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A Hawthorne man was sentenced to 212 years in federal prison for intentionally driving his ex-wife and two disabled sons off a wharf at the Port of Los Angeles into the ocean - drowning the boys who were trapped in the car - to collect on accidental death insurance policies he had taken out on their lives.

Ali F. Elmezayen, 45, was sentenced by United States District Judge John F. Walter, who, in imposing the maximum sentence allowed by law, noted Elmezayen’s "evil and diabolical scheme" as well as the "vicious and callous nature of his crimes."

"He is the ultimate phony and a skillful liar - and is nothing more than a greedy and brutal killer," Judge Walter said. "The only regret that the defendant has is that he got caught."

Judge Walter also ordered Elmezayen to pay $261,751 in restitution to the insurance companies that he defrauded.

After a nine-day trial in October 2019, a federal jury found Elmezayen guilty of four counts of mail fraud, four counts of wire fraud, one count of aggravated identity theft, and five counts of money laundering.

Elmezayen obtained more than $3 million of life and accidental death insurance policies on himself and his family bought from eight different insurance companies . He paid premiums in excess of $6,000 per year for these policies - even though he reported income of less than $30,000 per year on his tax returns. Elmezayen began purchasing the insurance policies the same year he exited a Chapter 11 bankruptcy proceeding.

After purchasing the policies, Elmezayen repeatedly called the insurance companies - sometimes pretending to be his ex-wife in whose name he had obtained some of the policies - to verify that the policies were active and that they would pay benefits if his ex-wife died in an accident. Elmezayen also called at least two of the insurance companies to confirm they would not investigate claims made two years after the policies were purchased. These telephone calls were recorded and were played for the jury.

On April 9, 2015, 12 days after the two-year contestability period on the last of his insurance policies expired, Elmezayen drove a car with his ex-wife and two youngest children off a wharf at the Port of Los Angeles. The site of the crash was a loading dock and worksite for commercial fishermen.

Elmezayen swam out the open driver’s side window of the car. Elmezayen’s ex-wife, who did not know how to swim, escaped the vehicle and survived when a nearby fisherman threw her a flotation device. Two of the couple’s three sons, who were 8 and 13 and who were both severely autistic, were strapped into the car and drowned. The couple’s third son was away at camp at the time and was not in the car at the time his father drove it into the water.

Elmezayen then collected more than $260,000 in insurance proceeds from Mutual of Omaha Life Insurance and American General Life Insurance on the accidental death insurance policies he had taken out on the children’s lives. He used part of the insurance proceeds to purchase real estate in Egypt as well as a boat.

Following the crash, Elmezayen repeatedly lied to law enforcement officers and insurance companies. He also lied in subsequent civil litigation he filed concerning the crash - about the extent of the insurance he had purchased on his family, and specifically about whether he had insured his disabled children’s lives. He also attempted to persuade witnesses to lie to law enforcement and say he had given the insurance proceeds to charity.

He now also faces murder charges in a Los Angeles Superior Court ...
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/ 2021 News, Daily News
Daniel Clampitt, 41, of Denair, was arraigned on four felony counts including insurance fraud, grand theft and perjury for allegedly claiming to be too injured to work and simultaneously collecting $94,788 in workers’ compensation benefits while also working for another employer.

Clampitt injured his knee while on duty as a firefighter for the City of Hollister.

Due to his injury, Clampitt could not perform his firefighter duties and received wage loss benefits from June 2016 to June 2018.

Surveillance video was obtained in January 2017 of Clampitt working at another company while he was still collecting workers’ compensation benefits from the City of Hollister.

A Department of Insurance investigation further revealed that for nine months Clampitt continued to collect wage loss benefits while receiving a paycheck from a new employer. Clampitt did not report this employment and income to the City or the insurance company handling his claim.

During a deposition, Clampitt claimed he had worked as an independent contractor for the second employer before his injury and denied applying for employment after the date of his injury, but records from the second employer show that Clampitt started working for them in October 2016, four months after his June 2016 injury.

Clampitt was arraigned on February 2, 2021. The San Benito County District Attorney’s Office is prosecuting this case ...
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/ 2021 News, Daily News
Last November, the Department of Health and Human Services (HHS) extended compliance dates for a complex federal regulation aimed at ending information-blocking practices that impede the secure exchange and use of electronic health information by patients, doctors and health care organizations.

The HHS Office of the National Coordinator for Health Information Technology extended the final rule, implemented under the 21st Century Cures Act (Cures Act), extended the "applicability date" from November 2, 2020 to April 5, 2021. On and after that date, all "actors" - "which includes health information networks and exchanges, EHR vendors and health care providers - "will be subject to information blocking."

The compliance deadline delay comes in response to the AMA’s advocacy efforts. A Sept. 29, 2020 letter from the AMA, the American College of Physicians, the American Hospital Association and others told the ONC that "the COVID-19 pandemic continues to monopolize our members’ time and attention, and has strained resources, drastically limiting our members' ability to prepare" for the Nov. 2, 2020 deadline that had been in place.

In general, information blocking is a practice by a health IT developer of certified health IT, health information network, health information exchange, or health care provider that, except as required by law or specified by the Secretary of Health and Human Services (HHS) as a reasonable and necessary activity, is likely to interfere with access, exchange, or use of electronic health information (EHI).

