On January 10, 2022, the Departments of Health and Human Services (HHS), Labor, and Treasury announced new guidance outlining how insurers and group health plans will be required to cover and reimburse enrollees for up to eight at-home tests for COVID-19 per enrollee per 30-day period. This policy applies to tests purchased beginning on January 15, 2022 through the end of the declared public health emergency. Healthaffaris.org reports that under the new guidance, insurers are incentivized to use their bargaining power with in-network pharmacies and other retailers to ensure that enrollees can obtain at-home COVID-19 tests without cost sharing (i.e., for free) at the pharmacy or retail counter. The January 10 guidance clarifies that insurers and plans must cover and reimburse members for up to eight OTC COVID-19 diagnostic tests per enrollee per 30-day period. In general, insurers and plans cannot limit coverage or reimbursement to only tests purchased at in-network pharmacies and other retailers. Put another way, a member can seek reimbursement no matter where they purchased their test from - whether at an in-network pharmacy or through Amazon. But HHS strongly encourages insurers and plans to pay manufacturers or sellers directly for OTC COVID-19 tests. To that end, the guidance creates a safe harbor from enforcement for those that set up a "direct coverage" option. Under this option, the insurer or plan will arrange for OTC COVID-19 tests to be free (i.e., with no cost sharing) for enrollees through its in-network pharmacies and other retailers. Insurers and plans cannot impose prior authorization or medical management requirements - and must ensure that members truly have access to COVID-19 tests through an adequate number of retail locations. Those that offer direct coverage will be allowed to limit reimbursement to $12 per test or the actual price of the test (whichever is lower) when a member purchases a test from a non-network pharmacy or retailer. This $12 limit helps mitigate the risk of price gouging by manufacturers and sellers. If payer reimbursement was uncapped, manufacturers and sellers might be tempted to raise the price of tests significantly, putting COVID-19 tests further out of reach for millions of people. Insurers and plans can, of course, take reasonable steps to prevent, detect, and address suspected fraud and abuse, and the guidance identifies some examples of permissible activities for doing so. For instance, an insurer or plan can require an attestation, signature, or proof of purchase to confirm that an OTC COVID-19 test was purchased for the enrollee’s use (as opposed to someone else’s use), has not been reimbursed by another source, and is not for resale. Insurers and plans can adopt these types of fraud prevention measures so long as they do not create significant barriers for obtaining tests (such as requiring enrollees to submit documents or delaying reimbursement) ...

The California Department of Public Health issued guidance that allows health care networks to enable COVID-19-positive employees to keep working if they don’t show any symptoms. "The department is providing temporary flexibility to help hospitals and emergency services providers respond to an unprecedented surge and staffing shortages. Hospitals have to exhaust all other options before resorting to this temporary tool. Facilities and providers using this tool, should have asymptomatic COVID-19 positive workers interact only with COVID-19 positive patients to the extent possible," the Department of Public Health said in a statement to news outlets over the weekend. The Epoch Times contacted the agency for comment. Health care workers in the state now don’t have to isolate or show a negative COVID-19 test, the guidance said, before coming back to work if they are asymptomatic. The guidance, which remains in effect until Feb. 1, stipulates that staff wear N95 respirator masks while on the job. After the guidance was handed down, several unions that represent nurses and other hospital staff expressed alarm. "Healthcare workers and patients need the protection of clear rules guided by strong science. Allowing employers to bring back workers who may still be infectious is one of the worst ideas I have heard during this pandemic, and that’s really saying something," Bob Schoonover, the head of union SEIU California, told CBS Sacramento. Schoonover added that while his union supports "supplemental paid sick leave," the latest guidance imperils a "critical piece of the protection that workers and the public need." The president of the California Nurses Association, Sandy Reding, told local media that the California health department’s guidance will put patients at risk. "We are very concerned," she told KNTV news. "If you have health care workers who are COVID positive care for vulnerable populations, we can spread the COVID virus inside the hospital as well." Union officials did not mention the rampant staffing issues that have plagued hospitals across the United States and California in recent days. Health giant Kaiser Permanente suspended more than 2,000 employees who were not vaccinated in October. Other California systems such as Santa Clara Valley Medical Center and Sutter Health also terminated or suspended their employees who weren’t vaccinated in the fall of 2021. Meanwhile, Dr. George Rutherford, professor of Epidemiology at the University of California San Francisco, told KNTV that the guidance revision isn’t anything new. "This is about having infected people taking care of infected people. We did this with Ebola in South Africa. We’ve done it before. It’s not the first play option in our playbook. I think staffing issues are such that it led the state to put this guidance out," he told the outlet. It comes days after the Newsom administration mandated that booster shots be given to certain health care staffers by Feb ...

