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Despite the pandemic-driven recession, workers' comp claim frequency among California's private self-insured employers rose in 2020, fueled by a big increase in the incidence of indemnity claims which more than offset a decline in medical-only claim frequency. This conclusion was based on a California Workers' Compensation Institute (CWCI) analysis of data compiled by the state Office of Self-Insurance Plans (OSIP).

OSIP's annual summary of private self-insured data, released July 8, provides the first snapshot of California private, self-insured claims experience for cases reported in 2020, including the total number of covered employees, medical-only and indemnity claim counts, and total paid and incurred losses on those claims through the end of the year.

The latest summary reflects the experience of private self-insured employers who covered 2.34 million California employees last year, and who reported a total of 86,503 claims in 2020 - slightly more than the 85,852 claims shown in the 2019 initial report.

It is notable that the number of covered employees in the private sector self-insured sector held steady while statewide unemployment soared during the pandemic, though CWCI notes that many large, private self-insured employers fit into the "essential worker" category (e.g., major retail, health care, utilities) where workers were less impacted than the insured work force by furloughs, layoffs, and remote work.

OSIP’s initial report on 2020 private self-insured experience shows 43,779 medical-only claims (down 15.1 percent from 51,545 claims in 2019) and 42,724 indemnity claims (up 24.5 percent from 34,307 in 2019).

The 2020 claim count translates to an overall frequency rate of 3.70 claims per 100 private self-insured employees, nearly matching the overall frequency rates from 2018 and 2019, though the breakdown by claim type underscores the major shift in the claim distribution away from less costly medical-only claims and toward more expensive indemnity claims. While medical-only claim frequency per 100 employees fell from 2.21 in 2019 to a 15-year low of 1.87 in 2020, the indemnity claim rate rose from 1.47 to a 15-year high of 1.83.

That shift was also evident in the first report paid and incurred loss data.

Paid losses on the 2020 private self-insured claims through the fourth quarter totaled $268.4 million, $15.6 million more than the comparable figure for 2019, as total paid indemnity (primarily temporary disability payments) increased by $25.1 million (22.5 percent) while total paid medical fell by $9.5 million (6.7 percent).

Similarly, total incurred losses (paid benefits plus reserves for future payments) increased to $742.4 million, up $48.0 million from the initial incurred amount reported for 2019 claims, as total incurred indemnity at the first report climbed by $40.2 million (6.9 percent) and total incurred medical increased by $7.8 million (1.9 percent). Average paid and incurred losses in the initial report both rose sharply in 2020, climbing to $3,103 and $8,583 respectively, with all of the year-over-year increase in the average paid amount and most of the increase in average incurred due to increased indemnity ...
/ 2021 News, Daily News
A new study from the Workers Compensation Research Institute (WCRI) investigates patterns of medical care access and utilization that are specific to workers’ compensation during the first quarters of 2020 to understand how the timing and delivery of medical treatment were impacted by the pandemic.

"In our previous work, we examined the effect of the spread of COVID-19 along with the accompanying massive decline in economic activity on workers’ compensation claim composition. In this report, we continue examining the impact of the pandemic on workers’ compensation, shifting our attention to the timing and patterns of medical care delivery," said John Ruser, president and CEO of WCRI.

The main focus of the study, The Early Impact of COVID-19 on Medical Treatment for Workers’ Compensation Non-COVID-19 Claims, is on non-COVID-19 lost-time claims with injury dates in the first two quarters of 2019 (pre-pandemic) or 2020 (pandemic period). The following is a sample of the study’s major findings:

- - Claims with injury dates in the first two quarters of 2020 did not experience any noticeable delay in medical treatment as compared with the waiting time for claims with injuries in the first two quarters of 2019. In fact, several service types showed some slight improvement in waiting time from injury to medical treatment - in particular, for claims with injuries in the second quarter of 2020, emergency room services, physical medicine, major surgery, and neurological and neuromuscular testing were provided sooner.
- - In states hit hardest by the pandemic during the study period (Connecticut, Massachusetts, and New Jersey), patients sustaining work-related injuries during the early months of the pandemic did not have longer waiting times before getting medical treatment across eight service groups. There was shorter duration for select service types. In particular, major surgery on average happened sooner - 2020Q2 claims had about a 5-day shorter waiting time than 2019Q2 claims, with the average number of days decreasing from 16.3 days to 11.7 days from injury to major surgery.
- - Fractures and lacerations/contusions occurring in the first half of 2020 and 2019 did not have statistically different times before first medical services for most service types, except for a slightly shorter time before emergency services in 2020. In particular, for lacerations and contusions occurring in the second quarter of 2020, time to emergency services decreased from 0.6 days to 0.4 days on average.
- - For soft-tissue claims with injury dates in the first two quarters of 2020, no substantial delay in treatment for most services was observed, with some exceptions. The average number of days to major surgery increased for other non-spinal sprains and strains occurring in the first quarter of 2020 - an increase of about 3 days, from 57 days in 2019 to 60 days in 2020.
- - For lost-time claims with injury dates in the first two quarters of 2020, the shares of claims across eight types of services remained largely the same as the two first quarters of 2019. However, the study reports a 4-percentage point drop in the share of claims with emergency room services, which is consistent with the expectation that people would want to avoid going to the emergency room because of fear of virus contraction.

