaged, deficient, or otherwise altered masks."

The seller charged Amazon customers up to $23.21 for a single mask that normally listed for prices ranging from 60 cents to $3.40 each. Customer complaints tipped off Amazon ...

Facing budget shortfalls and double-digit unemployment, governors of U.S. states that are COVID-19 hotspots on Thursday pressed ahead with economic reopenings that have raised fears of a second wave of infections.

Governors face pressure to fire up economies facing fiscal year 2021 budget shortfalls of up to 30% below pre-pandemic projections in New Mexico. Nevada, which has seen cases increase by nearly a third in the past two weeks, is suffering 28% unemployment.

Reuters reports that the moves by governors of states such as Florida and Arizona came as Treasury Secretary Steven Mnuchin said the United States could not afford to let the novel coronavirus shut its economy again and global stocks tanked on worries of a pandemic resurgence.

As Florida reported its highest daily tally of new coronavirus cases on Thursday, Governor Ron DeSantis unveiled a plan to restart public schools at "full capacity" in the autumn, arguing the state’s economy depended on it.

North Carolina reported record COVID-19 hospitalizations for a fifth straight day on Thursday, a day after legislators passed a bill to reopen gyms, fitness centers and bars in a state where more than one in ten workers are unemployed.

"This is about saving lives, this is also about livelihoods in the state of Arizona," Governor Doug Ducey told a news briefing, adding that a second shutdown of the economy was "not under discussion" despite official figures showing a 211% rise in virus cases over the past 14 days.

About half a dozen states including Texas and Arizona are grappling with rising numbers of coronavirus patients filling hospital beds.

Ducey and Texas Governor Greg Abbott say their hospitals have the capacity to avoid the experiences of New York, where the system was stretched to near breaking point as some COVID patients were treated in hallways and exhausted workers stacked bodies in refrigerated trailers.

A note of caution came from Utah, where Governor Gary Herbert said most of the state would pause its reopening after a 126% rise in cases over the past two weeks.

Austin, Texas on Thursday also said it would likely extend stay-at-home and mask orders past June 15 after the state reported its highest new case count the previous day. Austin health officials blamed a record week of infections on easing business restrictions and Memorial Day gatherings.

There was no talk of new shutdowns.

In New Mexico, Health Secretary Kathy Kunkel pointed to outbreaks at the Otero County Prison Facility, as well as in nursing homes and assisted living facilities, as factors behind an uptick in cases ...

The California Public Utilities Commission said in an order Tuesday that drivers for Transportation Network Companies (TNCs), which include services like Uber and Lyft, are considered employees under AB-5, the state's hotly debated new gig work law.

"For now, TNC drivers are presumed to be employees and the Commission must ensure that TNCs comply with those requirements that are applicable to the employees of an entity subject to the Commission's jurisdiction," wrote commissioner Genevieve Shiroma.

The ruling from CPUC, the agency in charge of regulating ride-hail companies, marks a significant development in the battle over the employment status of tens of thousands of gig workers in California.

According to the report in Business Insider, both companies criticized the ruling, saying it could hurt drivers' wages and pointing to a ballot measure they support that would revoke the law.

"CPUC's presumption is flawed; drivers are correctly classified as independent contractors and overwhelmingly want to remain independent contractors," a Lyft spokesperson told Business Insider. "Forcing them to be employees will have horrible economic consequences for California at the worst possible time."

"Uber remains committed to expanded benefits and protections to drivers," a company spokesperson told Business Insider. "If California regulators force rideshare companies to change their business model it could potentially risk our ability to provide reliable and affordable services along with threatening access to this essential work Californians depend on."

Ride-hailing companies like Uber and Lyft have been at the center of AB-5, which went into effect this year and made it more difficult for companies to classify employees as independent contractors.

While many drivers and labor groups have praised AB-5, it has also received intense pushback from some corners. Beauticians, truckers, freelance writers and workers in industries long dominated by contractors have said the law is too far-reaching, for example.

AB-5's most ardent opponents, however, have been its intended targets: gig work companies.

Last year, Uber sued California, seeking an exemption from AB-5, and along with Lyft and various food delivery apps, has publicly argued that its drivers should not be classified as employees, called on taxpayers to foot the bill for drivers' unemployment insurance, and poured millions into a ballot measure aimed at revoking the law.

