The coronavirus variant first seen in Los Angeles in July now accounts for about 44% of new infections in Southern California and more than a third of new infections throughout the state, researchers reported Thursday.
In addition, the variant has spread across the United States and to six countries around the globe, according to the study in the Journal of the American Medical Assn.
It "remains uncertain" whether the genetic changes that characterize the fast-moving variant have improved its ability to transmit from person to person, or to make people infected with it sicker, a team from Cedars-Sinai Medical Center in Los Angeles acknowledged in the JAMA report. But the virus’ rapid propagation in California is a cause for some concern, they wrote.
The Los Angeles Times reports that the homegrown variant is distinct from other versions of the virus present in the U.S., including the B.1.1.7 strain from the United Kingdom and the B.1.351 strain from South Africa. But like those new strains, this variant is defined by several mutations in the virus’ spike protein, the "docking mechanism" the virus uses to latch on to human cells.
One of the California variant’s five mutations, known to scientists as L452R, could alter a particularly critical part of the spike protein called the receptor-binding domain.
A study conducted last year by Howard University researchers found that the mutation helps the virus attach more firmly to human cells. It therefore has the potential to enhance the virus’ transmission.
At both Cedars-Sinai and the UC San Francisco Medical Center, samples of the new variant are being tested in an effort to detect whether its altered genetic makeup has given the virus new powers to spread or sicken.
Its rapidly increasing share of California cases is also ominous, the study authors said.
Although the variant was barely detectable in early October, it accounted for 24% of roughly 4,500 viral samples gathered throughout Southern California in the last weeks of 2020, and 18% of statewide samples. Less than a month later, its share of new infections had climbed.
From Jan. 1 to Jan. 22, the variant accounted for 44% of coronavirus samples collected in Southern California and 35% of samples from throughout the state.
Shaolei Teng, a Howard University biologist who led a team exploring the effect of the virus’ genetic changes, said the variant’s L452R mutation clearly improved its ability to bind to human cells. In all likelihood, he said, the change also makes it easier for the virus to get inside cells - a crucial step in the replication process.
What’s more, the variant has begun to travel widely. It has been detected in Alaska, Arizona, Connecticut, Georgia, Hawaii, Maryland, Michigan, New Mexico, Nevada, New York, Oregon, Rhode Island, South Carolina, Texas, Utah, Washington, Wisconsin, Wyoming and Washington, D.C.
It has also made its way to Australia, Denmark, Israel, New Zealand, Singapore and the United Kingdom ...
In addition, the variant has spread across the United States and to six countries around the globe, according to the study in the Journal of the American Medical Assn.
It "remains uncertain" whether the genetic changes that characterize the fast-moving variant have improved its ability to transmit from person to person, or to make people infected with it sicker, a team from Cedars-Sinai Medical Center in Los Angeles acknowledged in the JAMA report. But the virus’ rapid propagation in California is a cause for some concern, they wrote.
The Los Angeles Times reports that the homegrown variant is distinct from other versions of the virus present in the U.S., including the B.1.1.7 strain from the United Kingdom and the B.1.351 strain from South Africa. But like those new strains, this variant is defined by several mutations in the virus’ spike protein, the "docking mechanism" the virus uses to latch on to human cells.
One of the California variant’s five mutations, known to scientists as L452R, could alter a particularly critical part of the spike protein called the receptor-binding domain.
A study conducted last year by Howard University researchers found that the mutation helps the virus attach more firmly to human cells. It therefore has the potential to enhance the virus’ transmission.
At both Cedars-Sinai and the UC San Francisco Medical Center, samples of the new variant are being tested in an effort to detect whether its altered genetic makeup has given the virus new powers to spread or sicken.
Its rapidly increasing share of California cases is also ominous, the study authors said.
Although the variant was barely detectable in early October, it accounted for 24% of roughly 4,500 viral samples gathered throughout Southern California in the last weeks of 2020, and 18% of statewide samples. Less than a month later, its share of new infections had climbed.
From Jan. 1 to Jan. 22, the variant accounted for 44% of coronavirus samples collected in Southern California and 35% of samples from throughout the state.
Shaolei Teng, a Howard University biologist who led a team exploring the effect of the virus’ genetic changes, said the variant’s L452R mutation clearly improved its ability to bind to human cells. In all likelihood, he said, the change also makes it easier for the virus to get inside cells - a crucial step in the replication process.
What’s more, the variant has begun to travel widely. It has been detected in Alaska, Arizona, Connecticut, Georgia, Hawaii, Maryland, Michigan, New Mexico, Nevada, New York, Oregon, Rhode Island, South Carolina, Texas, Utah, Washington, Wisconsin, Wyoming and Washington, D.C.
It has also made its way to Australia, Denmark, Israel, New Zealand, Singapore and the United Kingdom ...
A hearing officer has upheld the Labor Commissioner’s wage theft citations of nearly $2 million to a Southern California drywall contractor affecting 472 laborers who worked on 26 construction projects throughout Southern California.
In 2018, the Labor Commissioner’s Office cited Fullerton Pacific Interiors Inc. $1,964,679 for wage theft violations and civil penalties.
The workers who did taping and drywall installation at hotel, recreation centers and casino projects in Los Angeles, Orange and San Bernardino counties from August 2014 to June 2016 were paid a daily rate that did not properly compensate them for overtime hours and rest breaks, and 28 workers were paid less than minimum wage.
Fullerton Pacific Interiors Inc. appealed the citations, and the hearing officer affirmed each citation in January after a non-continuous 10-day administrative appeal hearing conducted throughout 2019.
The investigation into Fullerton Pacific Interiors Inc, began in June 2016, after a referral to the Labor Commissioner’s Bureau of Field Enforcement (BOFE) from the Carpenters/Contractors Cooperation Committee.
BOFE’s wage audit identified 472 workers employed during the violation period did not receive lawful rest periods, 289 were not paid overtime and 28 were paid less than minimum wage.
The Labor Commissioner’s Office issued citations for minimum wage violations, liquidated damages, overtime violations, rest periods violations, failure to comply with itemized statement provisions and waiting time penalties.
When workers are paid less than minimum wage, they are entitled to liquidated damages that equal the amount of underpaid minimum wages plus interest. Waiting time penalties are imposed when the employer intentionally fails to pay all wages due to the employee at the time of separation.
This penalty is calculated by taking the employee’s daily rate of pay and multiplying it by the number of days the employee was not paid, up to a maximum of 30 days.
...
In 2018, the Labor Commissioner’s Office cited Fullerton Pacific Interiors Inc. $1,964,679 for wage theft violations and civil penalties.
The workers who did taping and drywall installation at hotel, recreation centers and casino projects in Los Angeles, Orange and San Bernardino counties from August 2014 to June 2016 were paid a daily rate that did not properly compensate them for overtime hours and rest breaks, and 28 workers were paid less than minimum wage.
Fullerton Pacific Interiors Inc. appealed the citations, and the hearing officer affirmed each citation in January after a non-continuous 10-day administrative appeal hearing conducted throughout 2019.
The investigation into Fullerton Pacific Interiors Inc, began in June 2016, after a referral to the Labor Commissioner’s Bureau of Field Enforcement (BOFE) from the Carpenters/Contractors Cooperation Committee.
BOFE’s wage audit identified 472 workers employed during the violation period did not receive lawful rest periods, 289 were not paid overtime and 28 were paid less than minimum wage.
The Labor Commissioner’s Office issued citations for minimum wage violations, liquidated damages, overtime violations, rest periods violations, failure to comply with itemized statement provisions and waiting time penalties.
When workers are paid less than minimum wage, they are entitled to liquidated damages that equal the amount of underpaid minimum wages plus interest. Waiting time penalties are imposed when the employer intentionally fails to pay all wages due to the employee at the time of separation.
This penalty is calculated by taking the employee’s daily rate of pay and multiplying it by the number of days the employee was not paid, up to a maximum of 30 days.
...
Foster Farms, the nation’s 10th largest poultry producer, operates a plant in Livingston, California, about 100 miles east of San Jose. It employs over 2,500 workers there, making it the largest employer in Merced County.
The first outbreak at the Livingston plant peaked in August 2020. In total, nearly 400 workers tested positive and nine died. Merced County’s public health director called the incident "one of the largest occupational fatalities experienced during COVID-19 in the state of California."
The county health department shut down the plant for six days, during which Foster Farms completed two rounds of deep cleaning of its facilities and COVID-19 testing of its workforce.
In the aftermath of the first outbreak, United Farm Workers of America, the union that represents about 2,000 employees at the plant, alleged that Foster Farms had not been following county public health orders and other directives related to limiting the spread of COVID-19.
Fisher Phillips reports that following a second COVID-19 outbreak at Foster Farms, a California judge issued what is likely the first injunction in the nation against a meat processing plant over corona virus safety.
Soon after the suit was filed, the court issued a temporary restraining order (TRO) at the plaintiffs’ request. A TRO typically lasts no more than 30 days.
The court set a a preliminary injunction hearing on January 29, 2021 and decided to issue an injunction incorporating the TRO’s 20 requirements imposed on Foster Farms.
The ruling leaves in place the substance of a December 2020 temporary restraining order requiring the employer to take 20 specific steps to protect workers from the spread of the virus. The lawsuit was brought by the union that represents the employees at the plant.
Those requirements include:
- - Requiring all workers to wear face coverings and supplying them with masks;
- - Promoting social distancing by staggering employees’ works schedules and break times, and installing additional break areas;
- - Installing physical dividers in areas where social distancing is difficult to maintain, like production lines;
- - Training employees on COVID-19 hazard mitigation and informing them of testing requirements, outbreaks that occur, areas affected, and training on safety requirements; and
- - Warning and appropriately disciplining employees who do not comply with its new COVID-19 policies.
