Fifteen states that led the effort to block a controversial bankruptcy plan for OxyContin-maker Purdue Pharma have abandoned the fight.
That's according to court documents reviewed by NPR and filed by a mediator late Wednesday as part of a federal bankruptcy proceeding in White Plains, N.Y.
Among the states that have agreed to sign on to the bankruptcy deal are Massachusetts and New York, whose attorneys general had mounted fierce legal opposition to the agreement.
The other states now abandoning their opposition to the deal are: Colorado, Hawaii, Idaho, Illinois, Iowa, Maine, Minnesota, Nevada, New Jersey, North Carolina, Pennsylvania, Virginia and Wisconsin.
According to the mediator, 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.
"The negotiations were difficult and hard-fought, with the outcome uncertain," said federal bankruptcy Judge Shelley C. Chapman in the legal filing.
The settlement plan, which is now all but certain to be finalized next month, would shelter members of the Sackler family, who own Purdue Pharma, and many of their associates from future opioid lawsuits.
In return, the Sacklers have agreed to give up ownership of the bankrupt drug company. They will also pay out roughly $4.2 billion from their private fortunes in installments spread over the next decade.
According to the mediator's report, the Sacklers have now agreed to boost their settlement payment by a relatively modest amount - roughly $50 million.
The deal also includes a "material expansion" of the public document repository already created under the settlement plan that aims to provide some transparency about Purdue Pharma's role in the opioid epidemic.
Purdue Pharma has pleaded guilty twice to federal criminal charges related to its opioid marketing practices, first in 2007 and again last year.
The Sacklers have never faced charges. Under this deal, they will admit no wrongdoing and will remain one of the wealthiest families in the U.S.
...
That's according to court documents reviewed by NPR and filed by a mediator late Wednesday as part of a federal bankruptcy proceeding in White Plains, N.Y.
Among the states that have agreed to sign on to the bankruptcy deal are Massachusetts and New York, whose attorneys general had mounted fierce legal opposition to the agreement.
The other states now abandoning their opposition to the deal are: Colorado, Hawaii, Idaho, Illinois, Iowa, Maine, Minnesota, Nevada, New Jersey, North Carolina, Pennsylvania, Virginia and Wisconsin.
According to the mediator, 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.
"The negotiations were difficult and hard-fought, with the outcome uncertain," said federal bankruptcy Judge Shelley C. Chapman in the legal filing.
The settlement plan, which is now all but certain to be finalized next month, would shelter members of the Sackler family, who own Purdue Pharma, and many of their associates from future opioid lawsuits.
In return, the Sacklers have agreed to give up ownership of the bankrupt drug company. They will also pay out roughly $4.2 billion from their private fortunes in installments spread over the next decade.
According to the mediator's report, the Sacklers have now agreed to boost their settlement payment by a relatively modest amount - roughly $50 million.
The deal also includes a "material expansion" of the public document repository already created under the settlement plan that aims to provide some transparency about Purdue Pharma's role in the opioid epidemic.
Purdue Pharma has pleaded guilty twice to federal criminal charges related to its opioid marketing practices, first in 2007 and again last year.
The Sacklers have never faced charges. Under this deal, they will admit no wrongdoing and will remain one of the wealthiest families in the U.S.
...
Bank of America, which since 2010 has had an exclusive contract with the state to deliver unemployment benefits through prepaid debit cards, wants to end the contract - even though the Employment Development Department just renewed it for another two years.
The news, first reported by ABC 7 in San Francisco, comes about a month after a federal judge - as part of a class-action lawsuit first reported by CalMatters - ordered Bank of America to stop using an automated fraud filter that blocked tens of thousands of legitimate claimants from accessing their benefits after they reported suspicious account activity.
The bank said it received 230,000 claims of debit card fraud from October 2020 through March 2021.
Bank of America’s desire to end the contract is striking, given that both the bank and the state are paid merchant fees whenever an unemployment debit card is swiped. EDD has pocketed millions in fees amid the pandemic: It earned more than $47 million from March 2020 through April 2021, even though the claims of more than 1.1 million jobless Californians remain in limbo.
However, Bank of America told state lawmakers it lost "hundreds of millions" of dollars on the contract last year as it scrambled to respond to California’s rampant unemployment fraud, which experts say could total upward of $31 billion.
Bank of America: "We have advised the state that we would like to exit this business as soon as possible."
Ultimately, the cost of California’s unemployment fraud will likely fall on taxpayers. And businesses will likely shoulder the staggering weight of California’s unemployment insurance debt, which experts estimate could reach $26.7 billion by the end of the year.
Meanwhile, EDD is still struggling to answer the millions of calls it receives each week - so much so that California’s 80 state assemblymembers were just given the green light to hire two staffers each to handle EDD problems ...
The news, first reported by ABC 7 in San Francisco, comes about a month after a federal judge - as part of a class-action lawsuit first reported by CalMatters - ordered Bank of America to stop using an automated fraud filter that blocked tens of thousands of legitimate claimants from accessing their benefits after they reported suspicious account activity.
The bank said it received 230,000 claims of debit card fraud from October 2020 through March 2021.
Bank of America’s desire to end the contract is striking, given that both the bank and the state are paid merchant fees whenever an unemployment debit card is swiped. EDD has pocketed millions in fees amid the pandemic: It earned more than $47 million from March 2020 through April 2021, even though the claims of more than 1.1 million jobless Californians remain in limbo.
However, Bank of America told state lawmakers it lost "hundreds of millions" of dollars on the contract last year as it scrambled to respond to California’s rampant unemployment fraud, which experts say could total upward of $31 billion.
Bank of America: "We have advised the state that we would like to exit this business as soon as possible."
Ultimately, the cost of California’s unemployment fraud will likely fall on taxpayers. And businesses will likely shoulder the staggering weight of California’s unemployment insurance debt, which experts estimate could reach $26.7 billion by the end of the year.
Meanwhile, EDD is still struggling to answer the millions of calls it receives each week - so much so that California’s 80 state assemblymembers were just given the green light to hire two staffers each to handle EDD problems ...
The United States spends more on health care than any other country, with costs approaching 18% of the gross domestic product (GDP).
Overtreatment and low-value care cost the U.S. healthcare system between $75.7 and $101.2 billion annually. Despite the associated high cost, unnecessary or ineffective care appear to be on the rise.
A search of peer-reviewed and "gray" literature from January 2012 to May 2019 focused on the 6 waste domains previously identified by the Institute of Medicine and Berwick and Hackbarth: failure of care delivery.
Computations yielded the following estimated ranges of total annual cost of waste: failure of care delivery, $102.4 billion to $165.7 billion; failure of care coordination, $27.2 billion to $78.2 billion; overtreatment or low-value care, $75.7 billion to $101.2 billion; pricing failure, $230.7 billion to $240.5 billion; fraud and abuse, $58.5 billion to $83.9 billion; and administrative complexity, $265.6 billion.
One strategy to promote quality, value-based care is applying evidence-based medicine (EBM) to help guide treatment decisions. EBM integrates medical research with clinical expertise and patient values to support decision making based on the best available evidence.
How well does that work? Researchers attempted to answer that question in a study recently published in the journal PLOS, "Guideline adherence and lost workdays for acute low back pain in the California workers’ compensation system."
In the U.S., state workers’ compensation (WC) systems have developed or adopted treatment guidelines to promote evidence-based care for occupational injuries. The most common occupational injury is back strain, and occupational stressors are thought to contribute to low back pain (LBP). The point of this new study was to quantify the influence of adherence to guideline-recommended interventions in the first week of treatment for an initial low back pain (LBP) injury on lost workdays.
In a retrospective cohort of California’s workers’ compensation claims data from May 2009 to May 2018, 41 diagnostic and treatment interventions were abstracted from the medical claims for workers with acute LBP injuries and compared with guideline recommendations. Lost workdays within 1-year post-injury were compared by guideline adherence. 59,656 workers met the study inclusion criteria.
The reviewers concluded that when workers received guideline-recommended interventions, they typically returned to work in fewer days. The majority of workers received at least one non-recommended intervention, demonstrating the need for adherence to guideline recommendations. Fewer lost workdays and improved quality care are outcomes that strongly benefit injured workers.
With that being said, the study disclosed in its Conflict of Interest Statement that authors Gaspar and Wizner are employed by MDGuidelines, which is the sole proprietor of ACOEM guidelines. Hegmann is Editor-in-Chief of the ACOEM guidelines ...
Overtreatment and low-value care cost the U.S. healthcare system between $75.7 and $101.2 billion annually. Despite the associated high cost, unnecessary or ineffective care appear to be on the rise.
A search of peer-reviewed and "gray" literature from January 2012 to May 2019 focused on the 6 waste domains previously identified by the Institute of Medicine and Berwick and Hackbarth: failure of care delivery.
Computations yielded the following estimated ranges of total annual cost of waste: failure of care delivery, $102.4 billion to $165.7 billion; failure of care coordination, $27.2 billion to $78.2 billion; overtreatment or low-value care, $75.7 billion to $101.2 billion; pricing failure, $230.7 billion to $240.5 billion; fraud and abuse, $58.5 billion to $83.9 billion; and administrative complexity, $265.6 billion.
One strategy to promote quality, value-based care is applying evidence-based medicine (EBM) to help guide treatment decisions. EBM integrates medical research with clinical expertise and patient values to support decision making based on the best available evidence.
How well does that work? Researchers attempted to answer that question in a study recently published in the journal PLOS, "Guideline adherence and lost workdays for acute low back pain in the California workers’ compensation system."
In the U.S., state workers’ compensation (WC) systems have developed or adopted treatment guidelines to promote evidence-based care for occupational injuries. The most common occupational injury is back strain, and occupational stressors are thought to contribute to low back pain (LBP). The point of this new study was to quantify the influence of adherence to guideline-recommended interventions in the first week of treatment for an initial low back pain (LBP) injury on lost workdays.
In a retrospective cohort of California’s workers’ compensation claims data from May 2009 to May 2018, 41 diagnostic and treatment interventions were abstracted from the medical claims for workers with acute LBP injuries and compared with guideline recommendations. Lost workdays within 1-year post-injury were compared by guideline adherence. 59,656 workers met the study inclusion criteria.
The reviewers concluded that when workers received guideline-recommended interventions, they typically returned to work in fewer days. The majority of workers received at least one non-recommended intervention, demonstrating the need for adherence to guideline recommendations. Fewer lost workdays and improved quality care are outcomes that strongly benefit injured workers.
With that being said, the study disclosed in its Conflict of Interest Statement that authors Gaspar and Wizner are employed by MDGuidelines, which is the sole proprietor of ACOEM guidelines. Hegmann is Editor-in-Chief of the ACOEM guidelines ...