Uber and Lyft have so far refused to reclassify drivers under AB-5, leading city attorneys general from Los Angeles, San Francisco, and San Diego to sue the companies to force them to comply with the law. More than 4,000 drivers across the state have also taken action by filing $1 billion worth of back wage claims, driver group Rideshare Drivers United said in a statement.

The COVID-19 pandemic has brought new scrutiny to the labor practices of gig work companies like Uber and Lyft, with drivers facing a steep drop in income, struggling without healthcare or paid time off, and unable to claim unemployment insurance ...

From apple packing houses in Washington state to farm workers in Florida and a California county known as "the world’s salad bowl," outbreaks of the novel coronavirus are emerging at U.S. fruit and vegetable farms and packing plants.

Reuters reports that a rising number of sick farm and packing house workers comes after thousands of meat plant employees contracted the virus and could lead to more labor shortages and a fresh wave of disruption to U.S. food production.

The Trump administration said last month it may extend an executive order to keep meat plants operating to fruit and vegetable producers as well, a sign it is concerned fresh produce could be the next sector hit.

While social distancing can be more easily implemented for workers harvesting fruits and vegetables in fields and working outside may reduce some risks for virus spread, plants that package foods such as apples and carrots resemble the elbow-to-elbow conditions that contributed to outbreaks at U.S. meat packing plants.

By late May, there were more than 600 cases of COVID-19 among agricultural workers in Yakima County, Washington. Of those, 62% were workers in the apple industry and other packing operations or warehouses, according to a Reuters review of data from county health officials.

With 4,834 known cases as of June 10, the county had the highest per-capita infection rate on the West Coast.

"The (production) line moves super fast. And you’re working side by side and back to back," said Edgar Franks, political director with local farmworker union Familias Unidas por la Justicia in Washington state.

Workers at six fruit packing sites in Yakima County went on strike in May due to concerns they were not being provided adequate protection from COVID-19, Franks said.

The health department in Monterey County, California, known as "the world’s salad bowl" for its sprawling vegetable farms, reported 247 agricultural workers had tested positive for coronavirus as of June 5, 39% of county’s total cases. Monterey is one of only a handful of health departments in nearly 30 of the largest U.S. fruit and vegetable producing counties that tracks virus cases among agricultural workers, Reuters found.

On May 19 the U.S. Agriculture Department and Food and Drug Administration said the government could use the Defense Production Act to keep fruit and vegetable lines moving. The act would give companies some liability protection if workers fall sick.

An FDA spokesperson said the act could be used "to protect the food supply and prevent significant food shortages."

U.S. Senator Debbie Stabenow, a Michigan Democrat, said in an interview with Reuters farm workers face increased risks as fruits like apples and cherries enter harvest season.

Stabenow, ranking member on the Senate Agriculture Committee, introduced legislation on May 27 that would offer companies grants and loans to upgrade machinery and purchase personal protective equipment, fund COVID-19 testing and facility cleaning.

"You can get ahead of this, which is what didn’t happen in the meatpacking situation," she said. "The best way to protect our supply chain is to keep workers safe."

Meanwhile, coronavirus cases near tomato-growing Immokalee, Florida, are also on the rise. The spread of the coronavirus among Florida farm workers has significant implications for national food production, as many agricultural workers travel north through the summer following the harvest through Georgia, the Carolinas, and into the Northeast.

The Florida Department of Agriculture is planning for more on-farm outbreaks by partnering with county health departments, hotels for quarantine housing, and educating workers ...

The president of a California-based medical technology company was charged for his alleged participation in schemes to mislead investors, to manipulate the company’s stock price and to conspire to commit health care fraud in connection with the submission of over $69 million in false and fraudulent claims for allergy and COVID-19 testing.

The complaint against Mark Schena, 57, of Los Gatos, California, the president of Arrayit Corporation, is the first criminal securities fraud prosecution related to the COVID-19 pandemic that has been brought by the Department of Justice and charges one count of securities fraud and one count of conspiracy to commit health care fraud.

According to the affidavit in support of the complaint, Schena touted that Arrayit is the "only laboratory in the world that offers" revolutionary "microarray technology" that allows Arrayit to test for allergy and COVID-19 based on a drop of blood that is 250,000 times smaller than the technology touted by Theranos.