Is there any good news in the horizon about the COVID Pandemic. A new study just published today in Nature Communications by Imperial College London found that High levels of t-cells from common cold coronaviruses can provide protection against COVID-19. T-cells are also believed to play a vital role in providing protection, however, evidence of whether these T cells could provide such a protective effect has been lacking. The study, one of the first designed to find such scientific evidence, began in September 2020, looked at levels of cross-reactive T-cells generated by previous common colds in 52 household contacts of positive COVID-19 cases shortly after exposure, to see if they went on to develop infection. It found that the 26 who did not develop infection had significantly higher levels of those T-cells than people who did get infected. Imperial did not say how long protection from the T-cells would last. "We found that high levels of pre-existing T cells, created by the body when infected with other human coronaviruses like the common cold, can protect against COVID-19 infection," study author Dr Rhia Kundu said. Current COVID-19 vaccines target the spike protein, which mutates regularly, creating variants such as Omicron which lessen the efficacy of vaccines against symptomatic infection. "In contrast, the internal proteins targeted by the protective T-cells we identified mutate much less," Professor Ajit Lalvani, co-author of the study, said. "Consequently, they are highly conserved between the various SARS-CoV-2 variants, including Omicron. New vaccines that include these conserved, internal proteins would therefore induce broadly protective T cell responses that should protect against current and future SARS-CoV-2 variants." ...

Cal/OSHA just updated its FAQs on COVID-19 Prevention Emergency Temporary Standards (ETS) to incorporate new guidance from the California Department of Public Health (CDPH) on isolation and quarantine periods. In December 2020, Governor Newsom issued Executive Order N-84-20, which states that the recommended isolation and quarantine periods in the ETS will be overridden by any CDPH applicable isolation or quarantine recommendation if the ETS periods are longer than those recommended by CDPH. The CDPH Updates as of January 6, 2022 clarified quarantine for workplace settings for fully-vaccinated persons who are booster-eligible, but have not yet received their booster dose. And removed Appendix to determine when a person is "booster-eligible" and instead provided direct link to CDC recommendation. With only one exception noted in the FAQ, the new isolation and quarantine recommendations from CDPH replace the exclusion periods and return to work criteria in sections 3205(c)(9) and 3205(c)(10) of the ETS. Persons Who are Exposed to Someone with COVID-19 (Quarantine) - Unvaccinated; OR Vaccinated and booster-eligible but have not yet received their booster dose (Refer to CDC COVID-19 Booster Shots to determine who is booster eligible): - - Stay home (PDF) for at least 5 days, after your last contact with a person who has COVID-19. - - Test on day 5. - - Quarantine can end after day 5 if symptoms are not present and a diagnostic specimen collected on day 5 or later tests negative. - - If unable to test or choosing not to test, and symptoms are not present, quarantine can end after day 10. - - Wear a well-fitting mask around others for a total of 10 days, especially in indoor settings (see Section below on masking for additional information). - - Strongly encouraged to get vaccinated or boosted. - - If testing positive, follow isolation recommendations in another section of the guidance. - - If symptoms develop, test and stay home. In a workplace setting, asymptomatic employees in this category are not required to stay home from work if: - - A negative diagnostic test is obtained within 3-5 days after last exposure to a case - - Employee wears a well-fitting mask around others for a total of 10 days - - Employee continues to have no symptoms. Persons Who are Exposed to Someone with COVID-19 (No Quarantine) - Boosted; OR Vaccinated, but not yet booster-eligible. - - Test on day 5. - - Wear a well-fitting mask around others for 10 days, especially in indoor settings (see Section below on masking for additional information) - - If testing positive, follow isolation recommendations above. - - If symptoms develop, test and stay home. Workers who have questions about COVID-19 hazards at work can call 833-579-0927 to speak with a Cal/OSHA representative during normal business hours ...