The number of new COVID-19 infections in Los Angeles County again pushed over the 500 mark on Wednesday, July 7, while the number of people hospitalized reached nearly 300, prompting health officials to promote a community-outreach program aimed at spreading the word about infection-control efforts.
The county has been seeing a rise in daily COVID-19 infections over the past two weeks, reporting more than 600 new cases on Saturday - nearly triple the numbers being reported in mid-June.
The Daily News reported that on Wednesday, the county reported 515 new infections, although some of those cases could be the result of a reporting backlog from the long holiday weekend. The new cases pushed the cumulative countywide total during the pandemic to 1,253,536.
According to state figures, there were 296 people hospitalized due to COVID in the county, up from 275 on Tuesday. There were 71 people in intensive care, down from 73 a day earlier. While hospitalization numbers have been increasing slowly, they are still a fraction of the four-digit figures seen during the county’s winter surge of infections.
Health officials have said the county’s recent increases in daily infections and testing-positivity are being fueled by the rise in COVID-19 variants, particularly the highly contagious "Delta" variant. They added that with 4 million residents in L.A. County still unvaccinated - including 1.3 million children who aren’t eligible for shots - there is enough risk for the variant to pose a significant threat.
"Delta" has also become California’s most identified strain of the coronavirus, accounting for 35.6% of the variants analyzed in June, a steep increase from May, when the number was just 5.6%, according to the California Department of Public Health.
As of last week, more than 10.4 million doses of COVID-19 vaccine had been administered in the county. The latest numbers show that 59% of residents age 16 or older are fully vaccinated, while 68% have received at least one dose. The numbers are higher among seniors, with 76% of people 65 and older fully vaccinated, and 87% with at least one dose.
The weekly pace of vaccinations, however, has slowed from an winter/spring high of about 500,000 doses per week in the county to now less than 60,000. Vaccinations continue to lag among the Black community, which is also bearing the brunt of new COVID infections and hospitalizations.
And now the Seattle Times reports that the gamma variant, on the other hand, is associated with higher hospitalization rates and increased breakthrough infections. The variant, also known as P.1, now accounts for 16% of the cases in Washington state and is the fastest-rising variant in the state ...
The county has been seeing a rise in daily COVID-19 infections over the past two weeks, reporting more than 600 new cases on Saturday - nearly triple the numbers being reported in mid-June.
The Daily News reported that on Wednesday, the county reported 515 new infections, although some of those cases could be the result of a reporting backlog from the long holiday weekend. The new cases pushed the cumulative countywide total during the pandemic to 1,253,536.
According to state figures, there were 296 people hospitalized due to COVID in the county, up from 275 on Tuesday. There were 71 people in intensive care, down from 73 a day earlier. While hospitalization numbers have been increasing slowly, they are still a fraction of the four-digit figures seen during the county’s winter surge of infections.
Health officials have said the county’s recent increases in daily infections and testing-positivity are being fueled by the rise in COVID-19 variants, particularly the highly contagious "Delta" variant. They added that with 4 million residents in L.A. County still unvaccinated - including 1.3 million children who aren’t eligible for shots - there is enough risk for the variant to pose a significant threat.
"Delta" has also become California’s most identified strain of the coronavirus, accounting for 35.6% of the variants analyzed in June, a steep increase from May, when the number was just 5.6%, according to the California Department of Public Health.
As of last week, more than 10.4 million doses of COVID-19 vaccine had been administered in the county. The latest numbers show that 59% of residents age 16 or older are fully vaccinated, while 68% have received at least one dose. The numbers are higher among seniors, with 76% of people 65 and older fully vaccinated, and 87% with at least one dose.
The weekly pace of vaccinations, however, has slowed from an winter/spring high of about 500,000 doses per week in the county to now less than 60,000. Vaccinations continue to lag among the Black community, which is also bearing the brunt of new COVID infections and hospitalizations.
And now the Seattle Times reports that the gamma variant, on the other hand, is associated with higher hospitalization rates and increased breakthrough infections. The variant, also known as P.1, now accounts for 16% of the cases in Washington state and is the fastest-rising variant in the state ...
Luis Beltran Witron claimed an injury to the bilateral shoulders, neck, back and chest on May 5, 2019 while employed as a laborer by Polymeric Technology Corporation.
On August 13, 2019, defendant sent a letter to applicant acknowledging his claim. Enclosed with the letter was a copy of the Complete MPN Notification in English and Spanish.
Defendant subsequently sent applicant a Notice of Acceptance of Claim on August 26, 2019. An MPN Notification in English and Spanish was enclosed again. The parties stipulated that the claim was accepted for the left shoulder and that Witron initially treated at Concentra in the MPN.
Applicant’s attorney filed an Application for Adjudication of Claim on September 21, 2020. On the same date, applicant’s attorney sent a letter requesting a change of PTP and nominated NMCI Medical Clinic.
On February 10, 2021, applicant’s attorney sent a letter to defendant stating "the applicant will commence treatment with NMCI as the carrier failed to provide the applicant with an MPN PTP per the previous demand."
On the same date, defendant sent an email to applicant’s attorney stating: "The claim is accepted for the left shoulder. If your client is interested in receiving medical treatment for the left shoulder on an industrial basis, he can access the BHHC MPN and designate a treating physician."
At an expedited hearing the applicant contends that he has the right to treat outside the MPN because defendant failed to comply with applicant’s demand letter for a change of treating doctor and a request to schedule the initial appointment per CCR Section 9767.5(g).
The WCJ found that there was a delay by defendant in responding to applicant’s request for a change of treating physician, but the delay did not constitute a neglect or refusal of medical treatment. Reconsideration of this finding was denied in the WCAB panel decision of Witron v Polymeric Technology Corporation (ADJ13620994 - June 2021)
The issue was whether defendant’s delay in responding to applicant’s September 21, 2020 request to treat with NMCI constituted a neglect or refusal to provide care.
Applicant was treating regularly in the MPN from August 2019 until January 2020. There is no evidence in the record of any treatment after January 2020. Applicant sent his request to treat with NMCI in September 2020. As acknowledged by the WCJ in her Report, there was a delay by defendant in responding to this request until February 2021. However, applicant did not provide evidence at trial of any treatment (or even efforts to obtain treatment) following his September 2020 request.
The 20-day time limit for a Medical Access Assistant (MAA) to schedule an appointment per AD Rule 9767.5(g) only applies where the MAA is scheduling an appointment with a specialist based on a referral, not to the scheduling of an initial appointment with a primary treating physician.
The record does not indicate that applicant was seeking an appointment with a specialist based on a referral; rather, it shows that he was requesting treatment generally. Moreover, as noted above, applicant did not request assistance from the MAA. Therefore,AD Rule 9767.5(g) does not apply to the facts in this case.
"Defendant’s delay in responding to applicant’s single September 21, 2020 letter asking to treat with NMCI is not substantial evidence of a neglect or refusal to provide treatment such that applicant may treat outside the MPN." ...
On August 13, 2019, defendant sent a letter to applicant acknowledging his claim. Enclosed with the letter was a copy of the Complete MPN Notification in English and Spanish.
Defendant subsequently sent applicant a Notice of Acceptance of Claim on August 26, 2019. An MPN Notification in English and Spanish was enclosed again. The parties stipulated that the claim was accepted for the left shoulder and that Witron initially treated at Concentra in the MPN.
Applicant’s attorney filed an Application for Adjudication of Claim on September 21, 2020. On the same date, applicant’s attorney sent a letter requesting a change of PTP and nominated NMCI Medical Clinic.
On February 10, 2021, applicant’s attorney sent a letter to defendant stating "the applicant will commence treatment with NMCI as the carrier failed to provide the applicant with an MPN PTP per the previous demand."
On the same date, defendant sent an email to applicant’s attorney stating: "The claim is accepted for the left shoulder. If your client is interested in receiving medical treatment for the left shoulder on an industrial basis, he can access the BHHC MPN and designate a treating physician."
At an expedited hearing the applicant contends that he has the right to treat outside the MPN because defendant failed to comply with applicant’s demand letter for a change of treating doctor and a request to schedule the initial appointment per CCR Section 9767.5(g).
The WCJ found that there was a delay by defendant in responding to applicant’s request for a change of treating physician, but the delay did not constitute a neglect or refusal of medical treatment. Reconsideration of this finding was denied in the WCAB panel decision of Witron v Polymeric Technology Corporation (ADJ13620994 - June 2021)
The issue was whether defendant’s delay in responding to applicant’s September 21, 2020 request to treat with NMCI constituted a neglect or refusal to provide care.
Applicant was treating regularly in the MPN from August 2019 until January 2020. There is no evidence in the record of any treatment after January 2020. Applicant sent his request to treat with NMCI in September 2020. As acknowledged by the WCJ in her Report, there was a delay by defendant in responding to this request until February 2021. However, applicant did not provide evidence at trial of any treatment (or even efforts to obtain treatment) following his September 2020 request.
The 20-day time limit for a Medical Access Assistant (MAA) to schedule an appointment per AD Rule 9767.5(g) only applies where the MAA is scheduling an appointment with a specialist based on a referral, not to the scheduling of an initial appointment with a primary treating physician.
The record does not indicate that applicant was seeking an appointment with a specialist based on a referral; rather, it shows that he was requesting treatment generally. Moreover, as noted above, applicant did not request assistance from the MAA. Therefore,AD Rule 9767.5(g) does not apply to the facts in this case.
"Defendant’s delay in responding to applicant’s single September 21, 2020 letter asking to treat with NMCI is not substantial evidence of a neglect or refusal to provide treatment such that applicant may treat outside the MPN." ...
The DWC has not accepted any walk-in documents or walk-through documents as a safety measure resulting from the COVID pandemic.
Documents have only been accepted via e-filing, JET filing or by mail since that time. However, the pandemic related restrictions are showing some signs of relaxation at at least one local office.
Pamela Pulley, the Presiding Judge - Division of Workers’ Compensation Santa Ana Office - announced the status of her office availability for the immediate future.
She said that "First and foremost, let me be clear that we do not yet have a date to reopen the office for hearings."
"We do, however, have a date to reopen our counters to the public."
As of Monday July 26th, her offices will be open for the very limited purpose of filing documents, dropping off rating requests, obtaining calendar dates for hearings, copy service, and providing information and assistance to unrepresented litigants.
They are not yet reopening for walking through settlements or hearings of any nature. Those will continue to be conducted online and/or over the phone for the time being.
The building’s current policy is that unvaccinated persons must continue to wear masks ...
Documents have only been accepted via e-filing, JET filing or by mail since that time. However, the pandemic related restrictions are showing some signs of relaxation at at least one local office.