Beginning in or around 2018 and continuing to in or around February 2020, Schena and others paid kickbacks and bribes to recruiters and doctors to run an allergy screening test for 120 allergens (including things ranging from stinging insects to food allergens) on every patient regardless of medical necessity, and then made numerous misrepresentations to potential investors about Arrayit’s allergy test sales, financial condition, and its future prospects.

Schena and others issued press releases and tweeted about partnerships with Fortune 500 companies, government agencies and public institutions, without disclosing that such partnerships either did not exist or were of de minimis value.

As the COVID-19 crisis began to escalate in March 2020, Schena and others made false claims concerning Arrayit’s ability to provide accurate, fast, reliable and cheap COVID-19 tests in compliance with state and federal regulations, and made numerous misrepresentations to potential investors about the COVID-19 tests and Arrayit’s future prospects for COVID-19 testing.

Schena stated that it was simple to develop a test for COVID-19 because the switch from testing for allergies to testing for COVID-19 was "like a pastry chef" who switches from selling "strawberry pies" to selling "rhubarb and strawberry pies." Arrayit’s stock price doubled in mid-March, but Schena and others never disclosed that there were questions about the validity of its data and the accuracy of its COVID-19 test.

"The scheme described in the complaint, in which the defendant allegedly leveraged this allure by appending the fear of the Covid 19 pandemic, amounts to a cynical multi-million dollar hoax," said U.S. Attorney David L. Anderson of the Northern District of California.

"This defendant allegedly defrauded Medicare through illegal kickbacks and bribes, and then turned to exploiting the pandemic by fraudulently promoting an unproven COVID-19 test to the market," said Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division ...

U.S. commercial insurance prices again grew significantly in the first quarter of 2020, according to Willis Towers Watson’s most recent Commercial Lines Insurance Pricing Survey (CLIPS).

The survey compared prices charged on policies underwritten during the first quarter of 2020 to those charged for the same coverage during the same quarter in 2019.

The aggregate commercial price change reported by carriers was close to 2% for all four quarters of 2018 and the first quarter of 2019, climbing to almost 4% in the second quarter, almost 5% in the third quarter of 2019, and over 6% for the past two quarters.

Data for nearly all lines indicated significant price increases in the first quarter, with the largest coming from excess/umbrella liability and directors and officers liability, as both coverages saw significantly accelerating increases over the past three quarters.

However CLIPS indicates ongoing material price reductions for workers compensation, in contrast to nearly all other surveyed lines, though the decreases have tempered somewhat for each of the last five quarters.

The past outlier in the results, commercial auto, saw reported price increases near or above double digits for the tenth consecutive quarter, while property coverage saw near double digit increases for the fourth consecutive quarter.

Price changes for most lines other lines were fairly consistent with those observed in the prior quarter.

When comparing account sizes, reported price changes were more muted for small commercial accounts, higher for mid-market accounts, and approaching double digits for large accounts, whereas the prices were fairly consistent by account size four quarters ago.

Specialty lines price increases in aggregate were above double digits increases for the second consecutive quarter.
...

Michael Perani was a computer software engineer from 1988 until 1995, who sustained an injury to his "upper extremities" while employed by Island Graphics.

In 1994, he filed a workers’ compensation claim after he began suffering from pain, inflammation, swelling and impaired range of motion in his hands, wrists and arms. He was not specifically diagnosed as having a condition known as "thoracic outlet syndrome" (TOS), but his medical records describe symptoms consistent with TOS in the year following his claim.

TOS refers to a constellation of symptoms which arise due to compression of blood vessels or brachial plexus nerves in the space between the clavicle and the first rib (i.e., the thoracic outlet). Compression of the brachial plexus nerves causes a variety of symptoms, including pain in the shoulder and scapula area, pain, numbness, swelling and tingling in the arm or hand, reduced grip strength, and weakness when raising the arm. Thoracic outlet syndrome commonly arises in patients whose occupation requires repetitive motion, which causes inflammation, which in turn results in compression of the brachial plexus nerves." (Borrayo v. Avery (2016) 2 Cal.App.5th 304, 307.)

In 1998, Perani entered into a stipulated award which stated he ". . . sustained injury arising out of and in the course of employment." In the space labeled "(Parts of body injured)," the award stated, "bilateral upper extremities."