As more and more states look for opportunities to manage prescription drug utilization in their Workers Compensation systems, closed drug formularies continue to receive increased attention as a tool for managing the utilization of prescription drugs. One of the key components is to provide evidence-based guidance to physicians when prescribing drug treatments for injured workers. One such formulary, which has been implemented in several states, is the Official Disability Guidelines Workers’ Compensation Drug Formulary. Using data from NCCI’s Medical Data Call, this new report examines changes in price and utilization trends in WC prescription drug experience following implementation of the ODG Formulary for two different sets of states: - - States which recently adopted mandatory use of the ODG : Indiana, Kentucky, and Montana. For these states, we look at pharmacy utilization trends before and after the - - States where the initial impacts of formulary implementation were first studied by NCCI in 2019: Arizona and Tennessee. For these states, we focus only on post-implementation trends to observe longer-term impacts of the drug formulary. To the extent possible, post-reform experience in each state is compared against a control group of nonformulary states in an attempt to isolate any effects specific to the formulary. KEY FINDINGS - INITIAL IMPLEMENTATION EFFECTS (IN, KY, MT) - - Decreased utilization of drugs contributed to overall cost declines in each of the three states in the period immediately after formulary implementation. - - Post-reform decreases in drug costs for each state were comparable to decreases in overall drug costs observed in nonformulary states for the same periods. KEY FINDINGS - CONTINUED IMPLEMENTATION EFFECTS (AZ, TN) - - Overall drug costs decreased in each of the subsequent post-reform periods for both states. Overall cost declines were driven by decreased utilization of drugs, with a more significant decline in the utilization of drugs requiring prior authorization (N-drugs) relative to those that do not require prior authorization (Y-drugs). - - ​Opioid utilization declined by more than 20% in each post-reform period for both states; however, similar declines in opioid utilization were observed in nonformulary states for the same periods. - - Utilization of topicals continued to decrease in Tennessee in the post-formulary periods while the share of topicals increased in Arizona. Payors (i.e., insurers) in nonformulary states may use some prescription drug management practices when authorizing certain drugs despite the lack of a state-mandated drug formulary. The utilization of a formulary is a behavioral phenomenon and thus the resulting experience depends on the extent to which such formulary is used to make prescribing decisions by the physician, the insurer, and the injured worker. Please note that the findings in this report are largely observational, rather than inferential ...

Public Health and Medical Professionals for Transparency (PHMPT) is a not-for-profit organization. It's members include over 30 accomplished academics, professors, and scientists from the medical schools and related departments of our most prestigious universities, including Yale, Harvard, UCLA, UCSF, UCI and Brown. These academics and scientists represent a cross section of every discipline relevant to the licensure of the Pfizer vaccine and include many of the best our country has to offer when it comes to reviewing and assessing the appropriateness and validity of the FDA’s decision-making in licensing of the Pfizer COVID Vaccine. In furtherance of its mission, on August 27, 2021, PHMPT submitted the Freedom of Information Act (FOIA) Request to the FDA seeking all data and information pertaining to the application and approval of the Pfizer Vaccine. Federal law (21 C.F.R. § 601.51(e)) provides that: "After a license has been issued, the following data and information in the biological product file are immediately available for public disclosure unless extraordinary circumstances are shown." PHMPT desires to perform its own independent analysis of the safety and efficacy the the vaccine, especially in light of the vaccine mandates being promulgated at the federal and state levels. FOIA provides for "expedited processing of request for records" upon a showing of "compelling need." PHMPT requested expedited processing of the FOIA Request, which was rejected by the FDA. Thus, PHMPT filed a lawsuit in federal court, seeking to obtain the data and information relied upon by the FDA to license the Pfizer Vaccine by way of expedited processing. The FDA denied the expedited processing request. In the Second Joint Status Report following filing this case, the FDA assessed that there are more than 329,000 pages potentially responsive to the PHMPT FOIA request. The FDA asks that the Court limit the FOIA response to no more than 500 pages per month. This would be nearly 55 years or until about 2077. The FDA lost the battle. On January 6, a federal judge soundly rejected the FDA’s request and ordered the FDA to produce all the data at a rate of 55,000 pages per month. In doing so the judge noted that "the Court recognizes the 'unduly burden some' challenges that