The study tracks changes in key measures describing medical service utilization patterns for workers injured in 27 states: Arizona, Arkansas, California, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Massachusetts, Michigan, Minnesota, Mississippi, Nevada, New Jersey, New Mexico, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Wisconsin. These study states represent 68 percent of the workers’ compensation benefits paid in the United States ...
/ 2021 News, Daily News
With a $26 billion nationwide settlement in sight over claims that the three largest U.S. drug distributors and Johnson & Johnson helped fuel a nationwide opioid epidemic, state and local governments will soon turn their attention to pharmacies and a handful of drugmakers.

Reuters reports that U.S. state attorneys general are expected to unveil a settlement proposal this week with distributors McKesson Corp (MCK.N), Cardinal Health Inc (CAH.N) and AmerisourceBergen Corp (ABC.N) contributing a combined $21 billion, while Johnson & Johnson would pay $5 billion.

Noticeably absent from the potential $26 billion deal are pharmacy operators including Walgreens Boots Alliance, Walmart Inc , Rite Aid Corp and CVS Health Corp, which have been accused of ignoring red flags that opioid drugs were being diverted into illegal channels.

The deal also would not include drugmakers AbbVie Inc, Teva Pharmaceutical Industries Ltd or Endo International Plc, which have been accused of misleadingly marketing their pain medicines as safe.

The pharmacies and drugmakers have denied the claims, saying rising opioid prescriptions were driven by doctors, that they followed federal law and that the known risks were included in U.S.-approved labels for the drugs.

News of the proposed nationwide settlement came three weeks into a jury trial in New York, and legal experts said upcoming court proceedings will pressure the remaining defendants to reach a deal.

The drugmakers are currently defending themselves at the New York trial and a trial in Orange County, California, and are expected to face another trial in San Francisco along with the pharmacies later this year. The pharmacies, which settled the New York case shortly before trial, also face an October trial in Ohio.

After start of the Orange County case earlier this year, Allergan defense counsel Donna Welch, in her opening statements in front of Judge Wilson, initially threw co-defendants in the opioid litigation "The Pharmacy Chains" under the bus, claiming they were the responsible party in unleashing hundreds of millions of prescription opioids, the "firewall" in mitigating the now defense asserted, non-existent opioid crisis. This illustration of the "blame others" defense strategy has fewer targets as supply chain participants settle cases, removing opportunities for remaining defendants to shift blame.

Richard Ausness, a law professor at the University of Kentucky, said a settlement this week reduces the groups of defendants in the litigation and makes it harder for the remaining companies to blame others.

Endo is scheduled to go to trial next week to assess damages over a lawsuit brought on behalf of Tennessee counties and an infant allegedly born addicted to opioids, in which a judge has already ruled the company liable. District Attorney General Barry Staubus of Tennessee's Sullivan County told WHLJ television that the company offered to settle, but the deal would be limited to that case.

Peter Mougey, a lawyer representing the local governments pursuing opioid litigation around the country, said at a news conference to discuss proposed settlements that he was "frustrated" pharmacies were not part of the nationwide deal.

"They've had ample time to assess where they are with their liability, and we all have the common goal of trying to end this opioid epidemic," he said.

The pharmacies did not immediately respond to requests for comment ...
/ 2021 News, Daily News
The California Insurance Commissioner adopted and issued lower rates for workers’ compensation insurance, as businesses continue to recover from the COVID-19 pandemic and rehire workers - reducing the benchmark rate by $.05 to $1.41 per $100 of payroll for workers’ compensation insurance, effective September 1, 2021.

The recommended rate reduction is based on insurance companies’ cost data. The pure premium rate is only advisory, as the State Legislature has not given the Commissioner rate setting authority over workers’ compensation rates.

The newly approved average advisory pure premium rate level of $1.41 approved by the Commissioner is about 24.2 percent lower than the industry-filed average pure premium rate of $1.86 as of January 1, 2021.

This marks the eleventh consecutive reduction to the average advisory pure premium rate benchmark since January 2015.

Last year, the Commissioner resisted calls to add a COVID-19 surcharge to employers’ rates, citing uncertainty over the impact of the pandemic on future workers’ compensation claims and costs. The surcharge would have especially affected employers of farm workers, health care workers, grocery workers, and other front-line workers.

With workers’ compensation claims related to COVID-19 now falling amid the vaccine rollout and public health actions, this year’s pure premium rates again do not include a pandemic factor.

The decision results in an average advisory pure premium rate that is below the $1.50 average rate recommended by the Workers' Compensation Insurance Rating Bureau of California (WCIRB) in its filing with the Department of Insurance.

The advisory rate was issued after a public hearing that he convened on June 7, 2021 and careful review of the testimony and evidence submitted by stakeholders.
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/ 2021 News, Daily News
One of the largest hospital systems in the nation and two of its doctors will pay $37.5 million to resolve violations of the False Claims Act and the California False Claims Act. The settlement - which resolved two cases - is a joint resolution with the U.S. Department of Justice and the California Department of Justice.

The United States and California entered into a settlement agreement with the Prime Healthcare Services system; Prime’s founder and Chief Executive Officer, Dr. Prem Reddy; and interventional cardiologist Dr. Siva Arunasalam to resolve alleged violations of the False Claims Act and the California False Claims Act based on kickbacks paid by Prime to Arunasalam for patient referrals.

Prime includes the Ontario-based Prime Healthcare Services Inc., Prime Healthcare Foundation Inc., Prime Healthcare Management Inc., High Desert Heart Vascular Institute (HDHVI), and Desert Valley Hospital Inc.

Under the settlement agreement, Arunasalam will pay $2 million. Reddy has already paid $1,775,000, and Prime has paid $33,725,000. The United States will receive $35,463,057 of the settlement proceeds, and California will receive $2,036,943.