Pamela Pulley, the Presiding Judge - Division of Workers’ Compensation Santa Ana Office - announced the status of her office availability for the immediate future.
She said that "First and foremost, let me be clear that we do not yet have a date to reopen the office for hearings."
"We do, however, have a date to reopen our counters to the public."
As of Monday July 26th, her offices will be open for the very limited purpose of filing documents, dropping off rating requests, obtaining calendar dates for hearings, copy service, and providing information and assistance to unrepresented litigants.
They are not yet reopening for walking through settlements or hearings of any nature. Those will continue to be conducted online and/or over the phone for the time being.
The building’s current policy is that unvaccinated persons must continue to wear masks ...
The CEO of several Southern California-based medical imaging companies was found guilty by a federal jury today of running a scheme in which more than $250 million in claims were fraudulently submitted through the state workers’ compensation system for medical services procured through bribes and kickbacks to physicians and others.
40 year old Sam Sarkis Solakyan, who lives in Glendale, was found guilty of one count of conspiracy to commit honest services mail fraud and health care fraud, and 11 counts of honest services mail fraud.
Solakyan was the CEO of several medical-imaging companies, including the Glendale-based Vital Imaging Inc., and San Diego MRI Institute. Solakyan operated diagnostic imaging facilities throughout California, including the Bay Area, Los Angeles and Orange counties, and San Diego.
According to the evidence presented at the eight-day trial, from no later than mid-2013 to November 2016, Solakyan conspired with Steven Rigler, a Solana Beach-based chiropractor; Fermin Iglesias, the former CEO of MedEx Solutions, a patient-scheduling company; and others to perpetrate a scheme in which physicians were paid bribes and kickbacks in exchange for the referral of workers’ compensation patients. The compensation offered to the corrupt doctors consisted of either cash or referrals of new patients in what is known as a "cross-referral" scheme.
The conspirators obscured the true nature of their financial relationships in order to conceal the bribes and kickbacks, including by entering into various sham agreements such as contracts for "marketing," "administrative services," and "scheduling," when in fact the money Solakyan paid amounted to volume-based, per- magnetic resonance imaging (MRI) scan bribes and kickbacks to induce physicians to refer and continue referring patients to Solakyan’s companies.
Solakyan’s recruiters required physicians to refer a minimum number of patients to receive "cross-referrals," and those referrals stopped if the physicians failed to meet the minimum quota. Solakyan’s recruiters - Fermin Iglesias, 41 of Glendale, and Carlos Arguello, 39, of Bonita - were paid more than $8.6 million for obtaining MRI referrals, payments which were concealed from patients and health insurers.
Solakyan concealed his cash payments to Rigler for patient referrals by calling them "reports," and in March 2015 he asked Rigler if Solakyan could "send my driver with your reports," then stated, "I’ll have him contact you then I’ll just send him with your reports, buddy," according to a September 2018 federal grand jury indictment.
In total, Solakyan submitted and caused to be submitted more than $250 million in claims for medical services procured through the payment of bribes and kickbacks.
Rigler pleaded guilty in November 2015 to one count of conspiracy to commit honest services mail fraud and was sentenced to six months in federal prison.
Iglesias pleaded guilty in December 2016 to conspiracy to commit honest services mail fraud and health care fraud and was sentenced in February 2019 to five years in federal prison.
Arguello pleaded guilty in August 2016 to conspiracy to commit honest services mail fraud and health care fraud and was sentenced in April 2019 to four years in federal prison.
United States District Judge Cynthia A. Bashant has scheduled an October 4 sentencing hearing, at which time Solakyan will face a statutory maximum sentence of 240 years in federal prison.
The FBI and the California Department of Insurance, Fraud Division, investigated this matter. Assistant United States Attorney Faraz R. Mohammadi of the Santa Ana Branch Office and Assistant United States Attorney Adam P. Schleifer of the Major Frauds Section are prosecuting this case ...
40 year old Sam Sarkis Solakyan, who lives in Glendale, was found guilty of one count of conspiracy to commit honest services mail fraud and health care fraud, and 11 counts of honest services mail fraud.
Solakyan was the CEO of several medical-imaging companies, including the Glendale-based Vital Imaging Inc., and San Diego MRI Institute. Solakyan operated diagnostic imaging facilities throughout California, including the Bay Area, Los Angeles and Orange counties, and San Diego.
According to the evidence presented at the eight-day trial, from no later than mid-2013 to November 2016, Solakyan conspired with Steven Rigler, a Solana Beach-based chiropractor; Fermin Iglesias, the former CEO of MedEx Solutions, a patient-scheduling company; and others to perpetrate a scheme in which physicians were paid bribes and kickbacks in exchange for the referral of workers’ compensation patients. The compensation offered to the corrupt doctors consisted of either cash or referrals of new patients in what is known as a "cross-referral" scheme.
The conspirators obscured the true nature of their financial relationships in order to conceal the bribes and kickbacks, including by entering into various sham agreements such as contracts for "marketing," "administrative services," and "scheduling," when in fact the money Solakyan paid amounted to volume-based, per- magnetic resonance imaging (MRI) scan bribes and kickbacks to induce physicians to refer and continue referring patients to Solakyan’s companies.
Solakyan’s recruiters required physicians to refer a minimum number of patients to receive "cross-referrals," and those referrals stopped if the physicians failed to meet the minimum quota. Solakyan’s recruiters - Fermin Iglesias, 41 of Glendale, and Carlos Arguello, 39, of Bonita - were paid more than $8.6 million for obtaining MRI referrals, payments which were concealed from patients and health insurers.
Solakyan concealed his cash payments to Rigler for patient referrals by calling them "reports," and in March 2015 he asked Rigler if Solakyan could "send my driver with your reports," then stated, "I’ll have him contact you then I’ll just send him with your reports, buddy," according to a September 2018 federal grand jury indictment.
In total, Solakyan submitted and caused to be submitted more than $250 million in claims for medical services procured through the payment of bribes and kickbacks.
Rigler pleaded guilty in November 2015 to one count of conspiracy to commit honest services mail fraud and was sentenced to six months in federal prison.
Iglesias pleaded guilty in December 2016 to conspiracy to commit honest services mail fraud and health care fraud and was sentenced in February 2019 to five years in federal prison.
Arguello pleaded guilty in August 2016 to conspiracy to commit honest services mail fraud and health care fraud and was sentenced in April 2019 to four years in federal prison.
United States District Judge Cynthia A. Bashant has scheduled an October 4 sentencing hearing, at which time Solakyan will face a statutory maximum sentence of 240 years in federal prison.
The FBI and the California Department of Insurance, Fraud Division, investigated this matter. Assistant United States Attorney Faraz R. Mohammadi of the Santa Ana Branch Office and Assistant United States Attorney Adam P. Schleifer of the Major Frauds Section are prosecuting this case ...
Tedros Adhanom Ghebreyesus, the head of the World Health Organization (WHO), said on July 6, that he world is facing a "two-track pandemic" with some countries being hit by waves of hospitalisation and deaths, compounded by coronavirus variants.
The Wall Street Journal reports today that "the fast-spreading Delta variant of the coronavirus is driving up infections in developing countries that are dangerously short on Covid-19 vaccines to battle deadly surges and whose healthcare systems are struggling to cope."
The results of outbreaks of the Delta variant elsewhere also support the vaccines’ effectiveness. So far, vaccinated people seem to be protected against infection and illness from the Delta variant. One recent study found that the full two-dose course of the Pfizer-BioNTech vaccine was 88% effective against symptomatic disease caused by the Delta variant and 96% protective against hospitalization.
The characterization of the "two-track pandemic" seems to differentiate countries with high levels of vaccinated population, with those who have not been able to do so.
The delta variant of the coronavirus disease (Covid-19), which was first detected in India last year, has now spread to at least 98 countries across and is the most contagious variant of the virus to be identified till now. Ghebreyesus warned on Saturday that the world is currently in a very dangerous period of the pandemic and the delta variant is continuing to evolve and mutate.
Foreign news sources report that In Europe, Portugal, Russia and the United Kingdom are witnessing a massive spike in daily cases due to the delta variant. The entire continent at present, is struggling to accelerate the vaccination drive and outpace the spread of the variant.
Meanwhile, the WHO chief explained that there are ‘essentially’ two ways for countries to push back against the new COVID-19 surges. "Public health and social measures like strong surveillance, strategic testing, early case detection, isolation and clinical care remain critical. As well as masking, physical distance, avoiding crowded places and keeping indoor areas well ventilated", he said.
The second way, said Ghebreyesus, was through the global sharing of protective gear, oxygen, tests, treatments and vaccines. "I have urged leaders across the world to work together to ensure that by this time next year, 70% of all people in every country are vaccinated", Ghebreyesus highlighted, adding that this was the best way to slow the pandemic, save lives, drive a truly global economic recovery and prevent further dangerous variants from getting the ‘upper hand’.
"By the end of this September, we’re calling on leaders to vaccinate at least 10 per cent of people in all countries," he added. This is to protect health workers who are at most risk. So far, already three billion vaccines have been distributed. The WHO Chief further called for ramping up vaccine manufacturing by sharing vaccines as well as the technology and the know-how.
Last week, the IMF, the World Bank and the World Trade Organization joined the WHO in calling for "urgent action" to increase vaccine supplies. They also asked the G20 group of nations to accelerate efforts to reach vaccination targets. Scientists have emphasized the urgency of vaccinating the world, because the current vaccines are already less effective against the Delta variant than other variants, and Delta is substantially more transmissible ...
The Wall Street Journal reports today that "the fast-spreading Delta variant of the coronavirus is driving up infections in developing countries that are dangerously short on Covid-19 vaccines to battle deadly surges and whose healthcare systems are struggling to cope."
The results of outbreaks of the Delta variant elsewhere also support the vaccines’ effectiveness. So far, vaccinated people seem to be protected against infection and illness from the Delta variant. One recent study found that the full two-dose course of the Pfizer-BioNTech vaccine was 88% effective against symptomatic disease caused by the Delta variant and 96% protective against hospitalization.
The characterization of the "two-track pandemic" seems to differentiate countries with high levels of vaccinated population, with those who have not been able to do so.
The delta variant of the coronavirus disease (Covid-19), which was first detected in India last year, has now spread to at least 98 countries across and is the most contagious variant of the virus to be identified till now. Ghebreyesus warned on Saturday that the world is currently in a very dangerous period of the pandemic and the delta variant is continuing to evolve and mutate.
Foreign news sources report that In Europe, Portugal, Russia and the United Kingdom are witnessing a massive spike in daily cases due to the delta variant. The entire continent at present, is struggling to accelerate the vaccination drive and outpace the spread of the variant.