this FOIA request may present to the FDA. " Nonetheless, the Court went on to say that "Open government is fundamentally an American issue" - it is neither a Republican nor a Democrat issue. As James Madison wrote, "[a] popular Government, without popular information, or the means of acquiring it, is but a Prologue to a Farce or a Tragedy; or, perhaps, both. Knowledge will forever govern ignorance: And a people who mean to be their own Governors, must arm themselves with the power which knowledge gives." John F. Kennedy likewise recognized that "a nation that is afraid to let its people judge the truth and falsehood in an open market is a nation that is afraid of its people." And, particularly appropriate in this case, John McCain (correctly) noted that "[e]xcessive administrative secrecy . . . feeds conspiracy theories and reduces the public’s confidence in the government." Echoing these sentiments, "[t]he basic purpose of FOIA is to ensure an informed citizenry, [which is] vital to the functioning of a democratic society." And "Congress has long recognized that 'information is often useful only if it is timely' and that, therefore 'excessive delay by the agency in its response is often tantamount to denial.' " Attorney Aaron Siri, who represents the plaintiff in the case, said "This is a great win for transparency and removes one of the strangleholds federal 'health' authorities have had on the data needed for independent scientists to offer solutions and address serious issues with the current vaccine program - issues which include waning immunity, variants evading vaccine immunity, and, as the CDC has confirmed, that the vaccines do not prevent transmission." ...

California Correctional Peace Officers Association Benefit Trust Fund (CCPOA) paid money pursuant to its disability policy to real party in interest David Martin Jr., a CCPOA member, after he filed a workers’ compensation claim for injuries sustained while working as a correctional officer. CCPOA subsequently filed a lien against the prospective workers’ compensation award for $44,120.60, the sum it paid. It was represented in the workers’ compensation proceedings by petitioner Dan Escamilla, a non-attorney hearing representative. After Martin’s attorney petitioned for costs and sanctions against CCPOA and Escamilla for alleged misbehavior during proceedings on Martin’s claim, CCPOA withdrew the lien. At one point Escamilla sent a letter to the WCJ acknowledging receipt of the notice of one of the subsequent hearings, claiming he and CCPOA were not obligated to attend any hearings on the matter after CCPOA withdrew its lien on July 31, 3018. In total he failed to appear at four hearings on the petition for costs and sanctions. After two petitions for reconsideration and removal, among the WCAB’s findings was that withdrawal of the lien did not deprive the WCJ of jurisdiction to determine whether sanctions should be imposed for Escamilla’s actions during the pendency of the lien, and he therefore was not excused from appearing at proceedings on the sanctions issue held after the lien was withdrawn. The WCAB ultimately affirmed the denial of costs and sanctions, it affirmed an award of $3,280 in attorney fees (8.2 hours at $400 per hour) against CCPOA and Escamilla for the failure to appear at the four hearings. CCPOA filed a petition for writ of review, asserting the failure to notify them that a hearing held subsequent to the COVID-19 pandemic was to be held telephonically was a deprivation of due process, failure to appear following the withdrawal of the lien was not sanctionable bad faith, and attorney fees are not permitted for an attorney expending time litigating on his or her own behalf. The Court of Appeal affirmed the sanctions in the unpublished case of Cal. Correctional Peace Officers Assn. etc. v. Workers’ Comp. Appeals Bd. Although there is no record of the actual notice of the June 22, 2020 hearing given to the parties, petitioners do not claim that no notice was given, claiming instead there was only no notice that the hearing would be telephonic rather than suspended due to the COVID-19 pandemic. Both the WCJ and the WCAB found that all members of the workers’ compensation legal community received notice that hearings would be held telephonically due to the COVID-19 pandemic, and that representatives should have, and, with the exception of Escamilla, did in fact determine how to attend hearing telephonically. "In light of the considerable pressures placed on courts and administrative bodies caused by the COVID-19 pandemic, the general notice that hearings would be held telephonically was sufficient to place petitioners on notice that the June 22, 2020 hearing would be held in this manner, and that they had a duty to determine how to make this appearance. Due process requires no more, and we reject petitioners’ claim to the contrary." The opinion concluded "there was adequate notice of the one hearing in question, withdrawal of the lien did not deprive WCAB of jurisdiction to determine the petition for costs and sanctions, and the contention regarding attorney fees for work on behalf of the attorney is not properly before us, as it was determined by WCAB in a previous proceeding." ...