Some general examples of Information Blocking include:

- Hospital policies or procedures that require personnel to obtain an individual’s written consent before sharing the individual’s EHI with unaffiliated providers for treatment purposes even if obtaining such consent is not required by state or federal law.
- Contractual arrangements that prevent sharing or limit how EHI is shared with patients, their healthcare providers, or other third parties.
- Patients or healthcare providers become "locked in" to a particular technology or healthcare network because their electronic health information is not portable.
- A healthcare provider has the capability to provide same-day access to EHI in a form and format requested by a patient or a patient’s healthcare provider, but takes several days to respond.

The American Psychological Association published examples that apply to psychologists:

- EHR systems that put or allow an automatic hold on certain psychological records/mental health progress notes while psychologists determine what EHI is appropriate to include in the system (e.g., minor proxies and multiple patients).
- EHR systems that allow psychologists to simply classify that EHI is "sensitive" (without further justification) to limit access within the system.
- Practices that restrict access more than is legally justified (e.g., restricting patient access more than permitted under the HIPAA Privacy Rule and state law).
- Limiting the interoperability of health IT (e.g., disabling a capability that would allow sharing EHI with patients).

Enforcement is by the Office of the Inspector General (OIG) of HHS. OIG would have to show that the provider had knowledge and intent to interfere with access. However, it would not have to show that the provider understood that they were violating the information blocking rules; therefore, ignorance of the rules would not be an excuse. Nor would OIG have to show that the information blocking caused actual damage. OIG has, however, indicated that it does not plan to take enforcement action regarding innocent mistakes.

In the final rule, HHS identified eight categories of reasonable and necessary activities that do not constitute information blocking, provided certain conditions are met ...
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/ 2021 News, Daily News
A new California Workers’ Compensation Institute study finds that nonsteroidal anti-inflammatories (NSAIDs) now account for more than a third of all drugs dispensed to injured workers in California, triple the proportion noted for opioids.

The study also reveals that although most NSAIDs that are used are inexpensive, and utilization has been flat since the state’s evidence-based prescription drug formulary took effect in 2018, NSAIDs’ share of the total drug spend has soared from 14.2% to 23.5%, largely driven by increased payments for two low-volume, high-priced drugs that are exempt from prospective utilization review (UR) and that lack price controls.

The CWCI analysis of changes in the distribution of California workers’ compensation prescriptions and prescription payments over the past decade uses data on 5.85 million prescriptions dispensed to injured workers, resulting in payments totaling $623 million.

The data show that opioids accounted for 11.6% of the prescriptions filled in the first half of 2020, down from 31.0% in 2011 - a relative decline of 62.6% during the study period.

NSAIDs, often used as non-opioid alternatives to treat pain, surpassed opioids as the number one drug group in 2015, and in both 2019 and the first half of 2020 they accounted for more than a third of all prescriptions dispensed to injured workers, twice the proportion noted a decade earlier.

Ranking behind opioids in terms of utilization are anticonvulsants, dermatologicals, and antidepressants, which round out the top 5 drug groups.

Musculoskeletal drugs (muscle relaxants), which were the third most heavily used workers’ comp drug group until the formulary took effect, saw their share of the prescriptions fall sharply beginning in 2018 as under the formulary they are subject to prospective UR, with the exception of special fill or perioperative uses, where the quantity of the drug that can be dispensed is limited.

Total payments for a drug group reflect several factors besides the volume of prescriptions, including allowable fees under the pharmacy fee schedule, average quantities and dosages, mode of delivery, and the availability of generics.

While opioids still rank second in workers’ comp prescription volume, the study found their share of the prescription payments fell from 30.7% in 2011 to 7.0% in the first half of 2020, so they now rank fourth in terms of total drug spend, behind NSAIDs (23.5%), dermatological drugs (14.1%), and anticonvulsants (13.1%).

CWCI has released its study in a Research Update report, "California Workers’ Compensation Prescription Drug Trends." ...
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/ 2021 News, Daily News
A combination of two Eli Lilly antibody drugs cut the risk of COVID-19-related hospitalizations and deaths by 87%, the company announced Wednesday, further upholding dosing already authorized by the Food and Drug Administration.

New data from the randomized, double-blind, placebo-controlled BLAZE-1 Phase 3 study, demonstrates that bamlanivimab 700 mg and etesevimab 1400 mg together significantly reduced COVID-19 related hospitalizations and deaths in high-risk patients recently diagnosed with COVID-19.

These results provide additional efficacy and safety data that support the use of the dose recently granted both Emergency Use Authorization by the U.S. Food and Drug Administration and a positive scientific opinion by the European Medicines Agency's Committee for Medicinal Products for Human Use.

This new Phase 3 cohort of BLAZE-1 included 769 high-risk patients, aged 12 and older with mild to moderate COVID-19. Bamlanivimab and etesevimab together also demonstrated statistically significant improvements on key secondary endpoints. These results are consistent with those seen in other data sets from BLAZE-1: in the previous Phase 3 cohort, bamlanivimab 2800 mg with etesevimab 2800 mg reduced the risk of hospitalizations and deaths by 70 percent and in the Phase 2 cohort, bamlanivimab alone reduced the risk of hospitalizations and ER visits by approximately 70 percent.

In this new Phase 3 cohort, there were four deaths total, all of which were deemed related to COVID-19 and all of which occurred in patients taking placebo; no deaths occurred in patients receiving treatment with bamlanivimab and etesevimab together.