In 2018, Prime and Reddy paid $65 million to settle unrelated allegations of false claims and overbilling.

The settlement resolves allegations that:

- - Prime paid kickbacks when it overpaid to purchase Arunasalam’s physician practice and surgery center because the company wanted Arunasalam to refer patients to its Desert Valley Hospital in Victorville. The purchase price, which was substantially negotiated by Reddy, exceeded fair market value and was not commercially reasonable. Prime also knowingly overcompensated the doctor when HDHVI entered into an employment agreement with him that was based on the volume and value of his patient referrals to Desert Valley Hospital;
- - For approximately two years between 2015 and 2017, HDHVI and Arunasalam used Arunasalam’s billing number to bill Medicare and Medi-Cal for services that were provided by Dr. George Ponce, even though they knew Ponce’s Medicare and Medi-Cal billing privileges had been revoked, and that billing Ponce’s services under Arunasalam’s billing number was improper; and
- - Certain Prime hospitals billed Medi-Cal, the Federal Employees Health Benefits Program, and the U.S. Department of Labor’s Office of Workers’ Compensation Programs for false claims based on inflated invoices for implantable medical hardware. Arunasalam was not implicated in this conduct.

In connection with the settlement, Prime and Reddy entered into a five-year Corporate Integrity Agreement (CIA) with the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). The CIA requires, among other things, that Prime maintain a compliance program and hire an Independent Review Organization to review arrangements entered into by or on behalf of its subsidiaries and affiliates.

The civil settlement includes the resolution of claims brought under the qui tam, or whistleblower, provisions of the False Claims Act in two lawsuits filed in federal court in Los Angeles. One suit was filed by Martin Mansukhani, a former Prime executive. The second suit was filed by Marsha Arnold and Joseph Hill, who were formerly employed in the billing office at Shasta Regional Medical Center, a Prime hospital in Redding, California.

Under the qui tam provisions of the False Claims Act, a private party can file an action on behalf of the United States and receive a portion of any recovery. Although the United States did not intervene in these cases, it continued to investigate the whistleblowers’ allegations and helped to negotiate the settlement announced today. Mr. Mansukhani will receive $9,929,656 as his share of the federal government’s recovery ...
/ 2021 News, Daily News
The Division of Workers’ Compensation announced that as of July 26, 2021, the public counters at all district offices will open for in-person filing, questions, and assistance.

The Return-to-Work Supplement kiosks will also reopen. Information and Assistance officers will be onsite in most offices to answer questions and provide other assistance.

Parties are strongly encouraged to continue to submit documents by the DWC’s e-filing or JET filing system to reduce processing times due to limited DWC in-office staffing.

The Eureka office is now completely virtual as announced in the Newsline dated April 14, 2021, and all documents for cases venued in Eureka that cannot be e-filed or JET filed should be mailed to the Santa Rosa office.

District offices will not hold in-person hearings or accept "walk-through" documents at this time.

Until further notice, DWC will continue to hear all mandatory settlement conferences, priority conferences, status conferences, case-in-chief trials, lien conferences, lien trials, Special Adjudication Unit (SAU) trials and expedited hearings telephonically via the individually assigned judges’ conference lines as announced in Newslines issued on April 3, April 28, May 28, August 12, and September 9, 2020.

Parties may continue to contact the DWC’s call center to obtain assistance via telephone at (909) 383-4522.
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/ 2021 News, Daily News
Loews Hollywood Hotel, LLC employed Jessica Ferra as a bartender. Loews paid Ferra hourly wages as well as quarterly nondiscretionary incentive payments.

For the days when she had to work during lunch or a rest break, her employer paid Ferra only the hourly wage and did not include a percentage of the quarterly incentive.

Ferra filed a class action suit against Loews. Ferra alleged that Loews, by omitting nondiscretionary incentive payments from its calculation of premium pay, failed to pay her for noncompliant meal or rest breaks in accordance with her "regular rate of compensation" as required by Labor Code section 226.7(c).

The trial court granted summary adjudication for Loews on the ground that calculating premium pay according to an employee’s base hourly rate is proper under Labor Code section 226.7(c). The court agreed with Loews that "regular rate of compensation" in section 226.7(c) is "not interchangeable" with the term "regular rate of pay" under section 510(a), which governs overtime pay.

The Court of Appeal affirmed, holding that "regular rate of compensation" in section 226.7(c) and "regular rate of pay" in section 510(a) are "not synonymous, and the premium for missed meal and rest periods is the employee’s base hourly wage."

The California Supreme Court reversed in the case of Ferra v Loews Hollywood Hotel, LLC.

The question is what the Legislature meant when it used the phrase "regular rate of compensation" in section 226.7(c). Neither the Labor Code nor Wage Order No. 5-2001 defines the term, and the words by themselves may reasonably be construed to mean either hourly wages, as Loews contends, or hourly wages plus nondiscretionary payments, as Ferra contends.

After review of the legislative history and case law, The Supreme Court held that the term "regular rate of compensation" in section 226.7(c) has the same meaning as "regular rate of pay" in section 510(a) and encompasses not only hourly wages but all nondiscretionary payments for work performed by the employee.

This interpretation of section 226.7(c) comports with the remedial purpose of the Labor Code and wage orders and with our general guidance that the "state’s labor laws are to be liberally construed in favor of worker protection."

It also rejected Loews’s request that the decision be prospectively applied. The decision shall have retroactive effect ...
/ 2021 News, Daily News
On July 14, 2021, longtime occupational safety and health expert Fred A. Manuele received the inaugural Prevention through Design (PtD) Award for his outstanding foresight, wisdom, tireless effort and major accomplishments in preventing harm to workers by helping organizations avoid and prevent hazards.