Foster Farms plans to appeal the ruling, characterizing it as unnecessary court intervention, as both the county public health department and Cal/OSHA already have oversight of the plant. Company officials also highlighted the fact that Foster Farms has administered nearly 100,000 COVID-19 tests to its workforce since the pandemic began, 40,000 of them at the Livingston plant ...
The first outbreak at the Livingston plant peaked in August 2020. In total, nearly 400 workers tested positive and nine died. Merced County’s public health director called the incident "one of the largest occupational fatalities experienced during COVID-19 in the state of California."
The county health department shut down the plant for six days, during which Foster Farms completed two rounds of deep cleaning of its facilities and COVID-19 testing of its workforce.
In the aftermath of the first outbreak, United Farm Workers of America, the union that represents about 2,000 employees at the plant, alleged that Foster Farms had not been following county public health orders and other directives related to limiting the spread of COVID-19.
Fisher Phillips reports that following a second COVID-19 outbreak at Foster Farms, a California judge issued what is likely the first injunction in the nation against a meat processing plant over corona virus safety.
Soon after the suit was filed, the court issued a temporary restraining order (TRO) at the plaintiffs’ request. A TRO typically lasts no more than 30 days.
The court set a a preliminary injunction hearing on January 29, 2021 and decided to issue an injunction incorporating the TRO’s 20 requirements imposed on Foster Farms.
The ruling leaves in place the substance of a December 2020 temporary restraining order requiring the employer to take 20 specific steps to protect workers from the spread of the virus. The lawsuit was brought by the union that represents the employees at the plant.
Those requirements include:
- - Requiring all workers to wear face coverings and supplying them with masks;
- - Promoting social distancing by staggering employees’ works schedules and break times, and installing additional break areas;
- - Installing physical dividers in areas where social distancing is difficult to maintain, like production lines;
- - Training employees on COVID-19 hazard mitigation and informing them of testing requirements, outbreaks that occur, areas affected, and training on safety requirements; and
- - Warning and appropriately disciplining employees who do not comply with its new COVID-19 policies.
Foster Farms plans to appeal the ruling, characterizing it as unnecessary court intervention, as both the county public health department and Cal/OSHA already have oversight of the plant. Company officials also highlighted the fact that Foster Farms has administered nearly 100,000 COVID-19 tests to its workforce since the pandemic began, 40,000 of them at the Livingston plant ...
Telehealth services and providers have been in high demand as the world copes with the COVID-19 public health emergency. Federal and state agencies have amended, and often loosened, regulations in an attempt to facilitate and expand access to telehealth.
However, the honeymoon phase of relaxed oversight may be coming to an end as the world adjusts to a new-normal.
The Department of Health and Human Services Office of Inspector General, along with state and federal law enforcement partners, participated in a nationwide health care fraud takedown in September 2020.
The takedown focused on several schemes to include alleged telefraud, or scams that leverage aggressive marketing and so-called telehealth services to commit fraud.
This fraudulent activity resulted in charges for 345 defendants in 51 judicial districts, including telemedicine executives, the owners of durable medical equipment (DME) companies, genetic testing laboratories, pharmacies, and more than100 medical practitioners, for their alleged participation in health care fraud schemes involving more than $6 billion in alleged loss.
In the aftermath of this takedown, on January 26, 2021, the Department of Health and Human Services, Office of Inspector General ("OIG") announced a new telehealth-related audit targeting the implementation of telehealth waivers by home health agencies during the public health emergency.
On the same day, OIG announced a second telehealth-related audit to investigate a broad swath of telehealth services, dubbed "Audits of Medicare Part B Telehealth Services During the COVID-19 Public Health Emergency."
In the Announcement, the OIG reveals its plan to conduct a series of audits of Medicare Part B telehealth services. The audits will occur in two phases.
The first phase aims to make an early assessment of whether services "such as evaluation and management, opioid use order, end-stage renal disease, and psychotherapy" meet Medicare requirements.
The second phase will dive deeper into a broad range of Medicare Part B telehealth services and compliance issues, including "distant and originating site locations, virtual check-in services, electronic visits, remote patient monitoring, use of telehealth technology, and annual wellness visits." ...
However, the honeymoon phase of relaxed oversight may be coming to an end as the world adjusts to a new-normal.
The Department of Health and Human Services Office of Inspector General, along with state and federal law enforcement partners, participated in a nationwide health care fraud takedown in September 2020.
The takedown focused on several schemes to include alleged telefraud, or scams that leverage aggressive marketing and so-called telehealth services to commit fraud.
This fraudulent activity resulted in charges for 345 defendants in 51 judicial districts, including telemedicine executives, the owners of durable medical equipment (DME) companies, genetic testing laboratories, pharmacies, and more than100 medical practitioners, for their alleged participation in health care fraud schemes involving more than $6 billion in alleged loss.
In the aftermath of this takedown, on January 26, 2021, the Department of Health and Human Services, Office of Inspector General ("OIG") announced a new telehealth-related audit targeting the implementation of telehealth waivers by home health agencies during the public health emergency.
On the same day, OIG announced a second telehealth-related audit to investigate a broad swath of telehealth services, dubbed "Audits of Medicare Part B Telehealth Services During the COVID-19 Public Health Emergency."
In the Announcement, the OIG reveals its plan to conduct a series of audits of Medicare Part B telehealth services. The audits will occur in two phases.
The first phase aims to make an early assessment of whether services "such as evaluation and management, opioid use order, end-stage renal disease, and psychotherapy" meet Medicare requirements.
The second phase will dive deeper into a broad range of Medicare Part B telehealth services and compliance issues, including "distant and originating site locations, virtual check-in services, electronic visits, remote patient monitoring, use of telehealth technology, and annual wellness visits." ...
The California Attorney General, along with a coalition of attorneys general from 47 states, the District of Columbia and five U.S. territories, announced a $600 million settlement with one of the world’s largest consulting firms, McKinsey & Company (McKinsey).
McKinsey & Company is an American worldwide management consulting firm, founded in 1926 by University of Chicago professor James O. McKinsey, that advises on strategic management to corporations, governments, and other organizations.
Under the leadership of Marvin Bower, McKinsey expanded into Europe during the 1940s and 1950s. In the 1960s, McKinsey's Fred Gluck - along with Boston Consulting Group's Bruce Henderson, Bill Bain at Bain & Company, and Harvard Business School's Michael Porter - transformed corporate culture.
McKinsey advised opioid makers on how to "turbocharge" sales of OxyContin, propose strategies "to counter the emotional messages from mothers with teenagers that overdosed" on OxyContin, and help opioid makers circumvent regulation.
The firm also advised Purdue Pharma to offer pharmacies rebates based on the number of overdoses and addictions they caused.
In February 2021, McKinsey reached agreements with attorneys general in 49 states, five U.S. territories, and the District of Columbia. Across the settlements, the firm agreed to pay nearly $600 million to settle investigations into its role in promoting sales of OxyContin.
The settlement also resolves California’s investigation into the company’s role in advising opioid companies, helping those companies promote their drugs, and profiting from the opioid epidemic. California will receive $59,613,603.99 from the settlement.
In addition to providing funds to address the crisis, the agreement calls on McKinsey to prepare tens of thousands of its internal documents detailing its work for Purdue Pharma and other opioid companies for public disclosure online.
When states began to sue Purdue’s directors for their implementation of McKinsey’s marketing schemes, McKinsey partners began corresponding about deleting documents and emails related to their work for Purdue ...
McKinsey & Company is an American worldwide management consulting firm, founded in 1926 by University of Chicago professor James O. McKinsey, that advises on strategic management to corporations, governments, and other organizations.
Under the leadership of Marvin Bower, McKinsey expanded into Europe during the 1940s and 1950s. In the 1960s, McKinsey's Fred Gluck - along with Boston Consulting Group's Bruce Henderson, Bill Bain at Bain & Company, and Harvard Business School's Michael Porter - transformed corporate culture.
McKinsey advised opioid makers on how to "turbocharge" sales of OxyContin, propose strategies "to counter the emotional messages from mothers with teenagers that overdosed" on OxyContin, and help opioid makers circumvent regulation.
The firm also advised Purdue Pharma to offer pharmacies rebates based on the number of overdoses and addictions they caused.
In February 2021, McKinsey reached agreements with attorneys general in 49 states, five U.S. territories, and the District of Columbia. Across the settlements, the firm agreed to pay nearly $600 million to settle investigations into its role in promoting sales of OxyContin.
The settlement also resolves California’s investigation into the company’s role in advising opioid companies, helping those companies promote their drugs, and profiting from the opioid epidemic. California will receive $59,613,603.99 from the settlement.
In addition to providing funds to address the crisis, the agreement calls on McKinsey to prepare tens of thousands of its internal documents detailing its work for Purdue Pharma and other opioid companies for public disclosure online.
When states began to sue Purdue’s directors for their implementation of McKinsey’s marketing schemes, McKinsey partners began corresponding about deleting documents and emails related to their work for Purdue ...
The Federal Motor Carrier Safety Administration (FMCSA), an agency within the U.S. Department of Transportation, is tasked with issuing regulations on commercial motor vehicle safety. The FMCSA also has authority to determine that state laws on commercial motor vehicle safety are preempted, based on criteria Congress has specified.
In 2011, the FMCSA revised the federal hours-of-service regulations, which imposed certain limits on the driving time of commercial motor vehicle drivers, to require that drivers working more than eight hours must take at least one 30-minute break during the first eight hours of work, though the driver has flexibility as to when the break occurs.
The California rules are different. California’s rules are contained in wage orders issued by the State’s Industrial Welfare Commission (IWC), which is tasked with protecting workers’ "health, safety, and welfare."
California’s minimum required break (MRB) rules generally require that employers allow commercial truck drivers to take more rest breaks, at greater frequency, and with less flexibility as to when breaks occur.