The U.S. Postal Service has asked OSHA for a temporary waiver from President Biden’s coronavirus vaccine mandate, setting up a showdown on pandemic safety measures between the president and one of the government’s largest agencies. In a letter dated Jan. 4 to the Occupational Safety and Health Administration, Deputy Postmaster General Douglas A. Tulino wrote that requiring workers to be vaccinated against the coronavirus or present weekly negative tests would hurt the agency’s ability to deliver the mail and strain the nation’s supply chains. A vaccine-or-test mandate, he wrote, "is likely to result in the loss of many employees - either by employees leaving or being disciplined." The Postal Service is seeking a 120-day extension to implement the rule, saying that would allow enough time to update its systems for record collection and bargain with its unions over the details. "Given the significant challenges that our nation’s supply chains are already experiencing, we respectfully suggest that the nation cannot afford the additional potential substantial harm that would be engendered if the ability of the Postal Service to deliver mail and packages is significantly negatively impacted," USPS wrote in its request to OSHA. Postal management noted it is subject to Privacy Act and Freedom of Information Act laws that do not apply to large, private sector employers, and it therefore faces a larger burden to adapt its systems to collect and store employee records. Collecting records for its 650,000 employees is a "prodigious undertaking," USPS said, and it may require the agency to purchase additional "technological infrastructure." The agency must negotiate the implementation details of the rule with its unions, the Postal Service said, and expects it can complete that during the 120-day pause. In the meantime, USPS does not want to divert attention away from its front-line supervisors who are still in the midst of the agency’s peak season. The vaccine-or-test mandate is likely to result in the loss of "many employees," USPS said, and the current moment presents problematic timing. If the Supreme Court upholds the rule, the Postal Service said it will accept the impacts of the rule and adjust to it accordingly. "By virtue of being a massive, unique, and complex agency, it can be very difficult and time consuming to make even modest changes to policies and procedures that impact the working conditions of ... employees," USPS said. "This is especially true when the collection and use of medical information is involved." It added it is seeking to avoid disruption of its operations, given that it does not currently have sufficient resources for implementation. "While the impact to our service could be devastating at any time of year," USPS said, "requiring the Postal Service to absorb what could inevitably be a dramatic loss of employees at a time when the labor market is extremely tight and in the middle of the Postal Service’s peak season would have a potentially catastrophic impact on our ability to provide service to the American public when demand is at its highest." The Postal Service would implement the temporary variance at all postal facilities nationwide. "Because the Postal Service has over 30,000 facilities, it would not be practical to list specific addresses for each postal facility." ...

The numbers from the holiday weekend are in - and the East Bay Times reports that California has broken every record for new coronavirus cases. Obliterated them, actually. The California Department of Public Health reported more than 230,000 new cases on Tuesday, more than twice as many as has been reported in a single day before. The Los Angeles Daily News reports that number of COVID-19-positive patients in Los Angeles County surged well above the 2,000 mark on Tuesday, Jan. 4, amid a surge in infections that has seen daily case numbers skyrocket over the past two weeks. According to state figures, there were 2,240 COVID-positive patients in county hospitals as of Tuesday, a jump from 1,994 on Monday. Of those patients, 303 were being treated in intensive care, an increase from 278 a day earlier. The Marina Del Rey WCAB notified litigants that the office would suspend in-person trials this Monday and Tuesday due to COVID concerns, however they commenced again by Wednesday January 5. The Los Angeles Times reported Tuesday that Los Angeles County, still in the midst of a surge in violent crime, will suspend all criminal trials for two weeks due to the challenge of dealing with the omicron variant of the coronavirus, according to presiding county Judge Eric Taylor. The news came a day after a panel of judges ordered the suspension of all federal trials in Los Angeles, Riverside and Orange counties. There was no timetable given for a return to normal operations in the federal court system. And in another story, the Times reported that the L.A. healthcare system has been hit with widening staffing shortages as workers get coronavirus. ABC News reports that the 79th annual Golden Globes will be held Jan. 9 at the Beverly Hilton in Beverly Hills, California -- the same