The new PtD award recognizes individuals, teams, businesses or other organizations that have improved worker safety and health by designing-out hazards or contributing to the body of knowledge that enables PtD solutions. The annual award is presented by the National Institute for Occupational Safety and Health (NIOSH), the American Society of Safety Professionals (ASSP) and the National Safety Council (NSC).

PtD aims to prevent or reduce occupational injuries, illnesses and fatalities through the inclusion of prevention considerations in all designs that impact workers. This includes the design, redesign and retrofit of new and existing work premises, structures, tools, facilities, equipment, machinery, products, substances, work processes and the organization of work. In addition to reducing the risk of serious injury and illness, significant cost savings are often associated with hazard elimination and the application of engineering controls to minimize risks.

NIOSH Director John Howard, M.D., praised Manuele’s contributions to the field: "The work spearheaded by Fred Manuele was groundbreaking and inspired the NIOSH Prevention through Design effort. He has worked tirelessly to protect workers though design."

Manuele is a pioneer in the PtD field. ASSP republished many of his influential professional papers in a book titled, Fred Manuele on Safety Management: A Collection from Professional Safety. Manuele also published numerous occupational safety and health textbooks that always included the need for designing-out hazards and the methods to do so.

"I can’t think of an individual who is more worthy than Fred to receive this first award," said Deborah R. Roy, ASSP’s immediate past president. "I’ve known him for many years and served as a reviewer of the Prevention through Design standard that Fred guided. No one has been more dedicated or accomplished in this area of workplace safety and health."

In 1995, Manuele led a focused, 10-year NSC initiative, the Institute for Safety Through Design, which culminated in a textbook he co-authored titled, Safety Through Design. Over the years he has published other textbooks and many scientific papers on safety engineering.

"Fred’s leadership at NSC and beyond has greatly advanced the field of design safety," said Lorraine Martin, NSC president and CEO. "We thank him for his myriad contributions to worker safety and congratulate him on this well-deserved award."

In 2007, NIOSH and numerous partners launched a National Prevention through Design Initiative. Manuele volunteered to lead the effort to develop and approve a broad, generic voluntary consensus standard on PtD aligned with international design activities and practice. Under the standards-development arm of ASSP, the ASSP/ANSI Z590.3 Prevention through Design standard was published in 2011, reaffirmed in 2016, and is now under revision to expand its usefulness and impact worldwide.

Manuele has received many honors and awards for his accomplishments. He is an ASSP Fellow and a recipient of the NSC’s Distinguished Service to Safety Award. He is a former board member of ASSP, NSC and the Board of Certified Safety Professionals, where he also served as president and received a Lifetime Achievement Award in 2013. In 2015, the University of Central Missouri presented him with its Distinguished Service Award. In 2016, Manuele received the ASSP President's Award for his dedication to advancing the practice of safety ...
/ 2021 News, Daily News
In 2007, Purdue Pharma paid out one of the largest fines ever levied against a pharmaceutical firm for mislabeling of its product OxyContin, and three executives were found guilty of criminal charges. The company is seen by many as the origination of what became the opioid crisis.

After becoming the target of multiple civil actions across the states, Purdue Pharma, is seeking Chapter 11 bankruptcy protection in the U.S. Bankruptcy Court in the Southern District of New York.

Nine states have yet to agree to the Purdue Pharma bankruptcy plan. They include Connecticut, where the company is headquartered, as well as California, Delaware, Maryland, New Hampshire, Oregon, Rhode Island, Vermont and Washington. The District of Columbia also hasn't agreed to the deal. They seek further liability from Purdue’s owners. Specifically, the states say individual members of the Sackler family directed marketing that misled the doctors who wrote OxyContin prescriptions and the patients given the addictive painkiller recklessly.

Courthouse News reports that Connecticut Attorney General William Tong had harsh words Friday when attorneys representing the family who owns the bankrupt OxyContin maker Purdue Pharma, threatened a demand for sanctions against four states and the District of Columbia.

Tong said the Sackler’s attorneys sent an email the previous day with a motion for sanctions, complete with about 165 pages of exhibits, against Connecticut, California, Maryland, Rhode Island and the District of Columbia.

In the draft motion, the Sackler family’s attorneys said they sought the sanctions, including fees and reprimands, because the states made allegations that lacked evidence.

One example quoted in the filing is that Connecticut ignored the Sacklers’ demand that it produce documents to back up its allegation that the family engaged in "Knowing Participation in Deception."

"There is no evidence that Beverly, David, Jonathan or Richard Sackler had any involvement in the drafting or approval of the content of marketing material or what sales representatives said, were authorized to say or prohibited from saying during the Relevant Period," the draft motion states. Attorneys for the Sackler family wrote that they were serving the draft 21 days before they intended to file it to give the states an opportunity to back up their assertions.

Tong said the Sackler family attorneys withdrew the motion Friday morning "after they got tremendous blowback from a lot of different parties" for the move. In a sharp series of comments, Tong described the withdrawn proposal as a threat against his state, "an organized crime family intimidation tactic" and "colossally idiotic."

Tong said he made the allegations at issue in a complaint filed more than two years ago, and the last-minute filing was an attempt to pressure the state to accept a settlement proposal. "The Sacklers are trying to use the company’s bankruptcy to shield themselves from liability and from paying what they ought to pay for their role in causing and fueling the opioid crisis," Tong said ...
/ 2021 News, Daily News
A 24-year-old San Jacinto man who faked an injury to collect tens of thousands of dollars in workers’ compensation insurance funds pleaded guilty Thursday to a felony charge and was immediately sentenced to 24 months probation.