Meanwhile, the WHO chief explained that there are ‘essentially’ two ways for countries to push back against the new COVID-19 surges. "Public health and social measures like strong surveillance, strategic testing, early case detection, isolation and clinical care remain critical. As well as masking, physical distance, avoiding crowded places and keeping indoor areas well ventilated", he said.
The second way, said Ghebreyesus, was through the global sharing of protective gear, oxygen, tests, treatments and vaccines. "I have urged leaders across the world to work together to ensure that by this time next year, 70% of all people in every country are vaccinated", Ghebreyesus highlighted, adding that this was the best way to slow the pandemic, save lives, drive a truly global economic recovery and prevent further dangerous variants from getting the ‘upper hand’.
"By the end of this September, we’re calling on leaders to vaccinate at least 10 per cent of people in all countries," he added. This is to protect health workers who are at most risk. So far, already three billion vaccines have been distributed. The WHO Chief further called for ramping up vaccine manufacturing by sharing vaccines as well as the technology and the know-how.
Last week, the IMF, the World Bank and the World Trade Organization joined the WHO in calling for "urgent action" to increase vaccine supplies. They also asked the G20 group of nations to accelerate efforts to reach vaccination targets. Scientists have emphasized the urgency of vaccinating the world, because the current vaccines are already less effective against the Delta variant than other variants, and Delta is substantially more transmissible ...
GlaxoSmithKline Plc agreed to pay San Francisco based biotech Alector Inc. as much as $2.2 billion to develop therapies targeting diseases such as Parkinson’s and Alzheimer’s.
Neurodegenerative disease has been the subject of costly workers' compensation claims in past years. The most notable of them was the NFL and contact sport related claims for concussion caused dementia.
The agreement comes weeks after the FDA approved the first new Alzheimer's drug in almost two decades, Biogen Inc's Aduhelm, reinvigorating the industry's efforts to develop more treatments in a challenging therapy category.
The trategic global collaboration was formed for the development of two clinical-stage, potential first-in-class monoclonal antibodies (AL001 and AL101), which are targeting neurodegenerative disease.
AL001 is currently in a Phase 2 study in symptomatic frontotemporal dementia patients with a mutation in the C9orf72 gene and is planned to enter Phase 2 development for amyotrophic lateral sclerosis (ALS) in the second half of 2021.
Enrolment is currently underway for a pivotal Phase 3 trial for AL001 in people at risk for or with frontotemporal dementia due to a progranulin gene mutation (FTD-GRN).
AL101 is in a Phase 1a clinical trial and is designed to treat patients suffering from more prevalent neurodegenerative diseases, including Parkinson’s disease and Alzheimer’s disease.
Frontotemporal dementia is a rapidly progressing and severe form of dementia found most frequently in people less than 65 years old at the time of diagnosis. It affects 50,000 to 60,000 people in the United States and roughly 110,000 in the European Union, with potentially higher prevalence in Asia and Latin America.
There are currently no FDA-approved treatment options for frontotemporal dementia.
The therapies are part of an emerging field of research that tries to use the body’s own immune system to fight neurodegenerative diseases. In this case, scientists are seeking to increase levels of a protein in the brain called progranulin, which helps regulate the immune response and affects the survival of neurons.
Under the terms of the collaboration agreement, Alector will receive $700 million in upfront payments. In addition, Alector will be eligible to receive up to an additional $1.5 billion in clinical development, regulatory and commercial launch-related milestone payments.
Alector will lead the global clinical development of AL001 and AL101 through Phase 2 proof-of-concept. Thereafter, Alector and GSK will share development responsibilities for all late-stage clinical studies for AL001 and AL101 and all costs for global development will be divided between the two companies.
...
Neurodegenerative disease has been the subject of costly workers' compensation claims in past years. The most notable of them was the NFL and contact sport related claims for concussion caused dementia.
The agreement comes weeks after the FDA approved the first new Alzheimer's drug in almost two decades, Biogen Inc's Aduhelm, reinvigorating the industry's efforts to develop more treatments in a challenging therapy category.
The trategic global collaboration was formed for the development of two clinical-stage, potential first-in-class monoclonal antibodies (AL001 and AL101), which are targeting neurodegenerative disease.
AL001 is currently in a Phase 2 study in symptomatic frontotemporal dementia patients with a mutation in the C9orf72 gene and is planned to enter Phase 2 development for amyotrophic lateral sclerosis (ALS) in the second half of 2021.
Enrolment is currently underway for a pivotal Phase 3 trial for AL001 in people at risk for or with frontotemporal dementia due to a progranulin gene mutation (FTD-GRN).
AL101 is in a Phase 1a clinical trial and is designed to treat patients suffering from more prevalent neurodegenerative diseases, including Parkinson’s disease and Alzheimer’s disease.
Frontotemporal dementia is a rapidly progressing and severe form of dementia found most frequently in people less than 65 years old at the time of diagnosis. It affects 50,000 to 60,000 people in the United States and roughly 110,000 in the European Union, with potentially higher prevalence in Asia and Latin America.
There are currently no FDA-approved treatment options for frontotemporal dementia.
The therapies are part of an emerging field of research that tries to use the body’s own immune system to fight neurodegenerative diseases. In this case, scientists are seeking to increase levels of a protein in the brain called progranulin, which helps regulate the immune response and affects the survival of neurons.
Under the terms of the collaboration agreement, Alector will receive $700 million in upfront payments. In addition, Alector will be eligible to receive up to an additional $1.5 billion in clinical development, regulatory and commercial launch-related milestone payments.
Alector will lead the global clinical development of AL001 and AL101 through Phase 2 proof-of-concept. Thereafter, Alector and GSK will share development responsibilities for all late-stage clinical studies for AL001 and AL101 and all costs for global development will be divided between the two companies.
...
Sacramento skilled nursing facility operator Plum Healthcare Group LLC and its entity Azalea Holdings LLC, dba McKinley Park Care Center have agreed to pay more than $451,439 to resolve allegations that they violated the False Claims Act.
Plum Healthcare Group agreed to resolve allegations that an employee at its McKinley Park Care Center knowingly created billing records for services that were not actually provided. According to the settlement agreement, Plum Healthcare Group then used these false records to bill Medicare, leading it to obtain Medicare reimbursements that were higher than warranted.
The government also alleges that the management of Plum Healthcare Group learned of the extent of these false billings to Medicare, did not conduct an adequate investigation into this conduct, and then failed to submit a refund to Medicare for the full amount management knew had been overbilled or otherwise disclose its false billings to the government.
The settlement with Plum Healthcare Group resolves allegations originally brought in a lawsuit filed by a former employee under the whistleblower provisions of the False Claims Act.
The act permits private parties to sue on behalf of the government for false claims for government funds and to receive a share of any recovery. The whistleblower will receive over $90,000 as her share of the recovery from Plum Healthcare Group. The whistleblower’s claims for retaliation and attorneys’ fees are not resolved by this settlement.
This case was the result of an investigation by the HHS Office of the Inspector General, the Federal Bureau of Investigation, along with the U.S. Attorney’s Office for the Eastern District of California. Assistant U.S. Attorney Steven Tennyson handled the matter for the United States. The claims settled by this agreement are allegations only, and there has been no determination of liability ...
Plum Healthcare Group agreed to resolve allegations that an employee at its McKinley Park Care Center knowingly created billing records for services that were not actually provided. According to the settlement agreement, Plum Healthcare Group then used these false records to bill Medicare, leading it to obtain Medicare reimbursements that were higher than warranted.
The government also alleges that the management of Plum Healthcare Group learned of the extent of these false billings to Medicare, did not conduct an adequate investigation into this conduct, and then failed to submit a refund to Medicare for the full amount management knew had been overbilled or otherwise disclose its false billings to the government.
The settlement with Plum Healthcare Group resolves allegations originally brought in a lawsuit filed by a former employee under the whistleblower provisions of the False Claims Act.
The act permits private parties to sue on behalf of the government for false claims for government funds and to receive a share of any recovery. The whistleblower will receive over $90,000 as her share of the recovery from Plum Healthcare Group. The whistleblower’s claims for retaliation and attorneys’ fees are not resolved by this settlement.
This case was the result of an investigation by the HHS Office of the Inspector General, the Federal Bureau of Investigation, along with the U.S. Attorney’s Office for the Eastern District of California. Assistant U.S. Attorney Steven Tennyson handled the matter for the United States. The claims settled by this agreement are allegations only, and there has been no determination of liability ...
A federal jury has found four Los Angeles-area residents guilty of criminal charges for scheming to submit fraudulent loan applications seeking millions of dollars in Paycheck Protection Program (PPP) and Economic Injury Disaster Loan (EIDL) COVID-19 relief funds.
At the conclusion of an eight-day trial, the following defendants were found guilty on June 25:
- - Richard Ayvazyan, 42, of Encino;
- - Richard Ayvazyan’s wife, Marietta Terabelian, 37, of Encino;
- - Richard Ayvazyan’s brother, Artur Ayvazyan, 41, of Encino;
- - Vahe Dadyan, 41, of Glendale.
All four defendants were found guilty of one count of conspiracy to commit bank fraud and wire fraud, 11 counts of wire fraud, eight counts of bank fraud and one count of conspiracy to commit money laundering. Richard Ayvazyan also was found guilty of two counts of aggravated identity theft. Artur Ayvazyan also was found guilty of one count of aggravated identity theft. Vahe Dadyan also was found guilty of one count of money laundering.
The jury also found the defendants must forfeit bank accounts, jewelry, watches, gold coins, three residential properties and approximately $450,000 in cash.
The defendants used fake, stolen and synthetic identities to submit fraudulent applications for PPP and EIDL loans guaranteed by the Small Business Administration (SBA) under federal law. In support of the fraudulent applications, the defendants often submitted false and fictitious documents to lenders and the SBA, including fake identity documents, tax documents and payroll records.
A September 13 sentencing hearing has been scheduled, and each defendant will face decades in federal prison.
Prior to the verdict, the following defendants pleaded guilty to criminal charges in this case:
- - Manuk Grigoryan, 46, of Sun Valley, pleaded guilty on June 7 to one count of bank fraud and one count of aggravated identity theft. Judge Wilson has scheduled a September 13 sentencing hearing, at which time Grigoryan will face a statutory maximum sentence of 32 years in federal prison.
- - Edvard Paronyan, 40, of Granada Hills, pleaded guilty on June 11 to one count of wire fraud. He will face a statutory maximum sentence of 20 years in federal prison at his August 30 sentencing hearing.