In 2018, two transportation industry groups asked the FMCSA to revisit a prior determination that federal law did not preempt California’s MRB rules.
The FMCSA, after seeking public comment on the preemption question, declared California’s MRB rules preempted as applied to operators of property-carrying motor vehicles subject to the federal hours-of-service regulations.
California’s Labor Commissioner and three other sets of petitioners (labor organizations and affected individuals) filed timely petitions for review.
The question was whether the FMCSA’s preemption decision was "arbitrary, capricious, an abuse of discretion, or otherwise not in accordance with law," or "in excess of statutory jurisdiction, authority, or limitations, or short of statutory right."
The 9th Circuit Court of Appeal affirmed the preemption of federal over state law in the published opinion of International Brotherhood of Teamsters, Local 2785 v. Federal Motor Carrier Safety Administration.
The court concluded that the FMCSA reasonably determined that California’s MRB rules imposed additional and more stringent requirements than the FMCSA’s own regulations, and that the FMCSA simply determined that, in its view, federal regulations adequately and more appropriately balanced the competing interests between safety and economic burden.
...
In 2011, the FMCSA revised the federal hours-of-service regulations, which imposed certain limits on the driving time of commercial motor vehicle drivers, to require that drivers working more than eight hours must take at least one 30-minute break during the first eight hours of work, though the driver has flexibility as to when the break occurs.
The California rules are different. California’s rules are contained in wage orders issued by the State’s Industrial Welfare Commission (IWC), which is tasked with protecting workers’ "health, safety, and welfare."
California’s minimum required break (MRB) rules generally require that employers allow commercial truck drivers to take more rest breaks, at greater frequency, and with less flexibility as to when breaks occur.
In 2018, two transportation industry groups asked the FMCSA to revisit a prior determination that federal law did not preempt California’s MRB rules.
The FMCSA, after seeking public comment on the preemption question, declared California’s MRB rules preempted as applied to operators of property-carrying motor vehicles subject to the federal hours-of-service regulations.
California’s Labor Commissioner and three other sets of petitioners (labor organizations and affected individuals) filed timely petitions for review.
The question was whether the FMCSA’s preemption decision was "arbitrary, capricious, an abuse of discretion, or otherwise not in accordance with law," or "in excess of statutory jurisdiction, authority, or limitations, or short of statutory right."
The 9th Circuit Court of Appeal affirmed the preemption of federal over state law in the published opinion of International Brotherhood of Teamsters, Local 2785 v. Federal Motor Carrier Safety Administration.
The court concluded that the FMCSA reasonably determined that California’s MRB rules imposed additional and more stringent requirements than the FMCSA’s own regulations, and that the FMCSA simply determined that, in its view, federal regulations adequately and more appropriately balanced the competing interests between safety and economic burden.
...
California’s drug formulary, which went into effect January 1, 2018, was intended to reduce frictional costs in the workers’ compensation system; restrict inappropriate prescribing, especially that related to opioids; and ensure that injured workers receive medically necessary medications in a timely manner.
In the July 1, 2018 Pure Premium Rate Filing, the WCIRB estimated that the drug formulary would reduce pharmaceutical costs by 10 percent, resulting in an overall 0.5 percent reduction in the advisory pure premium rate level.
The WCIRB’s initial estimate was based largely on projected reductions in the use of opioids, compounds, physician-dispensed drugs and brand name drugs when a generic alternative was available.
The WCIRB has updated the cost impact evaluation of the Drug Formulary, utilizing additional pharmaceutical transaction information in 2019 through the pre-pandemic period in 2020, in its Cost Impact of California’s Drug Formulary - Two-Year Checkup research brief.
Key findings in the research brief include:
- - While pharmaceutical costs had been declining sharply prior to implementation of the formulary, the decline accelerated in 2018 and continued at a somewhat slower rate through 2019 and the pre-COVID-19 period in 2020.
- - The share of prescriptions for drugs not subject to prospective UR in accordance with the formulary continued to increase in 2019 and early 2020, while that of drugs subject to UR continued to decline.
- - The share of pharmaceutical payments for opioids, compounds and brand name drugs with generic alternatives dropped sharply in 2018 and continued to drop at a similar rate in 2019 and early 2020.
- - While the share of pharmaceutical payments for physician dispensed drugs started to increase slightly toward the end of 2019, on an annual basis, the share of payments to these drugs continued to decline during the two years of the formulary implementation.
- - The continued downward trend in pharmaceutical costs through early 2020, as well as the continued decreases in the proportion of drugs not subject to UR, opioids, compounds, physician-dispensed drugs and brand name drugs with generic equivalents suggest the formulary is achieving its intended effects.
The COVID-19 pandemic and the resultant stay-at-home orders have affected the patterns of medical treatment of California injured workers. While elective medical services were suspended during the early weeks of the pandemic, pharmaceutical use has increased throughout the pandemic. The increases have driven the average drug payments in the system above the prepandemic level. Most of the increases came from non-opioid pain medications.
Given that the formulary impact on drug utilization and costs may be mixed with the impact of the stay-at-home orders during the ongoing pandemic, this updated evaluation focused on the pre-COVID-19 pandemic period and assessed how the drug formulary affected prescription drug utilization and costs during this period ...
In the July 1, 2018 Pure Premium Rate Filing, the WCIRB estimated that the drug formulary would reduce pharmaceutical costs by 10 percent, resulting in an overall 0.5 percent reduction in the advisory pure premium rate level.
The WCIRB’s initial estimate was based largely on projected reductions in the use of opioids, compounds, physician-dispensed drugs and brand name drugs when a generic alternative was available.
The WCIRB has updated the cost impact evaluation of the Drug Formulary, utilizing additional pharmaceutical transaction information in 2019 through the pre-pandemic period in 2020, in its Cost Impact of California’s Drug Formulary - Two-Year Checkup research brief.
Key findings in the research brief include:
- - While pharmaceutical costs had been declining sharply prior to implementation of the formulary, the decline accelerated in 2018 and continued at a somewhat slower rate through 2019 and the pre-COVID-19 period in 2020.
- - The share of prescriptions for drugs not subject to prospective UR in accordance with the formulary continued to increase in 2019 and early 2020, while that of drugs subject to UR continued to decline.
- - The share of pharmaceutical payments for opioids, compounds and brand name drugs with generic alternatives dropped sharply in 2018 and continued to drop at a similar rate in 2019 and early 2020.
- - While the share of pharmaceutical payments for physician dispensed drugs started to increase slightly toward the end of 2019, on an annual basis, the share of payments to these drugs continued to decline during the two years of the formulary implementation.
- - The continued downward trend in pharmaceutical costs through early 2020, as well as the continued decreases in the proportion of drugs not subject to UR, opioids, compounds, physician-dispensed drugs and brand name drugs with generic equivalents suggest the formulary is achieving its intended effects.
The COVID-19 pandemic and the resultant stay-at-home orders have affected the patterns of medical treatment of California injured workers. While elective medical services were suspended during the early weeks of the pandemic, pharmaceutical use has increased throughout the pandemic. The increases have driven the average drug payments in the system above the prepandemic level. Most of the increases came from non-opioid pain medications.
Given that the formulary impact on drug utilization and costs may be mixed with the impact of the stay-at-home orders during the ongoing pandemic, this updated evaluation focused on the pre-COVID-19 pandemic period and assessed how the drug formulary affected prescription drug utilization and costs during this period ...
Gig workers and labor unions on Thursday continued their challenge to California’s Proposition 22, filing a lawsuit in a lower court as urged by the state Supreme Court, which last week rejected a request for an expedited review of the case.
The plaintiffs, who filed the lawsuit in January, say the measure, which 58% of the state’s voters passed in November and exempts companies like Uber Technologies Inc. and Lyft Inc. from a law that would require them to treat their drivers as employees, is unconstitutional.
Among other things, they say Prop. 22 precludes gig workers’ inclusion in the workers’ comp system and keeps them from collective bargaining.
The new lawsuit, which they filed in Alameda County Superior Court, states "Because the Legislature has ‘plenary power, unlimited by any provision of this Constitution’ to address workers’ compensation, including occupational safety,an initiative statute cannot limit the Legislature’s authority in this area."
The lawsuit also says Prop. 22 is too broad because ballot measures are supposed to focus on only one issue: "[It] also attempts to impose other restrictions that are not substantively addressed in the measure."
The plaintiffs include the SEIU California and the national SEIU, individual drivers and a ride-hailing customer.
"I’m joining together with my fellow ride-share drivers to continue our fight against Prop. 22 because we know that in a democracy, corporations shouldn’t get the final say in determining our laws," said Saori Okawa, one of the plaintiffs, in a statement.
In a news release, the plaintiffs mentioned other constitutional challenges to state ballot measures and acknowledged that those efforts took a long time.
"In the case of Prop. 187 - which denied undocumented immigrants access to basic education and healthcare - it took nearly five years, multiple appeals, the end of Gov. Pete Wilson’s administration and the passage of federal legislation for the initiative to be struck down," the plaintiffs said. "It took almost seven years for Prop. 8 - which denied marriage equality to same-sex couples - to make its way to the United States Supreme Court, where it was struck down in 2015."
...
The plaintiffs, who filed the lawsuit in January, say the measure, which 58% of the state’s voters passed in November and exempts companies like Uber Technologies Inc. and Lyft Inc. from a law that would require them to treat their drivers as employees, is unconstitutional.
Among other things, they say Prop. 22 precludes gig workers’ inclusion in the workers’ comp system and keeps them from collective bargaining.
The new lawsuit, which they filed in Alameda County Superior Court, states "Because the Legislature has ‘plenary power, unlimited by any provision of this Constitution’ to address workers’ compensation, including occupational safety,an initiative statute cannot limit the Legislature’s authority in this area."