According to the report by MyNewsLA.com, Angel Luis Maces admitted one count of insurance fraud under a plea agreement with the Riverside County District Attorney’s Office, and in exchange for his admission, prosecutors dropped a second related charge.

Superior Court Judge David Gunn certified the terms of the plea deal and imposed the sentence stipulated by the prosecution and defense. In addition to probation, Gunn ordered the defendant to serve 270 days in a sheriff’s work release program and pay victim restitution totaling $76,868.

Maces was arrested in February following a months long investigation by the California Department of Insurance.

According to the DOI, in September 2018, the defendant was employed by a Temecula landscaping company that sent him to Duarte to perform turf upkeep, but while on the job, he told his supervisors that he’d slipped and injured his knee.

Maces filed a workers’ comp claim through his employer’s insurance company after several examinations, at which point he began collecting workers' compensation benefits.

The insurer suspected in April 2020 that Maces was not as injured as he had told his physician and employer, and the case was referred to the California Department of Insurance for further investigation.

"Surveillance during the investigation showed Maces conducting activities that contradicted the physical limitations he described," the agency stated. "On multiple occasions, Maces was seen not using a cane or crutches, even though he claimed he had to use them 100% of the time because of the injury."

Investigators claimed that $42,888 in unwarranted benefits were paid ...
/ 2021 News, Daily News
NPR-KCUR in Kansas City reports that Pfizer Inc. and two other companies have agreed to pay $345 million to resolve long-running litigation over EpiPen price hikes. In 2007 an EpiPen package cost about $100. Today, it costs more than $650 without pharmacy coupons or manufacturer discounts.

EpiPens are auto-injectable devices that deliver the drug epinephrine, which is used to treat life-threatening allergic reactions known as anaphylaxis. Anaphylaxis is most commonly caused by food allergies but can also be caused by insect bites, medications and other substances.

The litigation dates to 2016, when numerous class action lawsuits were filed against Pfizer, Mylan and other defendants alleging they engaged in anticompetitive conduct in connection with their marketing of the EpiPen.

The lawsuits were transferred to federal court in Kansas City, Kansas, because of its geographical centrality. Trial was scheduled to begin this Sept. 7, but if Crabtree approves the settlement, Pfizer and the two other companies proposing to settle - Meridian Medical Technologies Inc. and King Pharmaceuticals Inc. - will be off the hook.

Multiple law firms have been involved in the complex litigation, which featured the production of over 11 million pages of documents and 158 depositions, according to court documents.

In documents filed in federal court in Kansas City, Kansas, the companies asked the court to grant preliminary approval to the settlement, which would end the litigation against the three companies.

The proposed settlement comes just three weeks after U.S. District Judge Daniel Crabtree granted summary judgment to another defendant, Mylan, on the plaintiffs’ racketeering claims and some antitrust claims. But he allowed other antitrust claims against Mylan to proceed to trial.

A Pfizer spokesperson said in an email that the company "denies any wrongdoing and continues to believe its actions were appropriate."

"This resolution reflects a desire by the Company to avoid the distraction of continued litigation and focus on breakthroughs that change patients’ lives," the spokesperson said.

Rex Sharp, a Prairie Village lawyer representing the plaintiffs, said in an email that his clients were pleased that Pfizer had agreed to the settlement while noting it still requires court approval.

He said the plaintiffs looked forward to trying the remaining claims against Mylan before a jury. Mylan owns the rights to the EpiPen brand, but the devices are manufactured by Pfizer ...
/ 2021 News, Daily News
The Los Angeles County Department of Pubic Health reports that the community transmission of COVID-19 has rapidly increased from Moderate to Substantial, based on the trend in daily new cases of COVID-19.

On June 15, the day of the full reopening, the County saw 210 new cases and today the Los Angeles County Department of Public Health (Public Health) confirms the highest number of new COVID-19 cases since mid-March with 1,537 new cases. Today’s test positivity rate is 3.7%; on June 15, the test positivity rate was around 0.5%.

As a result, the Los Angeles County Health Officer Order will be modified to require masking for everyone while indoors, regardless of vaccination status, as Los Angeles County sees more than a seven-times increase in new cases since the June 15 reopening. Wearing a mask when indoors reduces the risk of both getting and transmitting the virus. This additional layer of protection can help to slow the spread and does not limit business occupancy and operations.

The L.A. County indoor masking requirements for everyone will be effective Saturday, July 17 at 11:59 p.m. Some exceptions will apply, similar to masking requirements that were in place prior to the June 15 reopening.

Tracking the proliferation of the Delta variant is a priority because the Delta variant is more easily spread between people - more than other variants of concern. And while emerging data affirms that fully vaccinated people are well protected from severe infections with Delta variants, people with only one vaccine are not as well-protected, and there is evidence that a very small number of fully vaccinated individuals can become infected and may be able to infect others.

From June 27 to July 3, the number of sequenced Delta variants was 124, 71% of all sequences collected that week. Given that slightly under 4 million residents in L.A. County are not yet vaccinated, the risk of increased spread of this variant within the County remains high.

To date, Public Health identified 1,262,578 positive cases of COVID-19 across all areas of L.A. County and a total of 24,566 deaths. Of the three new deaths reported today, one person that passed away was over the age of 80, and two people who passed were between the ages of 50 and 64. Testing results are available for more than 7,142,000 individuals with 16% of people testing positive. There are 406 people with COVID-19 currently hospitalized and 22% of these people are in the ICU.