"These positive results reinforce our previous findings and support the authorized dose of bamlanivimab 700 mg with etesevimab 1400 mg. These compelling data - in addition to the recent EUA from FDA, the decision from EMA and the recommendation for the therapy in the National Institutes of Health's COVID-19 Treatment Guidelines - give healthcare providers additional information regarding the use of bamlanivimab and etesevimab together as a potentially life-saving treatment to help those most at risk for severe complications of COVID-19," said Daniel Skovronsky, M.D., Ph.D., Lilly's chief scientific officer and president of Lilly Research Laboratories.

"The consistent results observed in multiple cohorts of this trial over several months, even as new strains of COVID-19 have emerged, indicate bamlanivimab with etesevimab maintains its effects against a range of variants, particularly those circulating in the U.S."

Lilly continues to engage with global regulators to make bamlanivimab alone and bamlanivimab and etesevimab together available around the world.

Bamlanivimab alone and bamlanivimab with etesevimab together are authorized under special/emergency pathways, in the context of the pandemic, in the U.S. and the European Union. In addition, bamlanivimab alone is authorized for emergency use in Canada, Panama, Kuwait, the UAE, Israel, Rwanda, Morocco and numerous other countries.

Through Lilly's work with the Bill & Melinda Gates Foundation, Lilly is providing doses of bamlanivimab free of charge in Rwanda and Morocco ...
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/ 2021 News, Daily News
In 2013, Ndiawar Diop, while working a licensed vocational nurse at the California Institution for Men in Chino, provided insulin to inmate George Philpott. After Philpott injected himself, he returned the needle through an opening in a window. Diop then placed the used needle into a container used for disposing of needles.

Philpott observed Diop put his hand into the container and get poked. Philpott called for a correctional officer to avoid getting in trouble. Upon seeing Diop prick himself, Philpott exclaimed, ‘I have Hep C.’ Philpott admitted that he did not like Diop, but claimed that he never attacked, injured,or threatened him.

Diop was treated for the needle stick, and completed an intake form at U.S. Healthworks stating that after and inmate injection he got poked by his needle on his right index finger while taking the needle back from him 2 hours ago.

Seven months later, Diop was evaluated and treated by mental health professionals. At this point the history morphed into an attack by the prisoner. Then later during a permanent and stationary evaluation the story morphed even more to a claim that he was "attacked by this inmate with a syringe" and for the first time, he claimed the inmate tried to stab him in the neck.

The change from an accidental to an intentional mechanism of injury affected the claim’s monetary value because, beginning in 2013, a claimant could not receive permanent disability for a stress-related claim unless it was the result of a "violent act" and stress was originally claimed as an injury.

A jury convicted him of five counts of insurance fraud and one count of attempted perjury in connection with his workers’ compensation claim. The Court of Appeal affirmed in the unpublished case of People v. Diop.

Diop contended on appeal that: (1) the evidence fails to support his convictions; (2) the trial court made many evidentiary errors; (3) the court erred in failing to unseal juror identification information; (4) the court erred in failing to instruct on the defense of mistake of fact; and (5) the court erred by denying his motion for new trial.

The Court of Appeal reviewed, and then rejected each one of these arguments. It then concluded the "evidence demonstrates that defendant’s account of how he was injured by an inmate’s dirty needle changed from accidental to intentional. From this evidence, it was reasonable for the jury to conclude that defendant knowingly made a false material statement for the purpose of obtaining greater workers’ compensation benefits." ...
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/ 2021 News, Daily News
The Labor Commissioner’s Office has cited Green Messengers Inc. and Amazon.com Services LLC $6.4 million for wage theft violations affecting 718 workers. The Santa Ana-based contractor delivered packages for Amazon.com Services in Los Angeles, Orange and San Bernardino counties.

The Labor Commissioner’s Office opened an investigation in June 2019 after receiving a report of labor law violations indicating Green Messenger workers were experiencing wage theft because they were not paid properly and did not receive correct pay statements.

Green Messengers provided delivery services for Amazon.com.

The investigation found that from April 2018 to January 2020, delivery drivers were scheduled to work 10-hour workdays and required to finish an Amazon delivery route in those 10 hours using Green Messenger or Amazon vehicles.

Due to the number of deliveries, drivers often had to work through their meal and rest breaks, and were not paid properly for the extra time when they had to work 11 or more hours to complete the route. This resulted in frequent minimum wage, overtime, meal break, rest period and split-shift violations.

The citations total $6,454,110, with $5,304,768 owed to the 718 workers. The amount payable to workers includes $3,377,988 in liquidated damages and waiting time penalties, $762,850 in penalty assessments for not providing proper wage statements, $882,735 for split-shift, meal and rest break premiums, and $281,195 for minimum wage, overtime and contract wages.

Green Messengers and Amazon.com Services are responsible for the amounts due to workers according to California’s client-employer liability law, in effect since 2015. The law holds client-employers that obtain labor from a subcontractor liable for their workplace violations.

The citations issued to Green Messengers Inc. include $1,149,342 in civil penalties payable to the state.

The companies have appealed the citations. Under the appeal procedure, the Labor Commissioner’s Office will hold a hearing before a Hearing Officer who will affirm, modify or dismiss the citations.
...
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/ 2021 News, Daily News
The Contra Costa County District Attorney’s Office filed a felony complaint against Segundo Collazos, the owner of Amazon’s Landscaping Company based out of Concord.

The charges relate to the 2018 death of Manuel Peralta, then 68, of Antioch, California, who died while operating a rented tree stump grinder in San Ramon.