The lawsuit also says Prop. 22 is too broad because ballot measures are supposed to focus on only one issue: "[It] also attempts to impose other restrictions that are not substantively addressed in the measure."
The plaintiffs include the SEIU California and the national SEIU, individual drivers and a ride-hailing customer.
"I’m joining together with my fellow ride-share drivers to continue our fight against Prop. 22 because we know that in a democracy, corporations shouldn’t get the final say in determining our laws," said Saori Okawa, one of the plaintiffs, in a statement.
In a news release, the plaintiffs mentioned other constitutional challenges to state ballot measures and acknowledged that those efforts took a long time.
"In the case of Prop. 187 - which denied undocumented immigrants access to basic education and healthcare - it took nearly five years, multiple appeals, the end of Gov. Pete Wilson’s administration and the passage of federal legislation for the initiative to be struck down," the plaintiffs said. "It took almost seven years for Prop. 8 - which denied marriage equality to same-sex couples - to make its way to the United States Supreme Court, where it was struck down in 2015."
...
President Joe Biden nominated Julie Su, the head of California’s labor agency, on Wednesday as the deputy U.S. secretary of labor, potentially putting another Californian in a top administration job and focusing a brighter spotlight on the state's ongoing unemployment fraud scandal.
If confirmed by the Senate, Su would be tasked with helping to lead a sprawling department that oversees laws that regulate worker standards and pay, workplace safety, workers’ compensation, unions, family and medical leave and more. She would work in partnership with Boston Mayor Marty Walsh, Biden's nominee for labor secretary, if he is confirmed.
Julie A. Su is currently the Secretary of the California Labor and Workforce Development Agency. Governor Gavin Newsom appointed Su in January of 2019 to serve as his cabinet advisor on labor issues and employment programs for workers and businesses throughout California.
Secretary Su oversees the state departments and boards that enforce labor laws, including minimum wage and occupational safety standards, provide state disability and unemployment insurance benefits, fund workforce training and apprenticeship programs, combat wage theft, protect injured workers, and arbitrate public sector contract disputes.
Su is a nationally recognized expert on workers’ rights and civil rights who has dedicated her distinguished legal career to advancing justice on behalf of poor and disenfranchised communities, and is a past recipient of a MacArthur Foundation “Genius” grant.
As California Labor Commissioner from 2011 through 2018, Su enforced the state’s labor laws to ensure a fair and just workplace for both employees and employers. A report on her tenure released in May 2013 found that her leadership has resulted in a renaissance in enforcement activity and record-setting results. In 2014, she launched the first “Wage Theft is a Crime” multi-media, multilingual statewide campaign to reach out to low-wage workers and their employers to help them understand their rights and feel safe speaking up about labor law abuses.
Prior to her appointment as California Labor Commissioner, Su was the Litigation Director at Asian Americans Advancing Justice-Los Angeles, the nation’s largest non-profit civil rights organization devoted to issues affecting the Asian American community. In her 17 years as a civil rights lawyer, Su brought landmark lawsuits resulting in millions of dollars for low-wage workers and policy changes in California and the United States protecting immigrant victims of crime and human trafficking. In 1995, she was the lead attorney for Thai garment workers who were trafficked into the United States and forced to sew behind barbed wire and under armed guard in an apartment complex in El Monte, California. Su is known for pioneering a multi-strategy approach that combines successful impact litigation with multiracial organizing, community education, policy reform, coalition building, and media work.
Su has taught at UCLA Law School and Northeastern Law School. She is a graduate of Stanford University and Harvard Law School and began her career with a Skadden Fellowship. Su is the daughter of Chinese immigrants and speaks Mandarin and Spanish ...
If confirmed by the Senate, Su would be tasked with helping to lead a sprawling department that oversees laws that regulate worker standards and pay, workplace safety, workers’ compensation, unions, family and medical leave and more. She would work in partnership with Boston Mayor Marty Walsh, Biden's nominee for labor secretary, if he is confirmed.
Julie A. Su is currently the Secretary of the California Labor and Workforce Development Agency. Governor Gavin Newsom appointed Su in January of 2019 to serve as his cabinet advisor on labor issues and employment programs for workers and businesses throughout California.
Secretary Su oversees the state departments and boards that enforce labor laws, including minimum wage and occupational safety standards, provide state disability and unemployment insurance benefits, fund workforce training and apprenticeship programs, combat wage theft, protect injured workers, and arbitrate public sector contract disputes.
Su is a nationally recognized expert on workers’ rights and civil rights who has dedicated her distinguished legal career to advancing justice on behalf of poor and disenfranchised communities, and is a past recipient of a MacArthur Foundation “Genius” grant.
As California Labor Commissioner from 2011 through 2018, Su enforced the state’s labor laws to ensure a fair and just workplace for both employees and employers. A report on her tenure released in May 2013 found that her leadership has resulted in a renaissance in enforcement activity and record-setting results. In 2014, she launched the first “Wage Theft is a Crime” multi-media, multilingual statewide campaign to reach out to low-wage workers and their employers to help them understand their rights and feel safe speaking up about labor law abuses.
Prior to her appointment as California Labor Commissioner, Su was the Litigation Director at Asian Americans Advancing Justice-Los Angeles, the nation’s largest non-profit civil rights organization devoted to issues affecting the Asian American community. In her 17 years as a civil rights lawyer, Su brought landmark lawsuits resulting in millions of dollars for low-wage workers and policy changes in California and the United States protecting immigrant victims of crime and human trafficking. In 1995, she was the lead attorney for Thai garment workers who were trafficked into the United States and forced to sew behind barbed wire and under armed guard in an apartment complex in El Monte, California. Su is known for pioneering a multi-strategy approach that combines successful impact litigation with multiracial organizing, community education, policy reform, coalition building, and media work.
Su has taught at UCLA Law School and Northeastern Law School. She is a graduate of Stanford University and Harvard Law School and began her career with a Skadden Fellowship. Su is the daughter of Chinese immigrants and speaks Mandarin and Spanish ...
The Division of Workers’ Compensation (DWC) has posted an order adjusting the Physician and Non-Physician Practitioner Services section of the Official Medical Fee Schedule (OMFS) to conform to relevant 2021 changes in the Medicare payment system as required by Labor Code section 5307.1. The Administrative Director update order adopting the OMFS adjustments is effective for services rendered on or after March 1, 2021. Some of the significant changes include the following.
- Revisions relating to Evaluation and Management (E&M) services for office visits for new and established patients
- - 1995 and 1997 Evaluation and Management Documentation Guidelines are no longer used
- - American Medical Association’s Current Procedural Terminology (CPT) E&M office visit code descriptors and guidelines have been revised
- - Level of E&M office visit service is reported using either level of medical decision making or total time
- -First level new patient office visit code CPT 99201 has been eliminated
- Medicare Prolonged Service Code HCPCS G2212 is adopted for use in place of CPT code 99417 for prolonged E&M service provided on the date of service where the level of service is selected based upon time
- - Updated relative value units
- - Updated conversion factors
- - Updated Table A – anesthesia conversion factors adjusted for Geographic Practice Cost Index
- - Updated telehealth list
The Order, effective for services rendered on or after March 1, 2021, and related documents can be found at the DWC OMFS physician fee schedule webpage ...
- Revisions relating to Evaluation and Management (E&M) services for office visits for new and established patients
- - 1995 and 1997 Evaluation and Management Documentation Guidelines are no longer used
- - American Medical Association’s Current Procedural Terminology (CPT) E&M office visit code descriptors and guidelines have been revised
- - Level of E&M office visit service is reported using either level of medical decision making or total time
- -First level new patient office visit code CPT 99201 has been eliminated
- Medicare Prolonged Service Code HCPCS G2212 is adopted for use in place of CPT code 99417 for prolonged E&M service provided on the date of service where the level of service is selected based upon time
- - Updated relative value units
- - Updated conversion factors
- - Updated Table A – anesthesia conversion factors adjusted for Geographic Practice Cost Index
- - Updated telehealth list
The Order, effective for services rendered on or after March 1, 2021, and related documents can be found at the DWC OMFS physician fee schedule webpage ...
A West Los Angeles pharmacy and its owner pleaded guilty to federal criminal charges stemming from a scheme in which millions of dollars in reimbursements for compounded drugs were generated through the payment of illegal kickbacks for patient referrals and by fraudulently paying patients’ copayments.
41 year old Navid Vahedi, who lives in Brentwood, pleaded guilty to one count of conspiracy to commit health care fraud and payment of illegal remunerations. Vahedi also entered a guilty plea to the felony offense on behalf of his business, Fusion Rx Compounding Pharmacy.
Vahedi and Fusion Rx admitted routing millions of dollars in kickback payments through the businesses of two marketers to steer prescriptions for compounded drugs to Fusion Rx. As part of the scheme, Vahedi and the two marketers provided physicians with preprinted prescription script pads that offered "check-the-box" options on the form to maximize the amount of insurance reimbursement for the compounded drugs.
From May 2014 to at least February 2016, Fusion Rx received approximately $14 million in reimbursements on its claims for compounded drug prescriptions.
As part of its contracts with various insurance networks, Fusion Rx was obligated to collect copayments from patients. Because the copayments might discourage patients from requesting expensive and potentially unnecessary compounded drug prescriptions, Fusion Rx did not collect copayments with any regularity and, in other instances, it provided gift cards to patients to offset the amount of the copayments, according to court documents.
After an audit raised concerns that Fusion Rx’s failure to collect copayments would be discovered, Vahedi directed Fusion Rx funds to be used to purchase American Express gift cards, which were then used to make copayments for certain prescriptions without the patients’ knowledge. Fusion Rx then submitted claims on these prescriptions to various insurance providers, falsely representing that patients had paid the required copayments.