As of July 11, more than 10,712,037 doses of COVID-19 vaccine have been administered to people across Los Angeles County. Of these, 5,946,447 were first doses and 4,763,590 were second doses. Among L.A. County residents 16 and over, 69% have received one dose of vaccine and 61% have been fully vaccinated. Among L.A. County seniors 65 and over, 88% have received one dose of vaccine and 78% have been fully vaccinated ...
/ 2021 News, Daily News
A man who is unable to move or speak can now generate words and sentences on a computer using only his thoughts.

The ability comes from an experimental implanted device that decodes signals in the man's brain that once controlled his vocal tract, as researchers reported Wednesday in The New England Journal of Medicine.

The man is currently limited to a vocabulary of just 50 words and communicates at a rate of about 15 words per minute, which is much slower than natural speech.

"This tells us that it's possible," says Edward Chang, a neurosurgeon at the University of California, San Francisco. "I think there's a huge runway to make this better over time."

A device that allowed people who can't speak to communicate using brain circuits previously used for speech would be "more natural, and hopefully effortless compared to current assistive devices," says Chethan Pandarinath, an assistant professor in the Department of Biomedical Engineering at Emory University and Georgia Tech.

Currently, people with paralysis who have lost the ability to speak usually rely on devices that use eye or head movements to spell out words one letter at a time. Some use a device that allows them to control a computer cursor with thoughts.

Chang's team wanted to find a better solution for the man, identified only as BRAVO1 to protect his privacy. The name refers to his status as the first patient in a study called BRAVO, or Brain-Computer Interface Restoration of Arm and Voice.

BRAVO1, who is in his late 30s, has been paralyzed and unable to speak since he had a stroke 15 years ago, Chang says.

"The stroke left him nearly completely paralyzed in his arms and legs but also in the muscles of his vocal tract," Chang says. But the areas of the brain that once issued speech commands are intact.

"We didn't know if the speech commands in the brain would still work after 15 years," he says. "And even if we could revive those dormant brain signals for speech, could we actually translate those into full words?"

To find out, the team implanted sensors on the surface of the man's brain. Then it had a computer study the patterns of electrical activity produced when he attempted to speak 50 different words. The process took months.

Once BRAVO1 could reliably generate words on a computer screen, the team began having him form sentences. To help improve accuracy, the team added a program that analyzed the context of each word as it was added.

The system is a bit like the texting software on most smartphones. "So, for example, if one word is just not decoded correctly, this autocorrect function can correct it," Chang says.

After months of adjustments to the system, the man was able to generate a word reliably every four seconds, or roughly 15 words per minute.

A device able to decode words in the brain could eventually help thousands of people who've had a stroke or a traumatic brain injury, says Krishna Shenoy, a professor in the School of Engineering at Stanford University.

The ability to recognize even 50 words in the brain is a huge achievement, Shenoy says. "But I think that's just the tip of the iceberg. I think that could easily become 500 or 5,000 words." ...
/ 2021 News, Daily News
A California licensed homeopathic doctor was arrested for her alleged scheme to sell homeoprophylaxis immunization pellets and falsify COVID-19 vaccination cards by making it appear that customers received the FDA authorized Moderna vaccine.

41 year old Juli A. Mazi N.D. , of Napa, is charged with one count of wire fraud and one count of false statements related to health care matters. The case is the first federal criminal fraud prosecution related to homeoprophylaxis immunizations and fraudulent CDC COVID-19 vaccination record cards.

Dr. Mazi received her doctorate in Naturopathic Medicine from the National University of Natural Medicine in Portland, Oregon where she trained in the traditional medical sciences as well as ancient and modern modalities that rely on the restorative power of Nature to heal.

According to court documents, in April 2021, an individual submitted a complaint to the Department of Health and Human Services Office of Inspector General (HHS-OIG) hotline. The complainant stated that the family members purchased pellets from Mazi, and were told the pellets contained the COVID-19 virus and would create an antibody response in the immune system.

The family members did not receive injections of any of the three FDA-authorized COVID-19 vaccines. However, Mazi sent COVID-19 Vaccination Record cards, with Moderna listed, to the family, and allegedly instructed the family members to mark the cards to falsely state that they received the Moderna vaccine on the date that they ingested the COVID-19 homeoprophylaxis immunization pellets.

Homeoprophylaxis involves the exposure of an individual to dilute amounts of a disease, purportedly to stimulate the immune system and confer immunity. Mazi is alleged to have falsely claimed that orally ingesting pellets with small amounts of COVID-19 would result in full lifelong immunity from COVID-19.

Prosecutors also claim Mazi offered homeoprophylaxis immunizations for childhood illnesses that she falsely claimed would satisfy the immunization requirements for California schools, and falsified immunization cards that were submitted by parents to California schools.

If convicted, Mazi faces a maximum statutory prison sentence of 20 years for the wire fraud charge and 5 years for the false statements charge. In addition, each charge carries a maximum $250,000 fine and 3 years of supervised release.

Dr. Juli Mazi is a member of the California Naturopathic Doctors Association and the American Association of Naturopathic Physicians (AANP) ...
/ 2021 News, Daily News
The U.S. government does not track death rates for every drug. However, the National Center for Health Statistics (NCHS) at the Centers for Disease Control and Prevention collects information on deaths involving many of the more commonly used drugs available through 2019 at a searchable database, called CDC Wonder. The NCHS also has 12 month-ending provisional data available by state and drug category.