According to the OSHA report, Collazos and Peralta were working at the 3700 block of Segovia Court in San Ramon on April 9, 2018. Peralta had a rope tied around him and was tied to a Dosko stump grinder. The owner of the company was operating the stump grinder.

Peralta's rope became entangled in the cutting wheel of the stump grinder, resulting in his being pulled into the grinder's cutting wheel killing him.

Collazos, the company owner who had been operating the machine, was fined $54,750 for six workplace violations.

At the time of the incident, Collazos had a suspended license with the Contractors State License Board. The investigation began from the California Department of Industrial Relations’ Division of Occupational Safety & Health Bureau of Investigations.

The first felony alleges that defendant Collazos permitted the victim Manuel Peralta to use a stump grinder in a manner contrary to manufacturer recommendations and to work in the danger zone of the cutting wheel, resulting in his death.

The second felony alleges that Collazos failed to properly train Peralta on the proper and safe use of the stump grinder, also resulting in his death.

"Employers must be made aware that disregarding the requirement to train and supervise workers using dangerous equipment can lead to tragedy and possible jail time," said Cal OSHA Chief Doug Parker in a statement.

The District Attorney’s Office reminds homeowners to check that a contractor is currently licensed and insured before hiring them for residential construction work. Homeowners can check the validity of a license number on the Contractors’ State Licensing Board website or call (800) 321-CSLB (2752).

Deputy District Attorney Ryan Morris is prosecuting the case on behalf of the People. DDA Morris is assigned to our Office’s Special Operations Division ...
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/ 2021 News, Daily News
More than a third of employers have fielded complaints from workers related to COVID-19, and claims involving the Americans with Disabilities Act have jumped since last summer, according to a survey of employers released by Blank Rome LLP on Wednesday.

Blank Rome's report, based on a February survey of 130 executives, human resources leaders, and in-house and general counsel, said that 34% of respondents had gotten COVID-19-related complaints. That's up from 21% in July and just 12% in March 2020, the firm said, adding that ADA claims climbed from 4% in July to 8%.

And while the overwhelming majority of the company leaders - 87% - are in favor of taking the COVID-19 vaccine themselves, only 15% said they would require workers to get the jab. Meanwhile, 39% of respondents said they would not require employees to be vaccinated, and the rest were undecided.

When it comes to asking workers if they have been vaccinated, 41% answered that they plan to do so, though half remained unsure.

When it comes to the potentially risky practice of incentivizing the shots, just 10% of respondents said they would, while 34% said they won't and the rest had yet to decide, according to the report.

"Employers are waiting to see how it all shakes out," Susan Bickley, a Blank Rome partner and study co-authors aid, adding that employers might be able to encourage workers to get vaccines without instituting mandates or structured incentive programs. "There's been some conflicting signals."

While the report showed a steady rise in complaints from employees, it also showed that nearly three-quarters of them don't fall into traditional categories for employment claims, such as discrimination, retaliation, and Occupational Safety and Health Administration complaints.

Employers have widely adopted medical screening requirements for on-site workers, which could be a driver of the increasing employee complaints, the report said. The majority of the surveyed employers have increased cleaning, social distancing requirements and associated signage. Roughly 97% require masks, a figure that has risen since the summer.

Three-quarters of employers allow their employees to work from home, and only 28% have three-quarters or more of their employees on site. Most continue to refrain from instituting workplace liability waivers.

Additionally, 78% of employers have faced increased requests for paid time off. And around 40% have seen increased requests for time off under the Family and Medical Leave Act or unpaid leave.

But those requests haven't had too much of an impact on typical time-off eligibility. Around 60% of the employers haven't made changes to PTO offerings, and just 6% have given parents of young children more PTO.

In April, more than half of employers had avoided taking employee-related cost-cutting measures, such as layoffs and furloughs. That number has dropped as the pandemic has raged on; now, just 31% have managed to evade those outcomes.

"This was the first survey where employers are feeling somewhat hopeful," Iley said. "We got some positive comments. People are coming out of the difficult decisions." ...
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/ 2021 News, Daily News
John Coffman, a longtime employee of the California Department of Transportation, died by suicide in 2015. He began working for Caltrans doing landscape maintenance work in the early 2000s.

Since at least May 1998, Caltrans has had a "zero tolerance" policy for workplace violence, including threats, harassment, verbal abuse, bullying, and intimidation. He began reporting incidents of verbal abuse, intimidation, and threats of physical harm starting in 2002. He documented incidents nearly every year until 2015.

The October 2, 2015 incident caused him to be "extremely stressed out." The following day, Coffman went to the hospital; his blood pressure was elevated, and he was prescribed medication to "help [him] cope." He was placed on leave due to emotional distress. He was scheduled to return to work on January 4, 2016, however he committed suicide on December 30, 2015.

His wife and son sued Caltrans and Coffman’s supervisor, Michael Nelson, for wrongful death. They allege that Coffman was bullied, ridiculed, and harassed at work by a number of coworkers and that Caltrans and Nelson failed to prevent those acts, causing Coffman’s death.

Caltrans and Nelson moved for summary judgment on the basis of their affirmative defense that the Coffmans’ claims are barred by workers’ compensation exclusivity. The trial court granted that motion.

The Court of Appeal affirmed the dismissal in the unpublished case of Coffman v. Dept. of Transportation.

The issue was whether the conduct of Nelson and Caltrans fell outside the compensation bargain such that workers’ compensation exclusivity does not bar appellants’ action. Coffmans advance two arguments for why their claims are not barred.