A sentencing hearing is scheduled for June 28, at which time Vahedi will face a statutory maximum sentence of five years in federal prison. Both defendants have agreed to pay restitution related to the copayment reimbursement part of the scheme, which is estimated to be $4,405,926.
In addition to his obligation under the plea agreement to pay restitution, Vahedi also agreed to forfeit $1,338,511.
Under the terms of the plea agreements, Fusion Rx has also agreed to pay a fine sufficient to divest itself of all its remaining assets, Vahedi has agreed to have his pharmacist license revoked, and both Vahedi and Fusion Rx will be excluded from federal health care programs such as Medicare and Medicaid going forward.
The two marketers involved in the scheme - Joshua Pearson, 41, of St. George, Utah, and Joseph Kieffer, 40, of West Los Angeles - previously pleaded guilty in this case and are scheduled to be sentenced by on May 24 and June 28 ...
41 year old Navid Vahedi, who lives in Brentwood, pleaded guilty to one count of conspiracy to commit health care fraud and payment of illegal remunerations. Vahedi also entered a guilty plea to the felony offense on behalf of his business, Fusion Rx Compounding Pharmacy.
Vahedi and Fusion Rx admitted routing millions of dollars in kickback payments through the businesses of two marketers to steer prescriptions for compounded drugs to Fusion Rx. As part of the scheme, Vahedi and the two marketers provided physicians with preprinted prescription script pads that offered "check-the-box" options on the form to maximize the amount of insurance reimbursement for the compounded drugs.
From May 2014 to at least February 2016, Fusion Rx received approximately $14 million in reimbursements on its claims for compounded drug prescriptions.
As part of its contracts with various insurance networks, Fusion Rx was obligated to collect copayments from patients. Because the copayments might discourage patients from requesting expensive and potentially unnecessary compounded drug prescriptions, Fusion Rx did not collect copayments with any regularity and, in other instances, it provided gift cards to patients to offset the amount of the copayments, according to court documents.
After an audit raised concerns that Fusion Rx’s failure to collect copayments would be discovered, Vahedi directed Fusion Rx funds to be used to purchase American Express gift cards, which were then used to make copayments for certain prescriptions without the patients’ knowledge. Fusion Rx then submitted claims on these prescriptions to various insurance providers, falsely representing that patients had paid the required copayments.
A sentencing hearing is scheduled for June 28, at which time Vahedi will face a statutory maximum sentence of five years in federal prison. Both defendants have agreed to pay restitution related to the copayment reimbursement part of the scheme, which is estimated to be $4,405,926.
In addition to his obligation under the plea agreement to pay restitution, Vahedi also agreed to forfeit $1,338,511.
Under the terms of the plea agreements, Fusion Rx has also agreed to pay a fine sufficient to divest itself of all its remaining assets, Vahedi has agreed to have his pharmacist license revoked, and both Vahedi and Fusion Rx will be excluded from federal health care programs such as Medicare and Medicaid going forward.
The two marketers involved in the scheme - Joshua Pearson, 41, of St. George, Utah, and Joseph Kieffer, 40, of West Los Angeles - previously pleaded guilty in this case and are scheduled to be sentenced by on May 24 and June 28 ...
The Kern County District Attorney announced the filing and arraignment of a major felony case alleging 24 felony counts related to alleged worker’s compensation fraud.
According to a probable cause declaration obtained by KGET.com, Ava McLean failed to disclose and denied prior injuries she suffered when she filed her worker’s compensation claims. Those alleged injuries, which she said prevented her from working, didn’t stop her from dancing, wearing high heels, ziplining and horseback riding.
Additionally, the declaration says, McLean altered medical records and submitted them to her insurance company. She deflected questions from a District Attorney’s office investigator, the document says, by talking about her son’s ailments and saying she now has a brain tumor.
Doctors who examined her over the years noted she showed "narcotic-seeking symptoms." Between November 2016 and October 2019, McLean had been prescribed or asked multiple doctors to prescribe her pain medications 25 times.
McLean was in vehicle crashes in 2012 and 2017. She initially did not report any injuries following the 2017 accident. But later said she suffered a strained neck, and later still said there were injuries to her feet that would require surgery. McLean filed worker’s compensation claims in both crashes.
Earlier in 2017, months before the crash, McLean had surgery on both ankles and feet to correct her "flat feet," the declaration says. Implants were placed in both feet, the hardware put in her right foot became displaced and she had post-op problems requiring medical leave from work and opioids for pain into August 2017.
When McLean made the claim regarding the 2017 crash, she failed to inform her insurance of any prior injuries to her feet or neck, the declaration says.
In April 2018, Bakersfield Heart Hospital gave her a final written warning, letting her know she would be fired for any further disciplinary actions, for and expired Basic Life Support Certification, wearing acrylic nails and insubordination.
The next month McLean reported she was experiencing foot and ankle pain, according to the filing. There was no mention of this injury happening at work. The following day, May 16, 2018, she reported neck pain to her doctor - making no mention of foot or ankle pain - and said she had injured herself at work.
McLean told her employer the same day that she had suffered two injuries, one to her back, the other to her ankle, while working at Bakersfield Heart Hospital, according to the filing. She was taken off work and didn’t return, and a co-worker contradicted McLean’s version of events in how she suffered the alleged injuries.
During examinations over the following days - and even when questioned multiple times the next year - McLean denied making any prior worker’s compensation claims, ongoing treatment or prior injuries, the filing says.
It was in 2018 that McLean posted a video on social media of her dancing, horseback riding and engaging in other physical activities with friends, the declaration says. Surveillance video taken of her showed she had no difficulty walking up or down stairs.
McLean pleaded not guilty to the 24 felony charges ...
According to a probable cause declaration obtained by KGET.com, Ava McLean failed to disclose and denied prior injuries she suffered when she filed her worker’s compensation claims. Those alleged injuries, which she said prevented her from working, didn’t stop her from dancing, wearing high heels, ziplining and horseback riding.
Additionally, the declaration says, McLean altered medical records and submitted them to her insurance company. She deflected questions from a District Attorney’s office investigator, the document says, by talking about her son’s ailments and saying she now has a brain tumor.
Doctors who examined her over the years noted she showed "narcotic-seeking symptoms." Between November 2016 and October 2019, McLean had been prescribed or asked multiple doctors to prescribe her pain medications 25 times.
McLean was in vehicle crashes in 2012 and 2017. She initially did not report any injuries following the 2017 accident. But later said she suffered a strained neck, and later still said there were injuries to her feet that would require surgery. McLean filed worker’s compensation claims in both crashes.
Earlier in 2017, months before the crash, McLean had surgery on both ankles and feet to correct her "flat feet," the declaration says. Implants were placed in both feet, the hardware put in her right foot became displaced and she had post-op problems requiring medical leave from work and opioids for pain into August 2017.
When McLean made the claim regarding the 2017 crash, she failed to inform her insurance of any prior injuries to her feet or neck, the declaration says.
In April 2018, Bakersfield Heart Hospital gave her a final written warning, letting her know she would be fired for any further disciplinary actions, for and expired Basic Life Support Certification, wearing acrylic nails and insubordination.
The next month McLean reported she was experiencing foot and ankle pain, according to the filing. There was no mention of this injury happening at work. The following day, May 16, 2018, she reported neck pain to her doctor - making no mention of foot or ankle pain - and said she had injured herself at work.
McLean told her employer the same day that she had suffered two injuries, one to her back, the other to her ankle, while working at Bakersfield Heart Hospital, according to the filing. She was taken off work and didn’t return, and a co-worker contradicted McLean’s version of events in how she suffered the alleged injuries.
During examinations over the following days - and even when questioned multiple times the next year - McLean denied making any prior worker’s compensation claims, ongoing treatment or prior injuries, the filing says.
It was in 2018 that McLean posted a video on social media of her dancing, horseback riding and engaging in other physical activities with friends, the declaration says. Surveillance video taken of her showed she had no difficulty walking up or down stairs.
McLean pleaded not guilty to the 24 felony charges ...
On May 22, 2006, Mesa Pharmacy filed Articles of Incorporation. A year later, Pharmacy Development Corporation sprang into existence. Both use the same pharmacy permit number PHY50766 doing business as Mesa Pharmacy VII in Irvine California.
John Garbino became involved with Mesa in late 2011 or 2012. There is a contract between his wholly owned company, Trestles Pain Management, to market Mesa’s pharmaceutical services to doctors. Those doctors would then submit prescriptions to Mesa for fulfillment.
According to the facts found by the WCJ, "Mesa went from a company barely squeaking by to an entity raking in hundreds of millions of dollars essentially overnight."
Mesa provided expensive compounded medications to injured workers and has been a major lien claimant with millions of dollars of liens that are currently outstanding and unpaid.
Garbino was ultimately charged by federal authorities and convicted of Medicare fraud, preventing him from participating in the Workers’ Compensation System. His association with Mesa Pharmacy was examined by the DWC and found to be sufficient to place Mesa on the list of suspended providers under Labor Code §4615.
Mesa Pharmacy challenged that decision, claiming that Garbino never held a position with Mesa that would subject them to the suspension.
A trial followed on the issue of "whether John Garbino, who was convicted of Medicare fraud, was a 10% or greater owner, a director, an officer, or had de facto control of the Lien Claimant, Mesa Pharmacy."
After taking extensive testimony and documentary evidence, the WCJ found that Garbino had de facto control of Mesa Pharmacy in the WCAB case of Melvin Garcia Galdames v Vinyl Technology.
The WCJ reasoned in part that "In order to be considered a corporation with an existence separate and apart from those who ran it, there were simple steps that had to be taken."