The NCHS recently reported that drug overdose deaths rose by close to 30% in the United States in 2020, hitting the highest number ever recorded.

More than 93,000 people died from drug overdoses in 2020, according to provisional data released by the CDC's National Center for Health Statistics. That's a 29.4% increase from the 72,151 deaths projected for 2019.

In California, more than 9,500 people died from drug overdoses in 2020, up from 6,500 projected in 2019, a 45.9% increase.

"Overdose deaths from synthetic opioids (primarily fentanyl) and psychostimulants such as methamphetamine also increased in 2020 compared to 2019. Cocaine deaths also increased in 2020, as did deaths from natural and semi-synthetic opioids (such as prescription pain medication)," the NCHS said in a statement.

"This is the highest number of overdose deaths ever recorded in a 12-month period, and the largest increase since at least 1999," Dr. Nora Volkow, director of the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, said in a statement.

"These data are chilling. The COVID-19 pandemic created a devastating collision of health crises in America," added Volkow.

As in recent years, inappropriate use of opioids was behind most of the deaths. The NCHS reported that overdose deaths from opioids rose from 50,963 in 2019 to 69,710 in 2020.

President Joe Biden on Tuesday nominated Dr. Rahul Gupta of West Virginia to serve as the administration’s top drug policy official. The former state health commissioner is slated to become the first physician to ever lead the White House Office of National Drug Control Policy, or ONDCP, if confirmed by the Senate. If confirmed, he will replace Regina LaBelle, acting director of the ONDCP , who is an Obama administration alum.

Gupta, a primary care doctor, went on to serve as the chief medical and health officer at March of Dimes, a maternal-and-child advocacy group, after his time working in the West Virginia state government.

Gupta received criticism from some drug reform advocates, who expressed disapproval of the closure of a needle exchange program in Charleston, West Virginia, under his leadership.

"Dr. Gupta brings firsthand experience as a medical doctor and public health official using evidence-based strategies to address the overdose epidemic in West Virginia," the White House said in a statement. "We hope he will be confirmed by the Senate soon."

Some say this nomination is a signal that government is looking to integrate medical solutions to reduce the national drug problem under Dr. Gupta's leadership ...
/ 2021 News, Daily News
The Medical Indicators & Trends dashboard - Q4 2020 Edition is part of NCCI’s ongoing strategy to deliver more medical data insight.

It provides an interactive way to visualize state-specific information presented in the Q2 and Q3 2020 Medical Perspective reports and allows readers to download various summary tables.

More detailed state-specific Medical Data Reports can be found in State Insight, which is available to affiliates and regulators.

NCCI just announced the second edition of the dashboard.

It now includes summarized statistics for hospital outpatient services and ambulatory surgery centers, in addition to the key metrics it has been following, to better understand the direct and indirect impacts of COVID-19.

These include impacts to physician services, time to treatment, telemedicine, prescription drugs, and specific COVID-19 treated claim characteristics.

The data source used in this dashboard is NCCI’s Medical Data Call. The Medical Data Call represents data from most of the workers compensation premium written, which includes experience for large-deductible policies. Lump-sum settlements are not required to be reported. Also, self-insured data is generally not included.

While it is too early to fully assess the impact that the COVID-19 pandemic will have on the workers compensation system, this dashboard allows users to analyze state-specific medical treatment results during the spread of the pandemic ...
/ 2021 News, Daily News
51 year old Jason Vertz, of Fresno, and 45 year old Alana Powers, an inmate at the Central California Women’s Facility (CCWF) in Chowchilla, were each sentenced to five years and one month in prison for conspiracy to commit mail fraud and aggravated identity theft.

According to court documents, Vertz and Powers submitted several fraudulent unemployment insurance claims in Powers’ and other CCWF inmates’ names to the California Employment Development Department (EDD). Recorded jail calls and emails show that Powers and other inmates provided names, dates of birth, and social security numbers for inmates at CCWF to Vertz to submit the fraudulent claims. Shortly thereafter, the benefits were loaded onto debit cards that were mailed to the addresses the defendants provided.

The underlying applications for the claims stated that the inmates had worked within the prescribed period as maids, cleaners, fabrication welders, and other occupations, and that they were available to work, which was not true because they were incarcerated. The claims would have been denied if accurate answers had been given. EDD and the United States have suffered an actual loss of over $74,000 as a result of the fraud.

This case was the product of an investigation by the FBI, the California Department of Corrections and Rehabilitation Investigative Services Unit, and the California EDD. Assistant U.S. Attorneys Alexandre Dempsey and Joseph Barton are prosecuting the case.

On May 17, 2021, the Attorney General established the COVID-19 Fraud Enforcement Task Force to marshal the resources of the Department of Justice in partnership with agencies across government to enhance efforts to combat and prevent pandemic-related fraud. The Task Force bolsters efforts to investigate and prosecute the most culpable domestic and international criminal actors and assists agencies tasked with administering relief programs to prevent fraud by, among other methods, augmenting and incorporating existing coordination mechanisms, identifying resources and techniques to uncover fraudulent actors and their schemes, and sharing and harnessing information and insights gained from prior enforcement efforts.