First, they maintain that the conduct of Coffman’s coworkers amounted to harassment, which they assert falls outside the compensation bargain. They further argue that Caltrans and Nelson ratified that conduct by failing to prevent it, such that they may be held liable for it. Second, appellants contend that Caltrans and Nelson’s failure to enforce Caltrans’s workplace violence prevention policy violated a fundamental policy of this state.

Analyzing the incidents individually reveals that the majority of the complained-of conduct by Coffman’s coworkers was within the compensation bargain. The incident in which Flores battered Coffman is an obvious exception, but that incident was investigated, Flores was found to have violated Caltrans’s workplace violence policy, and he was fired. Accordingly, Caltrans and Nelson cannot be said to have ratified that conduct and thus cannot be held liable for it.

Retaliation in violation of the FEHA, which count 2 does allege, likewise is outside the compensation bargain.
...
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/ 2021 News, Daily News
Medicare reimbursement policies for outpatient services have encouraged physician integration with hospitals, according to a new study and commentary published in Health Services Research.

An article on MedPageToday claims that's in part because Medicare reimbursement for physician services, on average, would have been $114,000 higher per physician per year for those who were integrated with a hospital, researchers found.

For primary care alone, reimbursement would have been $63,000 higher per physician per year for those who were integrated with a hospital. For medical specialties, the average reimbursement difference was $178,000, and for surgical specialties, it was $150,000.

The reimbursement difference per specialty ranged from $363,000 for urology to $15,000 for psychiatry, according to the study.

"These numbers are astonishing," healthcare technology consultant Dan O'Neill, MA, MS, tweeted. O'Neill is the former senior vice president and general manager of Change Healthcare and a former Robert Wood Johnson Foundation health policy fellow.

"The incentives and waste here are just ... incredible. As in, incredibly destructive," O'Neill tweeted. "Just imagine how much worse this is for commercial payers, given the 200% to 400% markups (over Medicare) in hospital outpatient departments."

Post and colleagues also found a modest association between a higher payment differential and the probability of integrating with a hospital. The effect was larger among primary care physicians and medical specialists, but not statistically significant among surgeons, they found.

Post also tweeted about the potential effects of vertical integration: "While integration is associated with higher prices, current evidence suggests a limited association with quality," he wrote. "As a result, we're not crazy about encouraging more of it."

There are several reasons the study has garnered attention, Michael Chernew, PhD, professor of healthcare policy at Harvard Medical School and author of the study's corresponding commentary, told MedPage Today.

"There's an enormous amount of concern about healthcare prices in this country," Chernew said. And much of the concern about high prices is because of consolidation.

Additionally, there is interest in Medicare spending, he said. One issue that has an impact on that is site-neutral payments. "This study links them together in a way that is both interesting and policy-relevant," Chernew said ...
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/ 2021 News, Daily News
Kia Lor, 54, of Merced, was arraigned on four counts of insurance fraud after an investigation by the Department of Insurance found that she allegedly lied about the extent of prior injuries in an attempt to receive nearly $7,000 in undeserved workers’ compensation payments.

On October 5, 2018, Lor, a former Nutrition Assistant at the Merced Community Action Agency, injured her lower back while lifting a cooler at a company picnic.

During the course of treatment, Lor denied any prior injuries to her lower back when completing paperwork and while talking with the workers’ compensation insurance carrier and the Qualified Medical Examiner.

However, during the course of the investigation, it was found that Lor had submitted multiple motor vehicle accident claims between 1999 and 2016 where she suffered injuries to her back.

Additionally, she filed a workers’ compensation claim in 2008 reporting a back injury.

Lor’s misrepresentations about the extent of her prior injuries could have resulted in her being paid $6,960 for permanent disability, but the investigation prevented the payment.

Lor was arraigned at the Merced County Superior Court. This case is being prosecuted by the Merced County District Attorney’s Office ...
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/ 2021 News, Daily News
Robert Piontkowski, an employee of Chevron, was seriously injured on the job at the company’s El Segundo refinery when he was splashed with super-heated materials. Plaintiff subsequently received workers’ compensation benefits for the injuries he sustained.

Piontkowski claims he was injured because a pipe that would normally have drained those materials in a different manner was plugged.

Chevron had a services agreement with Veolia Environmental Services, Inc. to hydroblast such pipes at Chevron’s direction. Plaintiff also alleged that a few days prior to the accident, Chevron requested that Veolia unplug the drain line. At the time of the accident, Veolia had not yet reported to unplug the line.

Plaintiff filed this negligence action against Veolia alleging Veolia owed him a duty, as a third-party beneficiary of the services agreement, to timely respond to a request from Chevron to clean the drainpipe at issue and, further, that Veolia’s failure to clean the pipe caused the condition that led to his injury.

The trial court granted Veolia ES Industrial Services, Inc.’s motion for summary judgment, finding as a matter of law that plaintiff could not establish that Veolia owed him a legal duty of care. Plaintiff appealed. Finding no error, the court of appeal affirmed the judgment of the trial court in the unpublished case of Piontkowski v. Veolia ES Industrial Services, Inc.

In considering whether a party has a legal duty in a particular factual situation, a distinction is drawn between claims of liability based upon misfeasance and those based upon nonfeasance.

Misfeasance exists when the defendant is responsible for making the plaintiff’s position worse, i.e., defendant has created a risk. Liability for misfeasance is based on the general duty of ordinary care to prevent others from being injured by one’s conduct.