"Mesa had to have a board of directors. On paper it did - but the people listed on those papers weren’t aware of it or admitted to being figureheads. Garbino ended up listed as an owner of Mesa with the Arizona Pharmacy Board. And while that doesn’t prove he was an actual owner, it does show that no one was paying attention to who was being asserted by the corporation as having ownership interest in legal filings in other states. That creates a strong inference that there was no actual corporate structure at Mesa, they just made it up with whatever names seemed to be the best fit at the time."
"Mesa Board of Directors had to keep regular accounts of their dealings.... People allegedly serving on the board couldn’t recall having meetings outside of an occasional vague memory. This court ordered Mesa to produce the corporate minutes. They could not, or would not, do so."
"The court can, and does, look to whether the facts demonstrate that there was a person behind the curtain pulling on the strings. Garbino showed up, turned on the music, and Kurtz and the others waltzed into the pile of cash that stood to be made. He told them what to do and how to do it. He connected them with financers. He supplied the pool of doctors to write the prescriptions Mesa would fill. He made them rich on paper. He was the catalyst that catapulted Mesa from a corner drug store to being in reach of nationwide chain status. Mesa’s two-bit cast of grifters with a reasonably intelligent front-man found a real crook to teach them to do business. Now they have to live with the taint of his wrong-doings."
Floyd Skeren Manukian Langevin, LLP Hearing Representative John Castro participated in this trial ...
John Garbino became involved with Mesa in late 2011 or 2012. There is a contract between his wholly owned company, Trestles Pain Management, to market Mesa’s pharmaceutical services to doctors. Those doctors would then submit prescriptions to Mesa for fulfillment.
According to the facts found by the WCJ, "Mesa went from a company barely squeaking by to an entity raking in hundreds of millions of dollars essentially overnight."
Mesa provided expensive compounded medications to injured workers and has been a major lien claimant with millions of dollars of liens that are currently outstanding and unpaid.
Garbino was ultimately charged by federal authorities and convicted of Medicare fraud, preventing him from participating in the Workers’ Compensation System. His association with Mesa Pharmacy was examined by the DWC and found to be sufficient to place Mesa on the list of suspended providers under Labor Code §4615.
Mesa Pharmacy challenged that decision, claiming that Garbino never held a position with Mesa that would subject them to the suspension.
A trial followed on the issue of "whether John Garbino, who was convicted of Medicare fraud, was a 10% or greater owner, a director, an officer, or had de facto control of the Lien Claimant, Mesa Pharmacy."
After taking extensive testimony and documentary evidence, the WCJ found that Garbino had de facto control of Mesa Pharmacy in the WCAB case of Melvin Garcia Galdames v Vinyl Technology.
The WCJ reasoned in part that "In order to be considered a corporation with an existence separate and apart from those who ran it, there were simple steps that had to be taken."
"Mesa had to have a board of directors. On paper it did - but the people listed on those papers weren’t aware of it or admitted to being figureheads. Garbino ended up listed as an owner of Mesa with the Arizona Pharmacy Board. And while that doesn’t prove he was an actual owner, it does show that no one was paying attention to who was being asserted by the corporation as having ownership interest in legal filings in other states. That creates a strong inference that there was no actual corporate structure at Mesa, they just made it up with whatever names seemed to be the best fit at the time."
"Mesa Board of Directors had to keep regular accounts of their dealings.... People allegedly serving on the board couldn’t recall having meetings outside of an occasional vague memory. This court ordered Mesa to produce the corporate minutes. They could not, or would not, do so."
"The court can, and does, look to whether the facts demonstrate that there was a person behind the curtain pulling on the strings. Garbino showed up, turned on the music, and Kurtz and the others waltzed into the pile of cash that stood to be made. He told them what to do and how to do it. He connected them with financers. He supplied the pool of doctors to write the prescriptions Mesa would fill. He made them rich on paper. He was the catalyst that catapulted Mesa from a corner drug store to being in reach of nationwide chain status. Mesa’s two-bit cast of grifters with a reasonably intelligent front-man found a real crook to teach them to do business. Now they have to live with the taint of his wrong-doings."
Floyd Skeren Manukian Langevin, LLP Hearing Representative John Castro participated in this trial ...
The Division of Workers’ Compensation (DWC) has issued a Notice of Emergency Regulation Re-Adoption to extend current measures that allow workers’ compensation claims to move forward during COVID-19 restrictions.
Emergency regulations § 46.2 and § 36.7 are set to expire on March 12, 2021. This re-adoption would extend the emergency regulations for up to an additional 210 days in accordance with Executive Orders N-40-20 and N-66-20. After this re-adoption, DWC can seek one final re-adoption.
Re-adopting the emergency regulations will continue to help employers and injured workers move workers’ compensation claims toward a resolution and avoid undue delay. These regulations provide for how a medical-legal evaluation can occur and alternatives for service of required forms for a medical-legal evaluation and report.
The regulations concern how medical-legal evaluations and payment for those evaluations can occur during this emergency period. Also provided in the regulations are alternative forms of service for required forms related to medical-legal evaluations and reports.
- - QME Regulation 36.7 specifies how and under what circumstances the parties may serve documents electronically.
- - QME Regulation 46.2 specifies how and under what circumstances QME, AME and other evaluations may be conducted by telehealth.
DWC will file the re-adoption of the emergency regulations with the state’s Office of Administrative Law (OAL) on February 16, 2021.
For information on the OAL procedure, and to learn how you may comment on the emergency regulations, go to the OAL’s website.
Upon OAL approval and filing with the Secretary of State, a notice will be posted on the DWC website ...
Emergency regulations § 46.2 and § 36.7 are set to expire on March 12, 2021. This re-adoption would extend the emergency regulations for up to an additional 210 days in accordance with Executive Orders N-40-20 and N-66-20. After this re-adoption, DWC can seek one final re-adoption.
Re-adopting the emergency regulations will continue to help employers and injured workers move workers’ compensation claims toward a resolution and avoid undue delay. These regulations provide for how a medical-legal evaluation can occur and alternatives for service of required forms for a medical-legal evaluation and report.
The regulations concern how medical-legal evaluations and payment for those evaluations can occur during this emergency period. Also provided in the regulations are alternative forms of service for required forms related to medical-legal evaluations and reports.
- - QME Regulation 36.7 specifies how and under what circumstances the parties may serve documents electronically.
- - QME Regulation 46.2 specifies how and under what circumstances QME, AME and other evaluations may be conducted by telehealth.
DWC will file the re-adoption of the emergency regulations with the state’s Office of Administrative Law (OAL) on February 16, 2021.
For information on the OAL procedure, and to learn how you may comment on the emergency regulations, go to the OAL’s website.
Upon OAL approval and filing with the Secretary of State, a notice will be posted on the DWC website ...
Two grocery stores in Southern California will shutter in April in response to a local "hero pay" measure requiring a $4-an-hour increase for grocery workers during the pandemic.
Kroger, which owns more than a dozen grocery chains, announced this week that it would close a pair of Long Beach stores - a Ralphs and a Food 4 Less - specifically citing the ordinance the city’s mayor signed into law late last month. The city was the first in the state to introduce a measure requiring some grocery retailers to give workers a temporary hourly pay bump during the pandemic.
"The irreparable harm that will come to employees and local citizens is a direct result of the City of Long Beach’s attempt to pick winners and losers," the company said in a statement, calling it "deeply unfortunate."
The report in the Washington Post says that Kroger’s move to close the stores comes amid growing momentum for similar hazard pay policies in cities across the state, as well as elsewhere in the country. Officials in two other cities - the Oakland City Council and the Los Angeles City Council - voted unanimously on Tuesday to mandate temporary $5-per-hour pay increases for some grocery workers.
The Long Beach policy is in place for 120 days and includes groceries that sell at least 70 percent food products and employ more than 300 people nationally with at least 15 employees per store. Under those terms, it may exclude retailers like Target and Walmart.
Long Beach Councilwoman Mary Zendejas, who sponsored the measure, said she was "incredibly disappointed" in Kroger’s move to close stores.
"It really saddens me that they’d rather take away 200 jobs instead of doing the right thing, which is paying hazard pay for these local grocery store workers who risk their lives every day they come in and who are putting their lives on the line every second they’re working," she told The Washington Post.
She said the closures will also have an impact on the communities they serve, noting that Food 4 Less serves many low-income residents in the area.
Experts and groups on both sides of the hazard pay debate are worried Kroger’s decision could signal a broader response.
Molly Kinder, a fellow at the Brookings Institution who studies front-line workers, said it was notable that Kroger is closing two stores in the first city in California to introduce such a mandate.
"I have to interpret that this statement is meant to signal that more Krogers could close if this is expanded," Kinder said, adding it seemed to "send a message that mandates could come with consequences."
Ronald Fong, president of the California Grocers Association trade group, which filed a lawsuit over the Long Beach ordinance, said the group tried to warn the city about "unintended consequences" of the measure.
"When a city tries to enact what is a 30 percent raise for grocery store workers, it is impossible to be able to absorb that without doing one of three things," Fong told The Post. "Raising prices and passing it along to our customers, closing stores because they will no longer be profitable with that kind of labor expense or reducing hours and cutting shifts."
The group announced Wednesday that it would also file lawsuits against Oakland and the city of Montebello to challenge similar $5-an-hour hazard pay measures.
...
Kroger, which owns more than a dozen grocery chains, announced this week that it would close a pair of Long Beach stores - a Ralphs and a Food 4 Less - specifically citing the ordinance the city’s mayor signed into law late last month. The city was the first in the state to introduce a measure requiring some grocery retailers to give workers a temporary hourly pay bump during the pandemic.
"The irreparable harm that will come to employees and local citizens is a direct result of the City of Long Beach’s attempt to pick winners and losers," the company said in a statement, calling it "deeply unfortunate."
The report in the Washington Post says that Kroger’s move to close the stores comes amid growing momentum for similar hazard pay policies in cities across the state, as well as elsewhere in the country. Officials in two other cities - the Oakland City Council and the Los Angeles City Council - voted unanimously on Tuesday to mandate temporary $5-per-hour pay increases for some grocery workers.