Anyone with information about allegations of attempted fraud involving COVID-19 can report it by calling the Department of Justice’s National Center for Disaster Fraud (NCDF) Hotline at 866-720-5721 or via the NCDF Web Complaint Form at: https://www.justice.gov/disaster-fraud/ncdf-disaster-complaint-form ...
/ 2021 News, Daily News
An Orange County man is expected to be arraigned in federal court on an indictment charging him with defrauding victims who paid for COVID-related medical protective equipment that was never delivered, causing nearly $3 million in losses. 60 year old Christopher John Badsey, who lives Lake Forest, was arrested by FBI agents on July 8 without incident. He is charged with four counts of wire fraud and two counts of money laundering. He was arraigned in United States District Court in downtown Los Angeles. According to an indictment returned by a federal grand jury on July 7, Badsey falsely represented that he had access to millions of boxes of medical-grade nitrile gloves through his Irvine-based company, First Defense International Security Services Corp. (FDI) This type of personal protective equipment was in high demand and short supply during the COVID-19 pandemic. Badsey allegedly entered into contractual agreements with victims, whom he required to provide a money deposit to inspect the gloves before delivery. After receiving the deposits, Badsey allegedly instructed victims to travel to the Los Angeles area, where he claimed the gloves were stored in a warehouse. But when victims attempted to visit the warehouse, Badsey and other FDI employees allegedly provided excuses as to why the gloves could neither be inspected, nor delivered, to the victims. Nitrile gloves were never provided to the victims, and Badsey is alleged to have absconded with the deposit money totaling nearly $3 million. After obtaining the victims’ wire deposits, Badsey and others are believed to have used those funds to make lavish purchases for their personal benefit. If convicted of all charges in the six-count indictment, Badsey would face a statutory maximum sentence of 100 years in federal prison ...
/ 2021 News, Daily News
An Orange County man is expected to be arraigned in federal court on an indictment charging him with defrauding victims who paid for COVID-related medical protective equipment that was never delivered, causing nearly $3 million in losses.

60 year old Christopher John Badsey, who lives Lake Forest, was arrested by FBI agents on July 8 without incident. He is charged with four counts of wire fraud and two counts of money laundering. He was arraigned in United States District Court in downtown Los Angeles.

According to an indictment returned by a federal grand jury on July 7, Badsey falsely represented that he had access to millions of boxes of medical-grade nitrile gloves through his Irvine-based company, First Defense International Security Services Corp. (FDI)

This type of personal protective equipment was in high demand and short supply during the COVID-19 pandemic.

Badsey allegedly entered into contractual agreements with victims, whom he required to provide a money deposit to inspect the gloves before delivery.

After receiving the deposits, Badsey allegedly instructed victims to travel to the Los Angeles area, where he claimed the gloves were stored in a warehouse. But when victims attempted to visit the warehouse, Badsey and other FDI employees allegedly provided excuses as to why the gloves could neither be inspected, nor delivered, to the victims.

Nitrile gloves were never provided to the victims, and Badsey is alleged to have absconded with the deposit money totaling nearly $3 million. After obtaining the victims’ wire deposits, Badsey and others are believed to have used those funds to make lavish purchases for their personal benefit.

If convicted of all charges in the six-count indictment, Badsey would face a statutory maximum sentence of 100 years in federal prison.
...
/ 2021 News, Daily News
The owner of trucking companies in the Inland Empire and elsewhere in California, who was out on bond awaiting trial in a separate federal criminal case, was arrested on a criminal complaint alleging he fraudulently obtained more than $667,000 in Paycheck Protection Program (PPP) COVID-19 pandemic relief funds.

62 year olld Carl Bradley Johansson, who lives in Newport Beach, was arrested and is charged with one count of bank fraud and one count of conspiracy to commit bank fraud.

Johansson was on pretrial release in a separate case that remains scheduled to go on trial on September 14. In that matter, Johansson is alleged to have schemed to defeat federal transportation laws by ordering the illegal repair of an oil tanker that resulted in a fatal explosion in 2014, and to have unlawfully avoided the payment of at least $298,562 in federal income taxes from 2012 to 2017.

According to an affidavit filed with the complaint, in April 2020, under Johansson’s direction, the Ontario-based trucking company Western Distribution LLC applied for a PPP loan in the amount of $436,390. Johansson’s son was listed as the company’s owner on the loan application and the loan application was approved.

Under Johansson’s direction, Western Distribution LLC immediately spent its PPP funds in May and June 2020, in large part on expenses unrelated to its payroll. Rather than use the funds to keep the company’s employees on staff, Johansson laid off most of the company’s employees, but rehired many of them in late 2020.

Also in April 2020, a different Johansson-controlled trucking company - a Merced County-based business identified in the affidavit as "Company A" - applied to another federally insured bank for its own PPP loan in the amount of $286,505, according to the affidavit. Johansson’s 85-year-old mother was listed as Company A’s owner on its PPP loan application, which was approved in the amount of $286,500.

To create the impression that Western Distribution LLC had spent more of its PPP loan on its payroll than it actually did, in September 2020 Johansson moved 21 of Company A’s employees onto Western Distribution LLC’s payroll, even though those employees never worked for Western Distribution, LLC, the affidavit alleges. This allegedly occurred just before the company’s 24-week window for spending its PPP funds closed.

As a result of this ruse, Western Distribution LLC could falsely claim on its PPP loan forgiveness application in January 2021 that the company had met the requisite threshold of spending at least 60 percent of its PPP loan on payroll, according to the affidavit.

In March 2021, Johansson allegedly caused Western Distribution LLC to repeat the same fraudulent representations concerning its employee lists and payroll numbers when the company submitted a second PPP loan application, this time for $231,527. The second loan application was approved.

The total loss alleged in this case is approximately $667,917.

If convicted of both charges, Johansson would face a statutory maximum sentence of 70 years in federal prison.
...
/ 2021 News, Daily News