The WCAB upheld a decision by the WCJ that thoracic outlet syndrome involves a different part of the body than did the award. It consequently denied Perani’s application for expenses incurred to treat that condition. The court of appeal annulled the decision in the unpublished decision of Perani v WCAB, Island Graphics.

The question presented was whether thoracic outlet syndrome is encompassed within the award.

"Upper extremity" includes the hand, wrist, elbow and the shoulder - in other words the entirety of the arm. (See Smith v. Empire Pencil Company (Tenn. S.C. 1989) 781 S.W.2d 833, 837.) The term can be defined even more expansively, to include the neck and shoulders; essentially, everything from the base of the skull down. (M.C. Dean, Inc. v. District of Columbia Employment Services (D.C. App. 2016) 146 A.3d 67, 72-73.

The 1998 stipulated award did not specify that future medical treatment was authorized only for a particular medical condition such as repetitive strain injury or carpal tunnel syndrome, which can be distinguished from TOS even when the symptoms overlap. Instead, the award broadly stated that the body parts injured were the "bilateral upper extremities," without specifying a particular medical condition, and that there was a need for further medical treatment of that injury.

Had the parties wished to limit future medical treatment to treatment for particular conditions, they could have done so ...

Amazon has found itself involved in a lawsuit, which was filed by a group of warehouse workers that claim the e-commerce giant put them at risk because of the working conditions at its fulfillment centers during the coronavirus pandemic.

This is not the first lawsuit that Amazon has been involved with over working conditions at its fulfillment centers during the coronavirus pandemic. The company has come under fire for its safety measures as it ramped up its workforce by 175,000 employees to meet the onslaught of demand caused by consumers stocking up on essential items from its website.

Employees at Amazon have staged walkout protests asking for hazard pay, better working conditions, and more COVID-19 testing. Amazon paid its workers $2 per hour extra during the height of the coronavirus pandemic, which expired at the end of May. The company said it has spent $800 million in the first two quarters of the year on safety measures.

Amazon said it was reviewing the complaint. "We are saddened by the tragic impact COVID-19 has had on communities across the globe, including on some Amazon team members and their family and friends," spokeswoman Lisa Levandowski said in an emailed statement. "From early March to May 1, we offered our employees unlimited time away from work, and since May 1 we have offered leave for those most vulnerable or who need to care for children or family members."

Amazon emerged as an indispensable service for many customers shopping online during "shelter-in-place" orders. The company scrambled to meet surging demand by hiring 175,000 workers while simultaneously announcing new procedures to protect its workforce.

According to Amazon, over 150 processes have been updated to protect employees, and the company is spending over $800 million in the first half of 2020 on coronavirus safety measures. Workers diagnosed with the virus are also being offered additional paid time off, the company has said.

But the new lawsuit claims Amazon has only "sought to create a facade of compliance" and continued with unsafe practices. Workers "continue to work at dizzying speeds, even if doing so prevents them from socially distancing, washing their hands, and sanitizing their work spaces," according to the lawsuit.

The plaintiffs also say Amazon punishes employees who complain about workplace safety and tells workers to avoid informing others if they become infected. Amazon has told employees its contact tracing consists only of reviewing its surveillance footage, rather than interviewing infected workers about their interactions, the lawsuit says.

"Amazon’s failures have already caused injury and death to workers and family members of workers," the lawsuit says, noting that a worker at the Staten Island warehouse has been confirmed to have died from Covid-19. One month later, the worker’s family member reportedly displayed COVID-19 symptoms and died. The plaintiffs in the case are not seeking damages for illness or death but instead asking for an injunction to force Amazon to follow public health guidelines, the news outlet said.

The Staten Island warehouse has been a focus of health and safety complaints since March, when employees mounted the first of a series of walkouts.

Amazon terminated the leader of that protest, claiming he violated a company quarantine order. The company’s action spurred denunciations and calls for investigation by officials including Senator Bernie Sanders and New York Attorney General Letitia James ...

Medical treatment in California Workers' Compensation is based upon treatment guidelines built upon high quality scientific research. At the core is the assumption that published medical studies in leading peer reviewed journals are high quality science. But that might not always be the case.

Nearly a decade ago, headlines highlighted a disturbing trend in science: The number of articles retracted by journals had increased 10-fold during the previous 10 years. Fraud accounted for some 60% of those retractions.