location as usual -- but this year there will be no audience, no red carpet and no media credentials provided for journalists to cover the event Down south, the San Diego Union-Tribune reported that unprecedented numbers of sick medical staff are causing gridlock in hospitals across San Diego County. Chris Van Gorder, CEO of Scripps Health, said that 14.5% of the health system’s workforce, about 700 workers, were out Tuesday afternoon. "I’ve never seen a staffing issue this serious before," Van Gorder said. Further north, in San Francisco, the San Francisco Chronicle reports that more than 600 classrooms in San Francisco were without their teachers or aides Tuesday and with only 157 substitutes available, every district employee with a teaching credential was ordered to take a class, including the superintendent and other high-ranking officials. San Francisco’s dramatic rise in omicron cases is straining the city’s essential services, according to the Chronicle, as hundreds of police officers, firefighters and transit operators began the new year under quarantine due to exposure or in isolation due to a positive COVID test. As of Tuesday, 167 San Francisco police officers, 135 Fire Department personnel and 85 employees in the city’s Municipal Transportation Agency were in quarantine due to a COVID exposure. And Politico reports that when President Joe Biden took office last January amid a winter Covid-19 surge, he vowed an all-out federal assault aimed at vanquishing the virus. A year later, with the country facing unprecedented levels of disease once again, his administration is now hoping to fight it to a draw. The new strategy has been defined as "a manage-not-contain Omicron game plan." ...

For more than fifty years, the UCLA Labor Center has created innovative programs that offer a range of educational, research, and public service activities within the university and in the broader community. And the Center just published a new report, Fast-Food Frontline: COVID-19 and Working Conditions in Los Angeles, which finds that fast-food workers in Los Angeles County are at higher risk of contracting COVID-19, in addition to facing difficult work conditions that became more acute during the pandemic. This study was commissioned by the Los Angeles County Department of Public Health (LACDPH) to understand the experience of fast-food workers during COVID-19 and more generally. The second of a two-part study, this report is based on 417 surveys and fifteen in-depth interviews with nonmanagerial fast-food workers in Los Angeles County conducted between June and October 2021.The report is the first in the nation to provide an in-depth portrait of COVID-19 safety compliance through the lens of fast-food workers themselves. According to the study, COVID-19 profoundly impacted the lives and workplaces of fast-food workers in Los Angeles County, and fast-food workers had their own specific set of experiences and challenges related to COVID-19 guidelines, transmission, employer response, and protection. - - Most employers provided masks and gloves. Yet, half of workers reported that the number of employer-provided masks or gloves was insufficient or provided too infrequently. Nearly 40% purchased their own masks or gloves, and more than one in ten needed the supplies but could not afford to buy their own. - - After the mask mandate, 84% of workers said customers were required to wear one, yet many workers interviewed shared stories of unmasked customers. - - Over half (53%) experienced negative interactions with restaurant patrons or co-workers over COVID- 19 safety protocols, including being yelled at (34%), threatened (13%), and physically assaulted (4%). - - Nearly a quarter (23%) of workers reported testing positive for COVID-19, and half (49%) knew about positive cases among their coworkers. - - Notification of potential transmission was haphazard. Employers rarely (42%) or sometimes (25%) notified workers of COVID-19 exposure in the workplace. A third (32%) said employers took no action of any kind to support exposed workers. - - Fewer than half (47%) were allowed paid sick leave if they or a co-worker contracted the virus. - - Nearly one in five (17%) workers said they experienced some type of retaliation when asking for protection or taking leave, and 16% were not sure if they had. - - Most (66%) fast-food workers experienced an increase in their stress levels due to the pandemic. Many (42%) feared having to come back into the workplace. Workers experienced irregular sleep patterns (41%), depression (34%), and appetite change (23%). This report shows that fast-food workers faced dangerous and difficult working conditions, high transmission rates of COVID-19, and significant economic and health impacts. These findings show the need for policy intervention in the fast-food industry. Based on the results of the survey and interview, the authors made several recommendations. The most significant was the recommendation that authorities enforce COVID-19 safety protocols and provide workers with adequate protection from retaliation and abuse for enforcing those protocols ...