- - Tamara Dadyan, 39, of Encino, Artur Ayvazyan’s wife and Vahe Dadyan’s cousin, pleaded guilty on June 14 to one count of conspiracy to commit bank fraud and wire fraud, one count of aggravated identity theft and one count of conspiracy to commit money laundering. She will face up to 52 years in federal prison at her September 27 sentencing hearing.
- - Arman Hayrapetyan, 41, of Glendale, pleaded guilty on June 21, to one count of conspiracy to commit money laundering. He will face up to 20 years in federal prison at his sentencing hearing, which is scheduled for September 20.
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 ...
At the conclusion of an eight-day trial, the following defendants were found guilty on June 25:
- - Richard Ayvazyan, 42, of Encino;
- - Richard Ayvazyan’s wife, Marietta Terabelian, 37, of Encino;
- - Richard Ayvazyan’s brother, Artur Ayvazyan, 41, of Encino;
- - Vahe Dadyan, 41, of Glendale.
All four defendants were found guilty of one count of conspiracy to commit bank fraud and wire fraud, 11 counts of wire fraud, eight counts of bank fraud and one count of conspiracy to commit money laundering. Richard Ayvazyan also was found guilty of two counts of aggravated identity theft. Artur Ayvazyan also was found guilty of one count of aggravated identity theft. Vahe Dadyan also was found guilty of one count of money laundering.
The jury also found the defendants must forfeit bank accounts, jewelry, watches, gold coins, three residential properties and approximately $450,000 in cash.
The defendants used fake, stolen and synthetic identities to submit fraudulent applications for PPP and EIDL loans guaranteed by the Small Business Administration (SBA) under federal law. In support of the fraudulent applications, the defendants often submitted false and fictitious documents to lenders and the SBA, including fake identity documents, tax documents and payroll records.
A September 13 sentencing hearing has been scheduled, and each defendant will face decades in federal prison.
Prior to the verdict, the following defendants pleaded guilty to criminal charges in this case:
- - Manuk Grigoryan, 46, of Sun Valley, pleaded guilty on June 7 to one count of bank fraud and one count of aggravated identity theft. Judge Wilson has scheduled a September 13 sentencing hearing, at which time Grigoryan will face a statutory maximum sentence of 32 years in federal prison.
- - Edvard Paronyan, 40, of Granada Hills, pleaded guilty on June 11 to one count of wire fraud. He will face a statutory maximum sentence of 20 years in federal prison at his August 30 sentencing hearing.
- - Tamara Dadyan, 39, of Encino, Artur Ayvazyan’s wife and Vahe Dadyan’s cousin, pleaded guilty on June 14 to one count of conspiracy to commit bank fraud and wire fraud, one count of aggravated identity theft and one count of conspiracy to commit money laundering. She will face up to 52 years in federal prison at her September 27 sentencing hearing.
- - Arman Hayrapetyan, 41, of Glendale, pleaded guilty on June 21, to one count of conspiracy to commit money laundering. He will face up to 20 years in federal prison at his sentencing hearing, which is scheduled for September 20.
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 ...
Efrain Nevarez filed an Application for Adjudication of Claim alleging that he sustained an industrial injury as a result of a cumulative trauma through August 30, 2015, while employed by American Choice Van Lines and/or Go East Movers.
Coverage was denied by American Casualty Insurance Company based on "limited endorsements" contained in the policies. Coverage disputes are subject to mandatory arbitration under Labor Code section 5275(a), thus the issue was submitted for arbitration.
The arbitrator found that Go East Movers was insured by American Casualty Insurance during the alleged cumulative trauma period.
The arbitrator found that "[n]one of the limiting endorsements" complied with the statutory and regulatory requirements. The arbitrator also found that there was insufficient evidence that the employer engaged in fraudulent misrepresentation during the application process and there is evidence that American and its agents did not do their due diligence regarding the nature of the business of the insured prior to issuing the policy.
The arbitrator issued orders that the insurers shall be liable for the workers’ compensation benefits that may be awarded to the applicant and that the order does not limit defendant’s right to dispute the date of injury or the period of coverage for the injury. The arbitrator also dismissed the Uninsured Employers Benefit Trust Fund as a party defendant.
American Casualty Insurance Company petitioned for reconsideration of the Findings and Order. A WCAB panel essentially affirmed the arbitrator in the case of Efrain Nevarez v American Choice Van Lines et. al. (AD10407856 - March 2021)
American contends, in essence, that it was not required to exclude non-clerical employees because the policy only covered clerical employees.
Workers’ compensation policies provide coverage to all employees of an employer unless employees are explicitly excluded in the insurance contract with a limiting and restricting endorsement in accordance with regulations adopted by the Insurance Commissioner. (citations omitted)
American could not enter into a workers’ compensation insurance contract covering only some of an insured’s employees without complying with the Insurance Commissioner’s regulations. If an insurer contends that it has issued a limited policy, the insurer must provide evidence in the form of policy documents.
Therefore, American is incorrect that the policy could be construed to only cover clerical employees without an endorsement explicitly limiting the policy to those employees.
With respect to American’s contention that the arbitrator erred in failing to admit and consider evidence of employer misrepresentation and insurer due diligence, the evidence would only be relevant if rescission of the insurance contract was at issue and it was not at issue.
A workers’ compensation policy may be rescinded based on a material misrepresentation by the insured. (Southern Ins. Co. v. Workers' Comp. Appeals Bd. (Berrios) (2017) 11 Cal.App.5th 961.) Rescission is a contract remedy that requires the rescinding party to give notice and restore or offer to restore everything of value obtained under the contract in accordance with a statutory procedure set forth in Civil Code section 1691.
However, in this case, American did not raise rescission as an issue and does not allege that it rescinded the insurance policy ...
Coverage was denied by American Casualty Insurance Company based on "limited endorsements" contained in the policies. Coverage disputes are subject to mandatory arbitration under Labor Code section 5275(a), thus the issue was submitted for arbitration.
The arbitrator found that Go East Movers was insured by American Casualty Insurance during the alleged cumulative trauma period.
The arbitrator found that "[n]one of the limiting endorsements" complied with the statutory and regulatory requirements. The arbitrator also found that there was insufficient evidence that the employer engaged in fraudulent misrepresentation during the application process and there is evidence that American and its agents did not do their due diligence regarding the nature of the business of the insured prior to issuing the policy.
The arbitrator issued orders that the insurers shall be liable for the workers’ compensation benefits that may be awarded to the applicant and that the order does not limit defendant’s right to dispute the date of injury or the period of coverage for the injury. The arbitrator also dismissed the Uninsured Employers Benefit Trust Fund as a party defendant.
American Casualty Insurance Company petitioned for reconsideration of the Findings and Order. A WCAB panel essentially affirmed the arbitrator in the case of Efrain Nevarez v American Choice Van Lines et. al. (AD10407856 - March 2021)
American contends, in essence, that it was not required to exclude non-clerical employees because the policy only covered clerical employees.
Workers’ compensation policies provide coverage to all employees of an employer unless employees are explicitly excluded in the insurance contract with a limiting and restricting endorsement in accordance with regulations adopted by the Insurance Commissioner. (citations omitted)
American could not enter into a workers’ compensation insurance contract covering only some of an insured’s employees without complying with the Insurance Commissioner’s regulations. If an insurer contends that it has issued a limited policy, the insurer must provide evidence in the form of policy documents.
Therefore, American is incorrect that the policy could be construed to only cover clerical employees without an endorsement explicitly limiting the policy to those employees.
With respect to American’s contention that the arbitrator erred in failing to admit and consider evidence of employer misrepresentation and insurer due diligence, the evidence would only be relevant if rescission of the insurance contract was at issue and it was not at issue.
A workers’ compensation policy may be rescinded based on a material misrepresentation by the insured. (Southern Ins. Co. v. Workers' Comp. Appeals Bd. (Berrios) (2017) 11 Cal.App.5th 961.) Rescission is a contract remedy that requires the rescinding party to give notice and restore or offer to restore everything of value obtained under the contract in accordance with a statutory procedure set forth in Civil Code section 1691.
However, in this case, American did not raise rescission as an issue and does not allege that it rescinded the insurance policy ...
The focus of the WCIRB Actuarial Committee meeting held on June 22, was a review of recent system medical costs, along with a comparison of the effects of the COVID 19 pandemic.
Summary of the Medical Severity Trends through 2020
Pre-COVID-19 (before 3/15)
- Overall medical severity per claim increased slightly (+4%)
- Physician services, inpatient and medical-legal costs per claim increased despite a downward trend in prior years
- Pharmaceutical costs per claim continued to drop (-14%) mostly driven by continuously steep declines in opioid costs (-42%)
- Telemedicine services per claim increased at typical pre-COVID-19 rate (approximately 100%)
COVID-19 pandemic period (3/15 - 12/31)
- Overall medical severity per claim increased (+10%)
- - Increases in both service utilization and paid per transaction likely when shelter-in-place orders were lifted
- Increases in inpatient and outpatient costs per claim were driven mostly by higher paid per transaction
- Pharmaceutical costs per claim increased (+14%) mostly driven by increased use of non-opioids
- Telemedicine services per claim increased by more than 50-fold
Legislative Cost Monitoring Update - SB 1160 UR Provisions
- During the two years after the SB 1160 UR provisions became effective:
- - Number of physical therapy visits per claim increased in the first 30 days, while utilization of other types of medical services decreased during the same period.
- - Physical therapy services were provided earlier. The median time from injury to first physical therapy in the first 30 days decreased by 17%, from 12 days for AY2017 claims to 10 days for AY2019 claims.
- - There was less utilization of physical therapy services 5 months after the first 30 days.
- There is no indication of the SB 1160 UR provisions significantly impacting the cost of medical services through 6 months from the date of injury, and the increased medical severity is driven mostly by fee schedule updates.
- There is no indication of the UR provisions significantly impacting utilization review costs within two years of the reform implementation.
Summary of 3/31/2021 Experience (Excluding COVID-19)
- Almost 100% of market included - Main insights:
- - Loss development generally flat
- - Claim settlement rates continuing to decline
- - 1Q 2021 non-COVID-19 claim frequency up over 1Q 2020
- - Significant number of COVID-19 claims reported in first three months of 2021
- Projection methodologies are consistent with 9/1/21 Filing
- Projected loss ratio for September 1, 2021 to August 31, 2022 policies is 0.596 (same as 9/1/21 Filing)
- - Small increase (<0.005) from updated wage forecast
- - Small decrease (<0.005) from updated 2020 frequency trend ...