The Long Beach policy is in place for 120 days and includes groceries that sell at least 70 percent food products and employ more than 300 people nationally with at least 15 employees per store. Under those terms, it may exclude retailers like Target and Walmart.
Long Beach Councilwoman Mary Zendejas, who sponsored the measure, said she was "incredibly disappointed" in Kroger’s move to close stores.
"It really saddens me that they’d rather take away 200 jobs instead of doing the right thing, which is paying hazard pay for these local grocery store workers who risk their lives every day they come in and who are putting their lives on the line every second they’re working," she told The Washington Post.
She said the closures will also have an impact on the communities they serve, noting that Food 4 Less serves many low-income residents in the area.
Experts and groups on both sides of the hazard pay debate are worried Kroger’s decision could signal a broader response.
Molly Kinder, a fellow at the Brookings Institution who studies front-line workers, said it was notable that Kroger is closing two stores in the first city in California to introduce such a mandate.
"I have to interpret that this statement is meant to signal that more Krogers could close if this is expanded," Kinder said, adding it seemed to "send a message that mandates could come with consequences."
Ronald Fong, president of the California Grocers Association trade group, which filed a lawsuit over the Long Beach ordinance, said the group tried to warn the city about "unintended consequences" of the measure.
"When a city tries to enact what is a 30 percent raise for grocery store workers, it is impossible to be able to absorb that without doing one of three things," Fong told The Post. "Raising prices and passing it along to our customers, closing stores because they will no longer be profitable with that kind of labor expense or reducing hours and cutting shifts."
The group announced Wednesday that it would also file lawsuits against Oakland and the city of Montebello to challenge similar $5-an-hour hazard pay measures.
...
The California Division of Workers’ Compensation announced dates for its 28th annual educational conference.
The conference will take place on a virtual platform from March 24-26, 2021.
Sessions will also be available to view on demand through April 9, 2021 for registered participants.
This annual event is the largest workers’ compensation training in the state and allows claims administrators, attorneys, medical providers, return-to-work specialists, employers, human resources and others to learn firsthand about the most recent developments in the system, including any new laws or requirements.
Speakers from the Division of Workers' Compensation and the private sector will address topics pertinent to claims administrators, medical providers, attorneys, rehabilitation counselors and others involved in workers' compensation.
DWC has applied for continuing educational credits by attorney, rehabilitation counselor, case manager, disability management, human resource and qualified medical examiner certifying organizations among others.
Organizations who would like to become sponsors of the DWC conference can do so by going to the IWCF Website.
Attendee, exhibitor, and sponsor registration may be found at the DWC Educational Conference Webpage ...
The conference will take place on a virtual platform from March 24-26, 2021.
Sessions will also be available to view on demand through April 9, 2021 for registered participants.
This annual event is the largest workers’ compensation training in the state and allows claims administrators, attorneys, medical providers, return-to-work specialists, employers, human resources and others to learn firsthand about the most recent developments in the system, including any new laws or requirements.
Speakers from the Division of Workers' Compensation and the private sector will address topics pertinent to claims administrators, medical providers, attorneys, rehabilitation counselors and others involved in workers' compensation.
DWC has applied for continuing educational credits by attorney, rehabilitation counselor, case manager, disability management, human resource and qualified medical examiner certifying organizations among others.
Organizations who would like to become sponsors of the DWC conference can do so by going to the IWCF Website.
Attendee, exhibitor, and sponsor registration may be found at the DWC Educational Conference Webpage ...
Inheriting a mounting bureaucratic disaster that has floated lifelines to inmates but left newly jobless Californians broke, lawmakers are calling for a reboot of the state’s Employment Development Department.
Pressed to act after a series of criminal investigations and audits revealed inmates and fraudsters took the department for at least $10 billion during the pandemic, a group of Assembly members say sweeping changes are needed to make the troubled department functional once again.
Assemblyman Rudy Salas, said "We want to fix it. EDD needs to be reformed, it needs to more responsive to Californians especially during a time of need."
The bills call for improvements to the department’s identity verification process, an oversight board to monitor unemployment claims, a task force to further investigate fraud, simplified application processes and direct deposit options for claimants.
Courthouse News reported that the reform package comes one day after the department’s leadership received a lashing from an Assembly committee.
During a marathon oversight hearing, flummoxed and angry lawmakers on both sides of the aisle spent five hours recounting stories of people forced to live in their cars while waiting for unemployment benefits that never came.
One of the proposals, Assembly Bill 110, attempts to prevent benefits from going to inmates by requiring EDD to cross-check all claims against state and local incarceration records. Lawmakers also want to spend $55 million on a task force to aid ongoing fraud investigations as well as a new oversight board to ensure unemployment benefits are being distributed swiftly and accurately.
Assemblywoman Cottie Petrie-Norris said many of the EDD’s troubles are systemic and far from new.
"The truth is this department has been failing for years and this pandemic really has brought those failures into sharp focus. It has become a crisis for our state."
In addition to cracking down on past and future fraud, the lawmakers want to make the system easier to use and more accessible.
As highlighted in the recent state audits, while unemployment skyrocketed last year EDD answered fewer than 1% of phone calls made by confused residents. Unable to get through to the department, residents have instead flooded their local elected officials with requests to help with unemployment applications.
Assembly Bill 402 would give people an official avenue for help by creating a sort of consumer advocate arm to sift through application issues. Related proposals would allow claimants to receive benefits via direct deposit, require EDD to offer more options for non-English speakers and a streamlined application process.
San Diego Assemblywoman Lorena Gonzalez said her direct deposit bill is a common-sense proposal born from an incident last summer when Bank of America froze benefit cards amid the spike in fraud. She noted California is just one of three states that doesn’t let people get benefits via direct deposit and that her bill would "cut out the middleman" in reference to the state’s contract with Bank of America.
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Pressed to act after a series of criminal investigations and audits revealed inmates and fraudsters took the department for at least $10 billion during the pandemic, a group of Assembly members say sweeping changes are needed to make the troubled department functional once again.
Assemblyman Rudy Salas, said "We want to fix it. EDD needs to be reformed, it needs to more responsive to Californians especially during a time of need."
The bills call for improvements to the department’s identity verification process, an oversight board to monitor unemployment claims, a task force to further investigate fraud, simplified application processes and direct deposit options for claimants.
Courthouse News reported that the reform package comes one day after the department’s leadership received a lashing from an Assembly committee.
During a marathon oversight hearing, flummoxed and angry lawmakers on both sides of the aisle spent five hours recounting stories of people forced to live in their cars while waiting for unemployment benefits that never came.
One of the proposals, Assembly Bill 110, attempts to prevent benefits from going to inmates by requiring EDD to cross-check all claims against state and local incarceration records. Lawmakers also want to spend $55 million on a task force to aid ongoing fraud investigations as well as a new oversight board to ensure unemployment benefits are being distributed swiftly and accurately.
Assemblywoman Cottie Petrie-Norris said many of the EDD’s troubles are systemic and far from new.
"The truth is this department has been failing for years and this pandemic really has brought those failures into sharp focus. It has become a crisis for our state."
In addition to cracking down on past and future fraud, the lawmakers want to make the system easier to use and more accessible.
As highlighted in the recent state audits, while unemployment skyrocketed last year EDD answered fewer than 1% of phone calls made by confused residents. Unable to get through to the department, residents have instead flooded their local elected officials with requests to help with unemployment applications.
Assembly Bill 402 would give people an official avenue for help by creating a sort of consumer advocate arm to sift through application issues. Related proposals would allow claimants to receive benefits via direct deposit, require EDD to offer more options for non-English speakers and a streamlined application process.
San Diego Assemblywoman Lorena Gonzalez said her direct deposit bill is a common-sense proposal born from an incident last summer when Bank of America froze benefit cards amid the spike in fraud. She noted California is just one of three states that doesn’t let people get benefits via direct deposit and that her bill would "cut out the middleman" in reference to the state’s contract with Bank of America.
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Cal/OSHA has cited multiple employers for not protecting workers from COVID-19 during inspections in various industries throughout the state.
Violations were identified in industries including health care, restaurant, retail, fitness centers, correctional institutions and more. Cal/OSHA opened the inspections after learning of COVID-19 fatalities and illnesses, after receiving complaints and during targeted inspections. The full list of employers cited for COVID-19 violations is posted on Cal/OSHA’s website.
Inspections at the San Quentin and Avenal state prisons occurred after reports of hospitalizations of staff following outbreaks at the institutions. Cal/OSHA determined that San Quentin staff were not provided adequate training or equipment for working with COVID-19 infected individuals, and employees who had been exposed to COVID-19 positive inmates were not provided proper medical services, including testing, contact tracing and referrals to physicians or other licensed health care professionals. Cal/OSHA issued citations for four willful-serious, five serious, one regulatory and four general category violations, including the employer’s failure to institute an effective aerosol transmissible diseases (ATD) control exposure plan.
Avenal State Prison was cited for three serious violations after Cal/OSHA found it failed to maintain an effective written ATD program including site-specific instruction, had an inadequate written respiratory protection plan, and failed to implement and/or enforce work practice controls to minimize exposure to COVID-19 amongst employees.
Ventura-based fitness center BSF Fitness was cited for one willful-serious, two serious and six general category violations following a complaint-initiated inspection opened last July, after a report that the employer was not enforcing face covering use and physical distancing in its gym.
Accident inspections were opened following reports of serious COVID-19 related illnesses at the Kaiser Permanente medical centers in San Leandro, Antioch and Walnut Creek, and Burlingame-based Mills-Peninsula Medical Center; and opened a complaint-initiated inspection at Fairfield-based NorthBay Medical Center. The facilities were cited for serious and regulatory violations after Cal/OSHA found multiple deficiencies in their ATD and respiratory protection programs.