Steve Menzies, founder and chairman of Applied Underwriters Inc., reacquired his company from Warren Buffett’s Berkshire Hathaway in 2019. Since then, he has been buying businesses, creating new subsidiaries, welcoming new teams of professionals and growing his firm domestically and internationally. Menzies and Jamie Sahara, President, have announced their goals for 2022 in a letter to stakeholders. Following what it termed a "pivotal year for the Company's growth," the leaders have set the realization of larger scale plans and the continued organic growth of the existing and newly introduced coverages and products as the two principal items on the corporate agenda. According to Mr. Menzies, "While uncertainty, inflation and societal ills have created new resting and directional inertia inside and outside all of our business organizations, we were able to continue working almost at full throttle to add to our financial capacity, bolster our stability and add several new business units in the US and abroad." The Excess & Surplus lines (E&S) is a specialty market that insures things standard carriers won't cover. Mr. Sahara observed that Applied remains somewhat cautious, but never fearful: "We consider the domestic, traditional admitted market to be way oversupplied. Primary carriers are not attaining adequate rates nor reasonable terms and conditions. Conversely, we view the E&S market as quite attractive in some segments, and we expect the E&S market to harden further before leveling off." Mr. Sahara continued, "Of course, E&S coverages are characteristically complex to underwrite. Continuing our successful efforts in 2021, Applied is well set to capitalize swiftly on changing market conditions and resulting opportunities." A summary of Applied's 2021 activities includes strategic acquisitions in niche sectors and the creation of new practices, including the transactions that follow Applied Underwriters... - - acquired Concept Special Risks in February. Founded in 1999, Concept Special Risks, a Yorkshire, UK-based international MGA, is a leader in providing coverage for an extensive variety of nautical vessels and operators across the globe. Concept Special Risks is a licensed cover holder at Lloyd's and holds a dominant market position in the US and Caribbean markets for motor yachts, trailer craft, sailboats, and catamarans covering both private/pleasure and charter; - - completed its acquisition of Centauri Specialty Insurance in February. The Centauri companies (Centauri Specialty Insurance Company and Centauri National Insurance Company) based in Sarasota, Florida serve independent agents and brokers in 10 states: Alabama, Florida, Hawaii, Louisiana, Massachusetts, Mississippi, North Carolina, Oklahoma, South Carolina and Texas. The Centauri companies also offer private flood insurance in Florida, Hawaii, and South Carolina; - - completed the acquisition of Oklahoma Property and Casualty Insurance Company in February. Applied sustained the Oklahoma company's writing of admitted business in the South Central United States; - - refocused its Texas Insurance Company in February for E&S Lines countrywide; - - acquired the Florida Casualty Insurance Company in March; formerly Ashmere Insurance Company, the newly re-branded, Ft. Lauderdale-based insurer is licensed in 41 states; - - acquired the insurance renewals to approximately 16,700 policies across Alabama, Louisiana and South Carolina from Gulfstream Property and Casualty Insurance Company and Gulfstream Select in February; - - acquired Alaska Timber Insurance Exchange in the fourth quarter. ATIE is an Alaska-domiciled reciprocal exchange, organized to write non-assessable workers' compensation policies in that state, and is set to conclude its conversion from a reciprocal to a stock insurance company, as approved by regulators; - - created Applied Financial Lines, following the acquisition of StarStone's core products in December 2020, with operations beginning early January. Applied moved into the EU and Middle East for Specialty Business from its Paris and Cologne offices to underwrite several specialty lines including professional indemnity and D&O through an extensive wholesale broker and local retail agent network throughout the EU, Israel and other countries in the region; - - created Applied Specialty Underwriters in November 2020, with the new excess and surplus casualty unit launching in January to focus on general liability, excess liability and workers compensation for New York construction; - - launched Applied Underwriters Aerospace in November, joining forces with the former PartnerRe D&F Space Team (Direct and Facultative). The new operation is based in Washington, D.C. with PartnerRe providing treaty reinsurance and other services as the enterprise expands; - - inaugurated Applied Specialty Risk Construction Infrastructure in November, the Company's new infrastructure and construction practice, providing alternative