Conversely, nonfeasance is found when the defendant has failed to aid plaintiff through beneficial intervention. Liability for misfeasance is based on the general duty of ordinary care to prevent others from being injured by one’s conduct. Liability for nonfeasance is limited to situations in which there is a special relationship that creates a duty to act.

The basic idea is often referred to as the "no duty to aid rule," which remains a fundamental and long-standing rule of tort law. As a rule, one has no duty to come to the aid of another. A person who has not created a peril is not liable in tort merely for failure to take affirmative action to assist or protect another unless there is some relationship between them which gives rise to a duty to act.

The services agreement was not intended to benefit Chevron’s employees nor was it focused on providing a safe work environment for them. Rather, it is plain from the agreement that Veolia’s services were intended to benefit Chevron by keeping its refineries and equipment operating smoothly ...
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/ 2021 News, Daily News
A Hawthorne-based physician has settled allegations that he violated the False Claims Act by receiving kickbacks and other improper payments in exchange for referring patients to Memorial Hospital of Gardena.

Dr. Ashok Kumar paid $215,228 on March 1 to settle the allegations brought against him in a whistleblower lawsuit that Memorial Hospital of Gardena provided compensation to Kumar, whom they hired as a medical director, that both exceeded the fair market value of his services and was an attempt to incentivize him to refer patients to their hospital.

The lawsuit alleged that Kumar violated the federal Anti-Kickback Statute as well as the Physician Self-Referral Law. The Anti-Kickback Statute imposes civil liability on those who willingly offer, solicit, receive or pay any sort of compensation in exchange for the referral of services provided by a federal health care program, including Medicare. The Physician Self-Referral Law, commonly known as the Stark Law, bans doctors from referring patients to receive designated health care services payable by Medicare or Medicaid from entities with which the doctor or an immediate family member has a financial relationship.

The settlement resolves allegations originally brought in a lawsuit by Dr. Joshua Luke, the former chief executive officer of Memorial Hospital of Gardena, against Kumar and other defendants under the whistleblower provisions of both the federal and California False Claims acts. Both statutes permit private parties to sue on behalf of the state and federal governments for false claims for government funds, and to receive a share of any recovery.

Dr. Luke will receive $42,529 from the federal government as his share of the recovery announced today. His allegations against the other defendants were resolved in 2018 when they agreed to pay the federal government an $8.1 million settlement. The allegations brought on behalf of the State of California have been resolved pursuant to a separate agreement.

This case was handled by Assistant United States Attorney Frank D. Kortum of the Civil Fraud Section, who worked closely with the U.S. Department of Health and Human Services - Office of Inspector General. Tips and complaints from all sources about potential fraud, waste, abuse and mismanagement can be reported to the Department of Health and Human Services, at 800-HHS-TIPS (800-447-8477).

The case is United States of America ex rel. Luke, State of California ex rel. Luke v. Gardena Hospital, L.P. DBA Memorial Hospital of Gardena, Avanti Hospitals, LLC, et al., CV 15-8732-MCS ...
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/ 2021 News, Daily News
A federal grand jury returned an indictment charging two defendants in a scheme that targeted California Employment Development Department unemployment insurance benefits that were intended for Californians hit hardest by the ongoing COVID-19 pandemic shutdown.

The three-count indictment charges Jason Vertz, 51, of Fresno, and Alana Powers, 45, an inmate at the Central California Women’s Facility in Chowchilla, with one count of conspiracy to commit mail fraud and two counts of aggravated identity theft.

The indictment was unsealed and Vertz was arraigned on Tuesday following his arrest.

According to court documents, Vertz and Powers submitted several fraudulent unemployment insurance claims in Powers’ and other Central California Women’s Facility inmates’ names to EDD.

Recorded jail calls and emails show that Powers and other inmates, provided names, dates of birth, and social security numbers for inmates at Central California Women’s Facility to Vertz to submit the fraudulent claims. Shortly thereafter, the benefits were loaded onto debit cards that were mailed to the addresses the defendants provided.

The underlying applications for the claims stated that the inmates had worked within the prescribed period as maids, cleaners, fabrication welders, and other occupations, and that they were available to work, which was not true because they were incarcerated.

The claims would have been denied if accurate answers had been given. EDD and the United States have suffered an actual loss of over $103,000 as a result of the fraud.

This case is the product of an investigation by the FBI, the California Department of Corrections and Rehabilitation Investigative Services Unit, and the California EDD.

If convicted of the conspiracy to commit mail fraud, Vertz and Powers each face a maximum statutory penalty of 20 years in prison and a fine of up to $250,000.

If convicted of the aggravated identity theft, they face a mandatory two-year sentence consecutive to any other sentence ...
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Cal/OSHA has cited multiple employers for not protecting workers from COVID-19 following inspections in various industries throughout the state.

Violations were identified in industries including construction, garment, correctional institutions and medical. Cal/OSHA opened the inspections after learning of COVID-19 fatalities and illnesses, and after receiving complaints. The full list of employers cited for COVID-19 violations is posted on Cal/OSHA’s website.