Also cited were four skilled nursing centers: Sunray Healthcare Center and Sherman Village Healthcare Center (both located in the Los Angeles area), Fremont Healthcare Center in Fremont, and San Miguel Villa in Concord. Fremont Healthcare Center and San Miguel Villa were also cited for a regulatory violation because they failed to immediately report serious illnesses suffered by employees.
Cardenas Market in Oakland was cited for multiple violations including three serious-category violations following media coverage of an outbreak where seventeen workers tested positive for COVID-19 last May.
Grimmway Enterprises, Inc. was cited for multiple violations including two serious-category violations, following a fatality-initiated inspection.
Cal/OSHA also cited Carter's Children's Wear in Gilroy for failing to immediately report a COVID-19 related serious illness and failing to establish, implement and maintain an effective Injury Illness Prevention Program ...
Violations were identified in industries including health care, restaurant, retail, fitness centers, correctional institutions and more. Cal/OSHA opened the inspections after learning of COVID-19 fatalities and illnesses, after receiving complaints and during targeted inspections. The full list of employers cited for COVID-19 violations is posted on Cal/OSHA’s website.
Inspections at the San Quentin and Avenal state prisons occurred after reports of hospitalizations of staff following outbreaks at the institutions. Cal/OSHA determined that San Quentin staff were not provided adequate training or equipment for working with COVID-19 infected individuals, and employees who had been exposed to COVID-19 positive inmates were not provided proper medical services, including testing, contact tracing and referrals to physicians or other licensed health care professionals. Cal/OSHA issued citations for four willful-serious, five serious, one regulatory and four general category violations, including the employer’s failure to institute an effective aerosol transmissible diseases (ATD) control exposure plan.
Avenal State Prison was cited for three serious violations after Cal/OSHA found it failed to maintain an effective written ATD program including site-specific instruction, had an inadequate written respiratory protection plan, and failed to implement and/or enforce work practice controls to minimize exposure to COVID-19 amongst employees.
Ventura-based fitness center BSF Fitness was cited for one willful-serious, two serious and six general category violations following a complaint-initiated inspection opened last July, after a report that the employer was not enforcing face covering use and physical distancing in its gym.
Accident inspections were opened following reports of serious COVID-19 related illnesses at the Kaiser Permanente medical centers in San Leandro, Antioch and Walnut Creek, and Burlingame-based Mills-Peninsula Medical Center; and opened a complaint-initiated inspection at Fairfield-based NorthBay Medical Center. The facilities were cited for serious and regulatory violations after Cal/OSHA found multiple deficiencies in their ATD and respiratory protection programs.
Also cited were four skilled nursing centers: Sunray Healthcare Center and Sherman Village Healthcare Center (both located in the Los Angeles area), Fremont Healthcare Center in Fremont, and San Miguel Villa in Concord. Fremont Healthcare Center and San Miguel Villa were also cited for a regulatory violation because they failed to immediately report serious illnesses suffered by employees.
Cardenas Market in Oakland was cited for multiple violations including three serious-category violations following media coverage of an outbreak where seventeen workers tested positive for COVID-19 last May.
Grimmway Enterprises, Inc. was cited for multiple violations including two serious-category violations, following a fatality-initiated inspection.
Cal/OSHA also cited Carter's Children's Wear in Gilroy for failing to immediately report a COVID-19 related serious illness and failing to establish, implement and maintain an effective Injury Illness Prevention Program ...
The California Supreme Court rejected a major labor union and several ride-hailing drivers attempt to overturn a newly passed ballot measure classifying gig workers as independent contractors in California.
The groups filed suit in the Supreme Court, alleging Proposition 22 violated the state constitution and limits the power of state legislators to implement certain worker protections they are authorized to grant.
The Service Employees International Union and group of ride-hailing drivers, asked the state Supreme Court to invalidate Prop 22, which classified gig driver’s status as independent contractors after more than 58 percent of voters supported it in November.
They argued the measure limits state legislators’ ability to implement a system of workers' compensation in defiance of their constitutional authority to do so. It also argues that the proposition unconstitutionally defines what comprises an amendment to the measure, as well as violating a rule limiting ballot measures to a single subject to prevent voter confusion.
The Protect App-Based Drivers and Services coalition, which represents gig companies such as Uber, Lyft and Doordash, criticized the lawsuit in a statement attributed to Uber driver Jim Pyatt, an activist who has worked in favor of Prop 22.
The groups that filed the suit, which also include SEIU California State Council, took particular issue with the measure’s inclusion of a provision requiring a seven-eighths legislative supermajority to amend and even define what constitutes an amendment.
They said they were suing in the state Supreme Court rather than a lower court because the issues were of broad public importance and required a speedy resolution to minimize harm to gig workers.
However the Supreme Court refused to hear the case, and did not write a formal opinion. The docket entry simply stated "The petition for writ of mandate is denied without prejudice to refiling in an appropriate court."
Thus, their arguments were not heard on the merits. They were redirected to the jurisdiction of lower courts. However, as they pointed out, this would now require years of costly litigation, first in lower courts, then intermediate appellate courts, and finally back to the Supreme Court.
It would not be unusual for this to be a ten year journey ...
The groups filed suit in the Supreme Court, alleging Proposition 22 violated the state constitution and limits the power of state legislators to implement certain worker protections they are authorized to grant.
The Service Employees International Union and group of ride-hailing drivers, asked the state Supreme Court to invalidate Prop 22, which classified gig driver’s status as independent contractors after more than 58 percent of voters supported it in November.
They argued the measure limits state legislators’ ability to implement a system of workers' compensation in defiance of their constitutional authority to do so. It also argues that the proposition unconstitutionally defines what comprises an amendment to the measure, as well as violating a rule limiting ballot measures to a single subject to prevent voter confusion.
The Protect App-Based Drivers and Services coalition, which represents gig companies such as Uber, Lyft and Doordash, criticized the lawsuit in a statement attributed to Uber driver Jim Pyatt, an activist who has worked in favor of Prop 22.
The groups that filed the suit, which also include SEIU California State Council, took particular issue with the measure’s inclusion of a provision requiring a seven-eighths legislative supermajority to amend and even define what constitutes an amendment.
They said they were suing in the state Supreme Court rather than a lower court because the issues were of broad public importance and required a speedy resolution to minimize harm to gig workers.
However the Supreme Court refused to hear the case, and did not write a formal opinion. The docket entry simply stated "The petition for writ of mandate is denied without prejudice to refiling in an appropriate court."
Thus, their arguments were not heard on the merits. They were redirected to the jurisdiction of lower courts. However, as they pointed out, this would now require years of costly litigation, first in lower courts, then intermediate appellate courts, and finally back to the Supreme Court.
It would not be unusual for this to be a ten year journey ...
45 year old Crescencio Velasco Covarrubias, who lives in Buttonwillow California, was arraigned on multiple felony counts of insurance fraud after allegedly failing to disclose prior work-related injuries in order to collect workers' compensation benefits.
Covarrubias filed a workers' compensation claim for an injury he sustained on June 26, 2017, while employed at a retail warehouse center. He alleged he injured his left ankle, foot, heel, and back when he misstepped while sweeping.
As part of the claims process, Covarrubias was responsible for reporting any prior injuries, as they could have affected the outcome of the current claim.
An investigation conducted by the California Department of Insurance revealed on November 11, 2010, Covarrubias filed a workers' compensation claim, processed by a different insurance company, for a bilateral knee, neck, and back injury, along with left foot and ankle injuries.
Those injuries were sustained when Covarrubias was driving a tractor shuttle loaded with almonds and was struck by another tractor shuttle. Covarrubias' injuries were treated by his primary treating physicians and he received a $90,000 settlement.
The investigation into the June 2017 injury claim found that Covarrubias not only failed to report the November 2010 injuries, but when specifically asked, he denied any prior injuries to his left foot, ankle or back.
Covarrubias' fraudulent statements resulted in a loss to his employer’s insurance company of more than $87,000. If Covarrubias would have reported the injuries from November 2010, the insurance company would have conducted an investigation and likely denied or modified the current claim, thereby preventing Covarrubias from receiving benefits he was not entitled to.
Covarrubias self-surrendered and was arraigned on January 7, 2021. He is scheduled to return to court on March 15, 2021. The Kern County District Attorney's Office is prosecuting this case ...
Covarrubias filed a workers' compensation claim for an injury he sustained on June 26, 2017, while employed at a retail warehouse center. He alleged he injured his left ankle, foot, heel, and back when he misstepped while sweeping.
As part of the claims process, Covarrubias was responsible for reporting any prior injuries, as they could have affected the outcome of the current claim.
An investigation conducted by the California Department of Insurance revealed on November 11, 2010, Covarrubias filed a workers' compensation claim, processed by a different insurance company, for a bilateral knee, neck, and back injury, along with left foot and ankle injuries.
Those injuries were sustained when Covarrubias was driving a tractor shuttle loaded with almonds and was struck by another tractor shuttle. Covarrubias' injuries were treated by his primary treating physicians and he received a $90,000 settlement.
The investigation into the June 2017 injury claim found that Covarrubias not only failed to report the November 2010 injuries, but when specifically asked, he denied any prior injuries to his left foot, ankle or back.
Covarrubias' fraudulent statements resulted in a loss to his employer’s insurance company of more than $87,000. If Covarrubias would have reported the injuries from November 2010, the insurance company would have conducted an investigation and likely denied or modified the current claim, thereby preventing Covarrubias from receiving benefits he was not entitled to.
Covarrubias self-surrendered and was arraigned on January 7, 2021. He is scheduled to return to court on March 15, 2021. The Kern County District Attorney's Office is prosecuting this case ...