Since then, two longtime health journalists founded the blog Retraction Watch, to get more insight into just how many scientific papers were being withdrawn, and why. They began to assemble a list of retractions.

That list, formally released to the public in 2018 as a searchable database, is now the largest and most comprehensive of its kind. In its tenth year, 2019, nearly 1500 retractions were added to its database in just one year.

The COVID-19 pandemic aftermath added the alarming retraction of what appeared to be a derogatory study of the effectiveness of Hydroxychloroquine as a treatment modality by two leading medical journals, the Lancet, and the New England Journal of Medicine.

The paper, "Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis," which relied on data from a private company called Surgisphere and had concluded that hydroxychloroquine was linked to a higher risk of death among some COVID-19 patients, has been dogged by questions since its publication in late May.

The publication of the study had prompted the World Health Organization (WHO) to halt a study of hydroxychloroquine, but the WHO resumed that trial once the expression of concern appeared.

Details in the Surgisphere data revealed many obvious inconsistencies to scientific observers - which should have been obvious to the "peers" who supposedly reviewed the article before publication by the Lancet and NEJM.

For example, Matthew Spinelli, MD, of University of California San Francisco, told MedPage Today the "claim to have captured data from over 60,000 hospitalizations at over 550 hospitals in North America by April 13th concerns me, given that there were approximately 60,000 COVID-19 hospitalizations total from approximately 6,000 hospitals across all of the United States through April 13th."

Walid Gellad, MD, of the University of Pittsburgh, noted on Twitter that 73 deaths were recorded in Australia according to the Lancet authors, which is "more than the number of deaths in Australia on April 20."

A blog hosted by statisticians at Columbia University in New York City raised several other issues, including the results being confounded by disease severity, lack of hierarchical modeling, and how the data appeared to be aggregated across continents.

Two days after issuing expressions of concern about controversial papers on Covid-19, The Lancet and the New England Journal of Medicine have retracted the articles because a number of the authors were not granted access to the underlying data ...

Reverse payment patent settlements, also known as "pay-for-delay" agreements, are a type of agreement that has been used to settle pharmaceutical patent infringement litigation (or threatened litigation), in which the company that has brought the suit agrees to pay the company it sued.

That is, the patent holder pays the alleged infringer to stop its alleged infringing activity (e.g., to stop selling a generic version of a drug) for some period of time and to stop disputing the validity of the patent. These agreements are distinct from most patent settlements, which usually involve the alleged infringer paying the patent holder. Reverse payment patent settlements result from a peculiarity in US regulatory law arising from the Hatch-Waxman Act passed in 1984.

One of the Federal Trade Commission’s top priorities in recent years has been to oppose a costly legal tactic that more and more branded drug manufacturers have been using to stifle competition from lower-cost generic medicines.

According to the FTA, drug makers have been able to sidestep competition by offering patent settlements that pay generic companies not to bring lower-cost alternatives to market. These "pay-for-delay" patent settlements effectively block all other generic drug competition for a growing number of branded drugs.

According to an FTC study, these anticompetitive deals cost consumers and taxpayers $3.5 billion in higher drug costs every year. Since 2001, the FTC has filed a number of lawsuits to stop these deals, and it supports legislation to end such "pay-for-delay" settlements.

Reuters just reported that EU Regulators have now successfully pursued similar initiatives.

EU antitrust enforcers, boosted by recent court victories, reinforced their case against Israeli drugmaker Teva over its deal with rival Cephalon to delay selling a generic version of its sleep disorder drug modafinil.

Three years ago, the European Commission said the company’s cash payments deal with Cephalon as part of a settlement to end a lawsuit over alleged infringement of Cephalon’s patents on the blockbuster drug may have jacked up the price of modafinil.

It sent a statement of objections, or charge sheet, outlining its concerns why the deal may be anti-competitive. Teva later acquired Cephalon in 2011.

On Monday, the EU competition enforcer sent a supplementary charge sheet to Teva, clarifying why it considered that the objective of the pay-for-delay deal was to restrict competition. It also cited recent court judgments backing its stand.

Teva can be fined up to 10% of its global turnover if found guilty of breaching EU antitrust rules. Regulators on both sides of the Atlantic have fought a long-running battle with drugmakers against such deals ...