The employers cited for COVID-19 violations, and citations include but are not limited to:

Los Angeles Apparel, Inc. Garment Manufacturer Los Angeles - - $102,550
California Prison Industry Authority Correctional Institutions Vacaville - - $24,300
Integrated Pain Management Medical Group, Inc. Medical Practice San Leandro - - $9,450
Erickson Framing CA LLC Construction Fairfield - - $9,000
Erickson Framing CA LLC Construction Vacaville - - $9,000

The inspection at the Los Angeles Apparel factory occurred after reports of an outbreak, including six employees who died from COVID-19 complications. Cal/OSHA determined that Los Angeles Apparel intentionally did not report the COVID-19 fatalities. Cal/OSHA cited the employer for six serious, one willful-regulatory, three regulatory and seven general violations. One of the serious violations was failure to evaluate COVID-19 hazards, such as the lack of physical distancing or barriers to separate employees operating sewing machines. Another serious violation was the lack of employee training on preventing COVID-19 infection in the workplace.

An inspection was opened at the California Prison Industry Authority in Vacaville after the employer reported the serious illness of an employee hospitalized for COVID-19 complications, and another employee tested positive for the virus. Cal/OSHA cited the employer for three serious violations after finding deficiencies in its Aerosol Transmissible Diseases (ATD) and respiratory protection programs that exposed employees to COVID-19 infection.

Also cited for two COVID-19 related serious violations was Integrated Pain Management Medical Group, a San Leandro-based medical practice. Cal/OSHA opened an accident inspection following a report of an employee who was hospitalized for COVID-19 complications. The employer was cited after Cal/OSHA found that it failed to implement an effective employee COVID-19 screening procedure and that it had deficiencies in its respiratory protection program.

Cal/OSHA cited the Roseville-based framing contractor Erickson Framing CA, LLC following two COVID-19 complaint-based inspections at worksites in Vacaville and Fairfield. At the Vacaville site, the Cal/OSHA inspector found that the employer was not enforcing the use of face coverings or physical distancing between employees. In a subsequent inspection at the Fairfield worksite a month later, the Cal/OSHA inspector again found the same hazards: a lack of physical distancing and failure to require the use of face coverings. Cal/OSHA cited the employer for a serious violation in each instance for the employer’s failure to effectively establish, implement and maintain procedures to correct unhealthy conditions related to COVID-19 that affected its employees, including its failure to enforce face covering use and physical distancing for COVID-19 prevention ...
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DEA announced the release of the 2020 National Drug Threat Assessment, DEA’s annual publication outlining the threats posed to the United States by domestic and international drug trafficking and the abuse of illicit drugs.

Drugs trends in the United States continue to evolve. Although progress has been made in reducing the smuggling of fentanyl and fentanyl analogues from China following the DEA’s 2018 emergency scheduling action of fentanyl related substances and China’s enactment of fentanyl-class controls in May 2019, Mexican drug trafficking organizations have increased production causing more fentanyl to flow across our border. The opioid threat remains at epidemic levels, affecting large portions of the country. Meanwhile, the stimulant threat, including methamphetamine and cocaine, is worsening both in volume and reach, with traffickers selling increasing amounts outside of traditional markets.

According to the U.S. Centers for Disease Control and Prevention, more than 83,000 people lost their lives to drug-related overdoses in the twelve-month period ending in July of 2020, a significant increase from 2019, when more than 70,000 people died of overdoses.

Illicit fentanyl is one of the primary drugs fueling the epidemic of overdose deaths in the United States, while heroin and prescription opioids remain significant challenges to public health and law enforcement.

California highlights:

- - In 2019, California had more fentanyl seized than any other state.
- - In 2019, California, Ohio, and Texas reported the highest dollar amounts in bulk cash seizures for a combined total of $131,039,840 USC. In the first six months of 2020, California, New York, and Texas accounted for 39 percent of the bulk cash seized. Border restrictions between the United States and Mexico, brought on due to the pandemic, have increased the difficulty of transporting loads of bulk currency from the United States across the SWB into Mexico. As a result, large amounts of U.S. currency are being held along the U.S. side, awaiting transport to Mexico.
- - California had the second greatest amount of cocaine seized in 2019 due to the proximity of the Southwest Border (SWB) and high-traffic international airports and seaports.
- - DEA Field Divisions seized 6,951 kilograms of heroin in 2019, a 30 percent increase from 2018, with the largest amounts of heroin seized in Texas, California, Arizona, and New York. California, Texas and Arizona are all major entry points for heroin sourced from Mexico and also serve as transshipment points for the onward movement of heroin to domestic markets throughout the United States.
- - California leads the U.S. in methamphetamine conversion labs. Methamphetamine conversion laboratories are used to convert powder methamphetamine into crystal methamphetamine or to recrystallize methamphetamine in solution back into crystal methamphetamine.
- - In 2019, 26 percent of illicit fentanyl tablets contained a potential lethal dose of fentanyl which increased from 14 percent and 10 percent the two years prior.

Mexican cartels are increasingly responsible for producing and supplying fentanyl to the U.S. market. China remains a key source of supply for the precursor chemicals that Mexican cartels use to produce the large amounts of fentanyl they are smuggling into the United States ...
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The National Association of Insurance Commissioners (NAIC) released data on life/fraternal and property/casualty insurers. The reports provide market share information and identify leading insurance writers in several key lines of business. The numbers in the reports will increase throughout the week and month as the report runs.

The 2020 market share data include countrywide direct written premiums for the top 25 groups and companies as reported on the state page of the annual financial statement for insurers that report to the NAIC.

The Property/Casualty Market Share report contains cumulative market share data for the following lines of business: personal auto, commercial auto, workers' compensation, medical professional liability, homeowners and other liability (excluding auto liability) insurance.

The top six carriers have more than a third of the market share (35.95%). Here are the top six.