Summary of the Medical Severity Trends through 2020
Pre-COVID-19 (before 3/15)
- Overall medical severity per claim increased slightly (+4%)
- Physician services, inpatient and medical-legal costs per claim increased despite a downward trend in prior years
- Pharmaceutical costs per claim continued to drop (-14%) mostly driven by continuously steep declines in opioid costs (-42%)
- Telemedicine services per claim increased at typical pre-COVID-19 rate (approximately 100%)
COVID-19 pandemic period (3/15 - 12/31)
- Overall medical severity per claim increased (+10%)
- - Increases in both service utilization and paid per transaction likely when shelter-in-place orders were lifted
- Increases in inpatient and outpatient costs per claim were driven mostly by higher paid per transaction
- Pharmaceutical costs per claim increased (+14%) mostly driven by increased use of non-opioids
- Telemedicine services per claim increased by more than 50-fold
Legislative Cost Monitoring Update - SB 1160 UR Provisions
- During the two years after the SB 1160 UR provisions became effective:
- - Number of physical therapy visits per claim increased in the first 30 days, while utilization of other types of medical services decreased during the same period.
- - Physical therapy services were provided earlier. The median time from injury to first physical therapy in the first 30 days decreased by 17%, from 12 days for AY2017 claims to 10 days for AY2019 claims.
- - There was less utilization of physical therapy services 5 months after the first 30 days.
- There is no indication of the SB 1160 UR provisions significantly impacting the cost of medical services through 6 months from the date of injury, and the increased medical severity is driven mostly by fee schedule updates.
- There is no indication of the UR provisions significantly impacting utilization review costs within two years of the reform implementation.
Summary of 3/31/2021 Experience (Excluding COVID-19)
- Almost 100% of market included - Main insights:
- - Loss development generally flat
- - Claim settlement rates continuing to decline
- - 1Q 2021 non-COVID-19 claim frequency up over 1Q 2020
- - Significant number of COVID-19 claims reported in first three months of 2021
- Projection methodologies are consistent with 9/1/21 Filing
- Projected loss ratio for September 1, 2021 to August 31, 2022 policies is 0.596 (same as 9/1/21 Filing)
- - Small increase (<0.005) from updated wage forecast
- - Small decrease (<0.005) from updated 2020 frequency trend ...
The New York Attorney General announced an agreement with Johnson & Johnson - the parent company of Janssen Pharmaceuticals, Inc. - that will deliver up to $230 million to New York state.
In March 2019, the New York Attorney General filed the nation’s most extensive lawsuit to hold accountable the various manufacturers and distributors responsible for the opioid epidemic. In addition to J&J, the manufacturers named in the complaint included Purdue Pharma and its affiliates, as well as members of the Sackler Family (owners of Purdue) and trusts they control; Mallinckrodt LLC and its affiliates; Endo Health Solutions and its affiliates; Teva Pharmaceuticals USA, Inc. and its affiliates; and Allergan Finance, LLC and its affiliates.
The distributors named in the complaint were McKesson Corporation, Cardinal Health Inc., Amerisource Bergen Drug Corporation, and Rochester Drug Cooperative Inc.
The agreement resolves claims made by for the company’s role in helping to fuel the opioid epidemic and would allocate payments over nine years, with substantial payments made upfront.
The agreement also makes enforceable a bar stopping J&J and all of its subsidiaries, predecessors, and successors from manufacturing or selling opioids anywhere in New York, and acknowledges Johnson & Johnson’s exit from the opioid business nationally.
The cases against Purdue Pharma (and subsequently the Sackler family), Mallinckrodt, and Rochester Drug Cooperative are all now moving separately through U.S. Bankruptcy Court. The trial against all other defendants is currently slated to begin this coming week.
The Attorney General negotiated substantial injunctive relief securing the end of J&J’s manufacturing of opioids and their distribution across New York and the rest of the nation.
The company will also provide the Office of the Attorney General with details of when the last of the inventory of opioids it has already shipped expires.
Additionally, J&J will be prohibited from promoting opioids or opioid products through sales representatives, sponsorships, financial support, or any other means; will not be allowed to provide financial incentives to its sales and marketing employees for the sale of these products; and will not, directly or indirectly, provide financial support or in-kind support to any third party that primarily engages in conduct that promotes opioids, opioid products, or products for the treatment of opioid-induced side effects.
J&J will additionally be forbidden from disciplining its sales and marketing employees for not hitting opioids sales quotas - one of the key motivators J&J and other companies had in marketing opioids so heavily to the American public - and will not be allowed to use, assist, or employ any third party to engage in any activity that J&J itself would be prohibited from engaging in pursuant to today’s agreement.
J&J will also be prohibited from lobbying federal, state, or local legislative or regulatory authorities about opioids or opioid products.
Finally, J&J will have to make additional information about opioids and opioid products more accessible to the public, including to patients, health care providers, and others. Part of how J&J will fulfill this provision is by sharing clinical trial data under the Yale University Open Data Access (YODA) Project to allow researchers qualified under the program to access the company’s propriety data under the terms of the project.
...
In March 2019, the New York Attorney General filed the nation’s most extensive lawsuit to hold accountable the various manufacturers and distributors responsible for the opioid epidemic. In addition to J&J, the manufacturers named in the complaint included Purdue Pharma and its affiliates, as well as members of the Sackler Family (owners of Purdue) and trusts they control; Mallinckrodt LLC and its affiliates; Endo Health Solutions and its affiliates; Teva Pharmaceuticals USA, Inc. and its affiliates; and Allergan Finance, LLC and its affiliates.
The distributors named in the complaint were McKesson Corporation, Cardinal Health Inc., Amerisource Bergen Drug Corporation, and Rochester Drug Cooperative Inc.
The agreement resolves claims made by for the company’s role in helping to fuel the opioid epidemic and would allocate payments over nine years, with substantial payments made upfront.
The agreement also makes enforceable a bar stopping J&J and all of its subsidiaries, predecessors, and successors from manufacturing or selling opioids anywhere in New York, and acknowledges Johnson & Johnson’s exit from the opioid business nationally.
The cases against Purdue Pharma (and subsequently the Sackler family), Mallinckrodt, and Rochester Drug Cooperative are all now moving separately through U.S. Bankruptcy Court. The trial against all other defendants is currently slated to begin this coming week.
The Attorney General negotiated substantial injunctive relief securing the end of J&J’s manufacturing of opioids and their distribution across New York and the rest of the nation.
The company will also provide the Office of the Attorney General with details of when the last of the inventory of opioids it has already shipped expires.
Additionally, J&J will be prohibited from promoting opioids or opioid products through sales representatives, sponsorships, financial support, or any other means; will not be allowed to provide financial incentives to its sales and marketing employees for the sale of these products; and will not, directly or indirectly, provide financial support or in-kind support to any third party that primarily engages in conduct that promotes opioids, opioid products, or products for the treatment of opioid-induced side effects.
J&J will additionally be forbidden from disciplining its sales and marketing employees for not hitting opioids sales quotas - one of the key motivators J&J and other companies had in marketing opioids so heavily to the American public - and will not be allowed to use, assist, or employ any third party to engage in any activity that J&J itself would be prohibited from engaging in pursuant to today’s agreement.
J&J will also be prohibited from lobbying federal, state, or local legislative or regulatory authorities about opioids or opioid products.
Finally, J&J will have to make additional information about opioids and opioid products more accessible to the public, including to patients, health care providers, and others. Part of how J&J will fulfill this provision is by sharing clinical trial data under the Yale University Open Data Access (YODA) Project to allow researchers qualified under the program to access the company’s propriety data under the terms of the project.
...
As part of the Becker's Hospital Review 11th Annual Meeting, Travis Bias, DO, Medical Director of Clinician Solutions for event sponsor 3M Healthcare Information Systems (3M HIS), shared industry insights and expertise with hospital leaders during a May 17 roundtable.
Physicians spend significant time performing nonpatient-facing tasks like documentation, that are necessary but ultimately take time away from one-to-one patient care.
Technology solutions powered by artificial intelligence can reduce the amount of time spent away from the patient, vastly improving both their experience, and the physician’s.
Five key takeaways:
1. The multiple demands on physicians can fracture their time and attention. Physicians are asked to do more than just provide patient care; they are tasked with capturing the clinical complexity of their patient population. Although the time spent on additional tasks can improve the overall efficiency and efficacy of the health system, it adds to the workload and stress of the physician. "We know the demands pulling the physicians in different directions are great," Dr. Bias said. "Because of that, we have to be really clear about how their time is prioritized."
2. Reducing unnecessary technology interruptions improves the patient and physician experience. Interruptions, especially those requiring task switching, can be extremely disruptive. Digital tools like the solutions offered by 3M HIS significantly decrease those interruptions by unifying and/or automating workflows. This frees up time for the physicians to focus on patient care.
3. Physician buy-in is critical for successful healthcare technology solutions. In order for a technology solution to make a meaningful difference, physicians need to be willing to use the solution. While executive leadership is a key factor in encouraging use, clinicians are most likely to use tools if they understand how they will benefit their jobs, and if the solutions are easy and efficient to use.
4. The pandemic may have removed the technology trust barrier. Healthcare providers and patients alike were forced to make a quick shift from in-person visits to telehealth visits. The successful and speedy adoption of telemedicine could prove beneficial for other technologies, removing any reservations or barriers commonly seen as healthcare systems roll out new solutions.
5. Digital transformation enables healthcare providers to improve delivery of care. Whether it's tracking the patient journey throughout the health system, visiting patients through telemedicine or remote patient monitoring through wearable technology, digital solutions can improve the patient and physician experience. Digital transformation can meet patients where they are, identify gaps in care and improve the overall quality of care, benefiting the patient, the physician and the bottom line ...
Physicians spend significant time performing nonpatient-facing tasks like documentation, that are necessary but ultimately take time away from one-to-one patient care.
Technology solutions powered by artificial intelligence can reduce the amount of time spent away from the patient, vastly improving both their experience, and the physician’s.
Five key takeaways:
1. The multiple demands on physicians can fracture their time and attention. Physicians are asked to do more than just provide patient care; they are tasked with capturing the clinical complexity of their patient population. Although the time spent on additional tasks can improve the overall efficiency and efficacy of the health system, it adds to the workload and stress of the physician. "We know the demands pulling the physicians in different directions are great," Dr. Bias said. "Because of that, we have to be really clear about how their time is prioritized."
2. Reducing unnecessary technology interruptions improves the patient and physician experience. Interruptions, especially those requiring task switching, can be extremely disruptive. Digital tools like the solutions offered by 3M HIS significantly decrease those interruptions by unifying and/or automating workflows. This frees up time for the physicians to focus on patient care.
3. Physician buy-in is critical for successful healthcare technology solutions. In order for a technology solution to make a meaningful difference, physicians need to be willing to use the solution. While executive leadership is a key factor in encouraging use, clinicians are most likely to use tools if they understand how they will benefit their jobs, and if the solutions are easy and efficient to use.