1) Travelers Grp - Written Premium of $3,737,454,477 - - Market Share 8.91%.
2) Hartford Fire & Cas Grp - Written Premium of $2,992,053,652 - - Market Share 7.13%.
3) Zurich Ins Grp - Written Premium of $2,495,405,266 - - Market Share 5.95%.
4) Chubb Ltd Grp - Written Premium of $2,294,088,995 - - Market Share 5.47%.
5) Amtrust Financial Serv Grp - Written Premium of $1,895,538,139 - - Market Share 4.52%.
6) Berkshire Hathaway Grp - Written Premium of $1,673,865,206 - - Market Share 3.99%.

Other highlights from the report include:

- - With 69.47% of property/casualty insurance companies reporting to date, direct premiums written for all lines of business are $520,900,408,551.
- - The top 10 property/casualty companies reporting to date have a cumulative market share of 50.04%.
- - The two largest lines of business, private passenger auto and homeowners, have direct written premiums of $162,476,549,796 and $76,733,238,097, respectively, as of March 1.

The reports reflect data filed by insurers as of March 1 and will be refreshed daily through March 5 and then each Monday throughout March. The full 2020 Market Share Reports for Life/Fraternal Groups and Companies and the full 2020 Market Share Reports for Property/Casualty Groups and Companies will be available this summer and will contain more in-depth information ...
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Following the implementation of the California Division of Occupational Safety and Health’s (Cal/OSHA) COVID-19 Emergency Temporary Standards (ETS) on November 30, 2020, several employers and trade associations filed a lawsuit in San Francisco Superior Court for declaratory and injunctive relief against Cal/OSHA.

The lawsuit, National Retail Federation, et al. v. California Department of Industrial Relations, et al. (Case No. CGC20588367), was the first filed seeking to prevent the agency from enforcing the ETS.

Shortly thereafter, the Western Growers Association filed a related case in Los Angeles Superior Court. However, in an effort to avoid "duplicative and inconsistent rulings," the Western Growers Association lawsuit was transferred to San Francisco and the cases are being heard together.

The lawsuits alleged that the ETS were improper for several reasons, including that Cal/OSHA "exceeded the scope of its authority to promote occupational safety and health by attempting to regulate wages and paid leave" and "arbitrarily and capriciously deprive[d] Plaintiffs of property without just compensation or due process, particularly with respect to the COVID-19 testing and mandatory periods of paid exclusion from work."

On January 28, 2021, Superior Court Judge Ethan P. Schulman heard oral argument on the motions for a preliminary injunction in both cases. Both sides articulated a number of arguments.

Jason S. Mills of Morgan, Lewis & Bockius LLP argued on behalf of the NFR, and claimed that two new requirements - mandatory testing and paid leave for exposed employees - exceed the agency’s authority. Freeing employers from those two requirements won’t lead to increased Covid-19 cases in workplaces, he argued.

David A. Schwarz of Sheppard, Mullin, Richter & Hampton LLP represented the Western Growers Association asked the court to also block provisions regulating employee-provided housing and transportation. The regulations, which dictate things like the distance between beds and the number of people allowed on a bus, border on logistical absurdity when applied to the agricultural industry, Schwarz said. And he asserted that the labor shortage in that industry will be exacerbated by these rules.

Last Thursday, Judge Schulman denied the request for a preliminary injunction. His ruling said that the standards board "properly found that the COVID-19 pandemic constitutes an emergency" and that prior guidance was "not sufficient to address" the risk of occupational spread.

Judge Schulman also dismissed the argument that Cal/OSHA lacked the authority to enforce the ETS, and held that if he granted the injunction, "numerous workers in California would suffer severe and irreparable harm."
...
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Intravenous injection of bone marrow derived stem cells in patients with spinal cord injuries led to significant improvement in motor functions, researchers from Yale University and Japan report Feb. 18 in the Journal of Clinical Neurology and Neurosurgery.

Yale scientists Jeffery D. Kocsis, professor of neurology and neuroscience, and Stephen G. Waxman, professor of neurology, neuroscience and pharmacology, were senior authors of the study, which was carried out with investigators at Sapporo Medical University in Japan. Key investigators of the Sapporo team, Osamu Honmou and Masanori Sasaki, both hold adjunct professor positions in neurology at Yale.

For more than half of the patients, substantial improvements in key functions - such as ability to walk, or to use their hands - were observed within weeks of stem cell injection, the researchers report. No substantial side effects were reported.

The patients had sustained non-penetrating spinal cord injuries, in many cases from falls or minor trauma, several weeks prior to implantation of the stem cells. Their symptoms involved loss of motor function and coordination, sensory loss, as well as bowel and bladder dysfunction.

The stem cells were prepared from the patients’ own bone marrow, via a culture protocol that took a few weeks in a specialized cell processing center. The cells were injected intravenously in this series, with each patient serving as their own control. Results were not blinded and there were no placebo controls.

Kocsis and Waxman stress that additional studies will be needed to confirm the results of this preliminary, unblinded trial. They also stress that this could take years. Despite the challenges, they remain optimistic.

"Similar results with stem cells in patients with stroke increases our confidence that this approach may be clinically useful," noted Kocsis. "This clinical study is the culmination of extensive preclinical laboratory work using MSCs between Yale and Sapporo colleagues over many years."

"The idea that we may be able to restore function after injury to the brain and spinal cord using the patient’s own stem cells has intrigued us for years," Waxman said. "Now we have a hint, in humans, that it may be possible." ...
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