4. The pandemic may have removed the technology trust barrier. Healthcare providers and patients alike were forced to make a quick shift from in-person visits to telehealth visits. The successful and speedy adoption of telemedicine could prove beneficial for other technologies, removing any reservations or barriers commonly seen as healthcare systems roll out new solutions.
5. Digital transformation enables healthcare providers to improve delivery of care. Whether it's tracking the patient journey throughout the health system, visiting patients through telemedicine or remote patient monitoring through wearable technology, digital solutions can improve the patient and physician experience. Digital transformation can meet patients where they are, identify gaps in care and improve the overall quality of care, benefiting the patient, the physician and the bottom line ...
In early 2020, COVID-19 seemed like a potentially significant and disruptive event for the workers compensation industry. NCCI responded by authoring its white paper, COVID-19 and Workers Compensation: Modeling Potential Impacts (PDF) and creating the COVID-19 Hypothetical Scenarios Tool to help the industry evaluate potential direct cost impacts the pandemic may have on WC losses.
Leveraging the COVID-19 claims data that has been reported to NCCI so far, can bring the ultimate impact that the pandemic may have on WC costs more into focus.
Key Takeaways:
- - NCCI has observed $260 million of case-incurred COVID-19 WC losses, excluding self-insureds, for Accident Year 2020 in jurisdictions where NCCI provides ratemaking services.
- - NCCI estimates that COVID-19 claims, excluding self-insureds, have the potential to ultimately result in WC losses exceeding $500 million over the entire duration of the pandemic across jurisdictions where NCCI provides ratemaking services. (NCCI provides ratemaking services in 38 jurisdictions.)
As of year-end 2020, private carriers and state funds reported 45,000 pandemic-related claims to NCCI associated with $260 million in case-incurred losses - an average COVID-19 cost per claim of approximately $6,000. Note: This claim count total reflects those claims with a reported payment or reserve (i.e., a loss or expense reserve).
Most of the reported COVID-19 claims to date have associated costs less than $1,500 and almost 95% have costs less than $10,000.
Further, while larger claims - those with losses greater than $100,000 - represent about 1% of all COVID-19 claims, they account for approximately 60% of reported COVID-19 losses to date. Claims in this category are generally more likely to remain open for extended periods of time, involve older workers, require inpatient hospitalization, and involve more complications due to the existence of comorbidities.
To date, nursing/convalescent home employees, other healthcare workers, and first responders have collectively accounted for more than 75% of all COVID-19 claims reported to NCCI. Other workers in the restaurant, building operations, distribution systems, and retail industries have collectively accounted for an additional 14% of reported COVID-19 claims.
Historically, medical-only claims (i.e., claims without an indemnity, lost-wage component) have accounted for almost 75% of all WC claims. Interestingly, this claim-type distribution reversed when we examined reported COVID-19 claims.
Of all the reported pandemic-related claims with a payment or loss reserve, almost 75% have an indemnity component, while only 25% are medical-only ...
Leveraging the COVID-19 claims data that has been reported to NCCI so far, can bring the ultimate impact that the pandemic may have on WC costs more into focus.
Key Takeaways:
- - NCCI has observed $260 million of case-incurred COVID-19 WC losses, excluding self-insureds, for Accident Year 2020 in jurisdictions where NCCI provides ratemaking services.
- - NCCI estimates that COVID-19 claims, excluding self-insureds, have the potential to ultimately result in WC losses exceeding $500 million over the entire duration of the pandemic across jurisdictions where NCCI provides ratemaking services. (NCCI provides ratemaking services in 38 jurisdictions.)
As of year-end 2020, private carriers and state funds reported 45,000 pandemic-related claims to NCCI associated with $260 million in case-incurred losses - an average COVID-19 cost per claim of approximately $6,000. Note: This claim count total reflects those claims with a reported payment or reserve (i.e., a loss or expense reserve).
Most of the reported COVID-19 claims to date have associated costs less than $1,500 and almost 95% have costs less than $10,000.
Further, while larger claims - those with losses greater than $100,000 - represent about 1% of all COVID-19 claims, they account for approximately 60% of reported COVID-19 losses to date. Claims in this category are generally more likely to remain open for extended periods of time, involve older workers, require inpatient hospitalization, and involve more complications due to the existence of comorbidities.
To date, nursing/convalescent home employees, other healthcare workers, and first responders have collectively accounted for more than 75% of all COVID-19 claims reported to NCCI. Other workers in the restaurant, building operations, distribution systems, and retail industries have collectively accounted for an additional 14% of reported COVID-19 claims.
Historically, medical-only claims (i.e., claims without an indemnity, lost-wage component) have accounted for almost 75% of all WC claims. Interestingly, this claim-type distribution reversed when we examined reported COVID-19 claims.
Of all the reported pandemic-related claims with a payment or loss reserve, almost 75% have an indemnity component, while only 25% are medical-only ...
The Los Angeles Times reports that the Delta coronavirus variant is now the third-most common in California, new data show, underscoring the danger of the highly contagious strain to people who have not been vaccinated against COVID-19.
The variant makes up 14.5% of California coronavirus cases analyzed so far in June, up from 4.7% in May, when it was the fourth-most identified variant in California, according to data released by the California Department of Public Health.
Experts say the Delta variant poses a greater chance of infection for unvaccinated people if they are exposed. The variant, first identified in India, may be twice as transmissible as the conventional coronavirus strains. It has been responsible for the rise in cases recently in India, the United Kingdom and elsewhere.
But vaccinated people are well protected against infection and illness from the Delta variant. One recent study found that the full two-dose course of the Pfizer-BioNTech vaccine was 88% effective against symptomatic disease caused by the Delta variant and 96% protective against hospitalization.
Los Angeles County, the nation’s most populous, has confirmed 123 Delta variant cases - 49 of them among residents of Palmdale and Lancaster. Fourteen cases of the Delta variant were in people from a single household.
L.A. County data suggest that vaccines are still overwhelmingly effective in protecting people against the Delta variant, as well as other known variants. Of those 123 confirmed cases of the Delta variant in the county, 89% occurred among people who were not vaccinated against COVID-19, and 2% among those who were partially vaccinated. No one has died from the Delta variant in L.A. County.
The few fully vaccinated people who have been infected with the Delta variant "experienced relatively mild illness," L.A. County Public Health Director Barbara Ferrer said.
Almost everyone who has died in L.A. County of COVID-19 has been unvaccinated. Data released by the county showed that 99.8% of COVID-19 deaths from Dec. 7 to June 7 occurred among unvaccinated people.
"If you are fully vaccinated, you have a lot of protection," Ferrer said, adding that for the "very small numbers" of people who contracted the Delta variant despite vaccination, "they really did not have serious illness. ...This is a pandemic of unvaccinated people."
The results of outbreaks of the Delta variant elsewhere also support the vaccines’ effectiveness.
Meanwhile, data released by California show that the percentage of the tested population who have antibodies to the coronavirus - a sign of immunity to COVID-19 - is also increasing.
Experts have estimated that 70% to 85% of a population needs to have immunity for a region to develop "herd immunity" to COVID-19, which interrupts the sustained transmission of the virus.
The Delta variant is also spreading nationwide. From May 9 to May 22, the Delta variant made up less than 3% of analyzed coronavirus samples nationwide. But from June 6 to June 19, that proportion rose to more than 20% ...
The variant makes up 14.5% of California coronavirus cases analyzed so far in June, up from 4.7% in May, when it was the fourth-most identified variant in California, according to data released by the California Department of Public Health.
Experts say the Delta variant poses a greater chance of infection for unvaccinated people if they are exposed. The variant, first identified in India, may be twice as transmissible as the conventional coronavirus strains. It has been responsible for the rise in cases recently in India, the United Kingdom and elsewhere.
But vaccinated people are well protected against infection and illness from the Delta variant. One recent study found that the full two-dose course of the Pfizer-BioNTech vaccine was 88% effective against symptomatic disease caused by the Delta variant and 96% protective against hospitalization.
Los Angeles County, the nation’s most populous, has confirmed 123 Delta variant cases - 49 of them among residents of Palmdale and Lancaster. Fourteen cases of the Delta variant were in people from a single household.
L.A. County data suggest that vaccines are still overwhelmingly effective in protecting people against the Delta variant, as well as other known variants. Of those 123 confirmed cases of the Delta variant in the county, 89% occurred among people who were not vaccinated against COVID-19, and 2% among those who were partially vaccinated. No one has died from the Delta variant in L.A. County.
The few fully vaccinated people who have been infected with the Delta variant "experienced relatively mild illness," L.A. County Public Health Director Barbara Ferrer said.
Almost everyone who has died in L.A. County of COVID-19 has been unvaccinated. Data released by the county showed that 99.8% of COVID-19 deaths from Dec. 7 to June 7 occurred among unvaccinated people.
"If you are fully vaccinated, you have a lot of protection," Ferrer said, adding that for the "very small numbers" of people who contracted the Delta variant despite vaccination, "they really did not have serious illness. ...This is a pandemic of unvaccinated people."
The results of outbreaks of the Delta variant elsewhere also support the vaccines’ effectiveness.
Meanwhile, data released by California show that the percentage of the tested population who have antibodies to the coronavirus - a sign of immunity to COVID-19 - is also increasing.
Experts have estimated that 70% to 85% of a population needs to have immunity for a region to develop "herd immunity" to COVID-19, which interrupts the sustained transmission of the virus.
The Delta variant is also spreading nationwide. From May 9 to May 22, the Delta variant made up less than 3% of analyzed coronavirus samples nationwide. But from June 6 to June 19, that proportion rose to more than 20% ...
The Los Angeles Times reports that the city of San Francisco's 35,000 employees will need to get vaccinated against COVID-19 or risk losing their jobs.
The new policy would make San Francisco the first major city and county in California to require COVID-19 vaccinations for its employees. Workers who refuse, or fail to provide a religious or medical exemption, could be terminated.
The mandatory vaccination requirement, which goes into effect once the vaccines have been formally approved by the Food and Drug Administration, extends to all city government employees, including police, firefighters, custodians and City Hall clerks. Teachers are not covered by this policy because they are school district employees. Earlier, San Francisco mandated that front-line workers in hospitals, nursing homes and jails be fully vaccinated against COVID-19.
Carol Isen, San Francisco’s director of human resources, said that employees will have until July 29 to report their current vaccination status to the city as a condition of their employment. Staff will need to upload their vaccination cards or documentation showing proof of vaccination through the city’s payroll system. Medical exemptions for employees who are ineligible for a COVID-19 vaccination must be verified by a healthcare provider. Religious exemptions will also be considered.
San Francisco enacted some of the nation’s strictest pandemic regulations and has the highest vaccination rate in the state, with at least 71% of eligible residents fully vaccinated, according to the city’s Department of Public Health. As of Wednesday, 55% of city employees have reported receiving at least one dose of a COVID-19 vaccine, according to the Department of Human Resources.
Not everyone is on board with the new policy. Theresa Rutherford, regional vice president of the Service Employees International Union Local 1021 chapter, said it threatens the livelihoods of front-line essential workers. The chapter represents more than half of all workers employed by the city and county of San Francisco.
At this point, Los Angeles County isn’t planning to follow in San Francisco’s footsteps, according to Public Health Director Barbara Ferrer. "We’d obviously be working very closely with our labor partners, with the Board of Supervisors and the CEO’s office on making a decision of that magnitude," she said during a briefing Thursday. "You know, there’s about 110,000 county employees, so we would want to really have a healthy discussion with our employees and particularly with our labor partners about what’s the most sensible path forward."
The University of California and California State University systems have announced they will be requiring all students, faculty and staff on their campuses to be vaccinated ...
The new policy would make San Francisco the first major city and county in California to require COVID-19 vaccinations for its employees. Workers who refuse, or fail to provide a religious or medical exemption, could be terminated.
The mandatory vaccination requirement, which goes into effect once the vaccines have been formally approved by the Food and Drug Administration, extends to all city government employees, including police, firefighters, custodians and City Hall clerks. Teachers are not covered by this policy because they are school district employees. Earlier, San Francisco mandated that front-line workers in hospitals, nursing homes and jails be fully vaccinated against COVID-19.
Carol Isen, San Francisco’s director of human resources, said that employees will have until July 29 to report their current vaccination status to the city as a condition of their employment. Staff will need to upload their vaccination cards or documentation showing proof of vaccination through the city’s payroll system. Medical exemptions for employees who are ineligible for a COVID-19 vaccination must be verified by a healthcare provider. Religious exemptions will also be considered.
San Francisco enacted some of the nation’s strictest pandemic regulations and has the highest vaccination rate in the state, with at least 71% of eligible residents fully vaccinated, according to the city’s Department of Public Health. As of Wednesday, 55% of city employees have reported receiving at least one dose of a COVID-19 vaccine, according to the Department of Human Resources.
Not everyone is on board with the new policy. Theresa Rutherford, regional vice president of the Service Employees International Union Local 1021 chapter, said it threatens the livelihoods of front-line essential workers. The chapter represents more than half of all workers employed by the city and county of San Francisco.
At this point, Los Angeles County isn’t planning to follow in San Francisco’s footsteps, according to Public Health Director Barbara Ferrer. "We’d obviously be working very closely with our labor partners, with the Board of Supervisors and the CEO’s office on making a decision of that magnitude," she said during a briefing Thursday. "You know, there’s about 110,000 county employees, so we would want to really have a healthy discussion with our employees and particularly with our labor partners about what’s the most sensible path forward."
The University of California and California State University systems have announced they will be requiring all students, faculty and staff on their campuses to be vaccinated ...
Researchers have conducted a study showing that the B.1.1.7 lineage of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that emerged in the UK is now rapidly being displaced as the dominant strain in the United States by the variants of concern B.1.617.2 (Delta) and P.1 (Gamma) that emerged in India and Brazil, respectively.
A pre-print version of the research paper is available on the medRxiv* server, while the article undergoes peer review.
Since B.1.617.2 has displaced B.1.1.7 as the dominant variant in England and other countries, Alexandre Bolze and colleagues from Helix in San Mateo, California, set out to determine whether it is also displacing B.1.1.7 in the United States.
The B.1.617.2 variant was first identified in the United States on March 16th, 2021.
To examine the impact that the B.1.617.2 and P.1 variants of concern have had on the prevalence of B.1.1.7 in the United States, the researchers analyzed PCR and sequencing results of samples collected by the Helix laboratory across the country since April 2021.
The team’s analysis of polymerase chain reaction (PCR) and viral sequencing results collected from across the United States showed that B.1.1.7 is no longer responsible for the majority of new cases in the country.
The percentage of SARS-CoV-2-positive cases that were of the B.1.1.7 lineage dropped from 70% in April 2021 to 42% over a period of just 6 weeks.
Next, the researchers compared the Helix sequencing data by county with the county vaccination rates reported by the CDC.
The study showed that B.1.617.2 had a higher growth rate than P.1 and was growing faster in counties with a lower vaccination rate.
This revealed that the prevalence of B.1.617.2, which is more transmissible but less resistant to vaccination, is higher in counties with lower vaccination rates. By contrast, P.1, which is less transmissible but more resistant to vaccination, is more prevalent in counties with higher vaccination rates.
Moreover, while a study by Public Health England showed that full immunization (two doses) with the AstraZeneca or Pfizer-BioNTech vaccine remains more than 90% effective at protecting against hospitalization following infection with B.1.617.2, the efficacy following one dose is lower, compared with B.1.1.7 infection, says Bolze and colleagues.
The researchers say they expect that B.1.617.2 will soon become the dominant variant in the United States ...
A pre-print version of the research paper is available on the medRxiv* server, while the article undergoes peer review.
Since B.1.617.2 has displaced B.1.1.7 as the dominant variant in England and other countries, Alexandre Bolze and colleagues from Helix in San Mateo, California, set out to determine whether it is also displacing B.1.1.7 in the United States.
The B.1.617.2 variant was first identified in the United States on March 16th, 2021.
To examine the impact that the B.1.617.2 and P.1 variants of concern have had on the prevalence of B.1.1.7 in the United States, the researchers analyzed PCR and sequencing results of samples collected by the Helix laboratory across the country since April 2021.
The team’s analysis of polymerase chain reaction (PCR) and viral sequencing results collected from across the United States showed that B.1.1.7 is no longer responsible for the majority of new cases in the country.
The percentage of SARS-CoV-2-positive cases that were of the B.1.1.7 lineage dropped from 70% in April 2021 to 42% over a period of just 6 weeks.
Next, the researchers compared the Helix sequencing data by county with the county vaccination rates reported by the CDC.
The study showed that B.1.617.2 had a higher growth rate than P.1 and was growing faster in counties with a lower vaccination rate.
This revealed that the prevalence of B.1.617.2, which is more transmissible but less resistant to vaccination, is higher in counties with lower vaccination rates. By contrast, P.1, which is less transmissible but more resistant to vaccination, is more prevalent in counties with higher vaccination rates.
Moreover, while a study by Public Health England showed that full immunization (two doses) with the AstraZeneca or Pfizer-BioNTech vaccine remains more than 90% effective at protecting against hospitalization following infection with B.1.617.2, the efficacy following one dose is lower, compared with B.1.1.7 infection, says Bolze and colleagues.
The researchers say they expect that B.1.617.2 will soon become the dominant variant in the United States ...
The U.S. Supreme Court said California was violating the Constitution with a decades-old regulation that gives union organizers access to agricultural company land for part of the year to talk to workers.
Voting 6-3 along ideological lines, the justices said the 1975 provision, which grew out of the efforts of Cesar Chavez to give farm workers collective bargaining rights, infringed the rights of landowners.
The California regulation grants labor organizations a "right to take access" to an agricultural employer’s property in order to solicit support for unionization. Cal. Code Regs., tit. 8, §20900(e)(1)(C). The regulation mandates that agricultural employers allow union organizers onto their property for up to three hours per day, 120 days per year.
Organizers from the United Farm Workers sought to take access to property owned by two California growers "Cedar Point Nursery and Fowler Packing Company.
The growers filed suit in Federal District Court seeking to enjoin enforcement of the access regulation on the grounds that it appropriated without compensation an easement for union organizers to enter their property and therefore constituted an unconstitutional per se physical taking under the Fifth and Fourteenth Amendments.
The District Court denied the growers’ motion for a preliminary injunction and dismissed the complaint, holding that the access regulation did not constitute a per se physical taking because it did not allow the public to access the growers’ property in a permanent and continuous manner.
A divided panel of the Court of Appeals for the Ninth Circuit affirmed, and rehearing en banc was denied over dissent.
The U.S. Supreme Court reversed and ruled in favor of the landowners in the case of Cedar Point Nursery v Hassid.
The Takings Clause of the Fifth Amendment, applicable to the States through the Fourteenth Amendment, provides: "[N]or shall private property be taken for public use, without just compensation."
When the government physically acquires private property for a public use, the Takings Clause obligates the government to provide the owner with just compensation.
California’s access regulation appropriates a right to invade the growers’ property and therefore constitutes a per se physical taking. Rather than restraining the growers’ use of their own property, the regulation appropriates for the enjoyment of third parties (here union organizers) the owners’ right to exclude. The right to exclude is "a fundamental element of the property right." ...
Voting 6-3 along ideological lines, the justices said the 1975 provision, which grew out of the efforts of Cesar Chavez to give farm workers collective bargaining rights, infringed the rights of landowners.
The California regulation grants labor organizations a "right to take access" to an agricultural employer’s property in order to solicit support for unionization. Cal. Code Regs., tit. 8, §20900(e)(1)(C). The regulation mandates that agricultural employers allow union organizers onto their property for up to three hours per day, 120 days per year.
Organizers from the United Farm Workers sought to take access to property owned by two California growers "Cedar Point Nursery and Fowler Packing Company.
The growers filed suit in Federal District Court seeking to enjoin enforcement of the access regulation on the grounds that it appropriated without compensation an easement for union organizers to enter their property and therefore constituted an unconstitutional per se physical taking under the Fifth and Fourteenth Amendments.
The District Court denied the growers’ motion for a preliminary injunction and dismissed the complaint, holding that the access regulation did not constitute a per se physical taking because it did not allow the public to access the growers’ property in a permanent and continuous manner.
A divided panel of the Court of Appeals for the Ninth Circuit affirmed, and rehearing en banc was denied over dissent.
The U.S. Supreme Court reversed and ruled in favor of the landowners in the case of Cedar Point Nursery v Hassid.
The Takings Clause of the Fifth Amendment, applicable to the States through the Fourteenth Amendment, provides: "[N]or shall private property be taken for public use, without just compensation."
When the government physically acquires private property for a public use, the Takings Clause obligates the government to provide the owner with just compensation.
California’s access regulation appropriates a right to invade the growers’ property and therefore constitutes a per se physical taking. Rather than restraining the growers’ use of their own property, the regulation appropriates for the enjoyment of third parties (here union organizers) the owners’ right to exclude. The right to exclude is "a fundamental element of the property right." ...