markets and options for the wide variety of business exposures in the construction sector; - - created Applied Warranty & Insurance Services acquiring the US Specialty Lines Division of Generali Group in June, including Generali Warranty Services, LLC, a fully licensed obligor. Applied Underwriters has aggregated the Specialty Lines business into its newly formed Applied Warranty & Insurance Services division; - - established Applied Fine Art & Collections in December 2020, which commenced operations in 2021 to create the preeminent global provider of coverage and risk management solutions for fine art, jewelry, collectibles, and collector automobiles; - - expanded D&O operations in January under Applied Financial Lines in New York to provide a range of D&O coverages in the U.S; and - - forged a unique partnership with Demotech in May to provide particular coverages for as many as 400 financially sound insurers, rated by Demotech, a top US insurance rating agency. Through the Applied custom program, Demotech-rated carriers are enabled to secure needed umbrella and excess coverages, providing a strong competitive advantage to the insurers for packaging and selling their primary coverages for small business insurance. Mr. Menzies concluded, "We have added larger scale transactions into our pipeline, and we are hoping to close some bigger deals in 2022. Our Company's strong work ethic has shown itself in our staff's desire to stay at work and ensure that our enterprise coasts no more than forced by circumstances." ...

The Workers’ Compensation Appeals Board has adopted its final rules of practice and procedure. The rules were filed with the Secretary of State on December 15, 2021 and went into effect on January 1, 2022. The primary purpose of this rulemaking is to formalize the processes for remote hearings, electronic filing, and electronic service that developed during the novel coronavirus pandemic. To this end, WCAB proposed several new rules to create processes for noticing and objecting to remote hearings, remote appearances, and remote witness testimony. The Board also proposed new definitions for "Appearance," "Hearing," and "Testimony," and revised existing rules regarding appearances to facilitate these processes. Also added are new definitions for "Electronic," "Filing," and "Service," and revised existing rules regarding filing and service, to provide for expanded electronic filing and service. Typographical errors were corrected in six rules. On March 18, 2020, the Board issued Misc. Order No. 260, in pertinent part suspending the provision of rule 10628 requiring service by mail by the WCAB. (Cal. Code Regs., tit. 8, § 10628.) Amended rule 10628 allows electronic service by the WCAB. Accordingly, on January 3, 2022, the Board issued Misc. Order No. 267 clarifying that the suspension of rule 10628 applies to the period from March 18, 2020 to January 1, 2022, the effective date of the amended rule. The newly adopted rules and their related Final Statement of Reasons are posted on the WCAB’s website ...

Courthouse news reports that a U.S. military veteran filed a federal class action lawsuit Thursday against the makers of an antimalarial drug distributed to military forces, claiming the drug made tens of thousands of veterans permanently sick. The lawsuit, filed in the Northern District of California by veteran John Nelson, accuses drug makers Roche Laboratories and Genentech of failing to inform the public of severe side effects of mefloquine, carrying the brand name Lariam, a drug given to U.S. service members to help prevent malaria. The defendants marketed and sold Mefloquine to the U.S. military for service members deployed to Somalia, Afghanistan and other foreign countries for the prevention of malaria. A significant proportion of service members took Mefloquine while deployed to Afghanistan and other foreign countries. Lariam (pharmacological name mefloquine) is an antimalaria drug discovered by the US Army shortly after the Vietnam War as a result of the US Army's huge post-Vietnam antimalaria drug discovery program. The drug was subsequently marketed worldwide by F. Hoffmann-La Roche. The first reported trials of mefloquine were in prisoners, and were performed at the Joliet Correctional Center, Illinois, in 1975, and at the Maryland House of Correction in 1976. There is no question that safe and effective antimalaria drugs were needed in the second half of the twentieth century, once it became apparent that the Plasmodium had developed resistance to the mainstay of antimalaria therapy, namely chloroquine. Chloroquine resistance was observed first in Thailand in 1957, then on the Colombian-Venezuelan border in 1959, and in Kenya and Tanzania in 1978. Within a decade of Lariam being marketed, the safety was in doubt. In 2013, the Food and Drug Administration required the drug to carry a black box warning due to the severity of its side effects. Roche pulled Lariam from the U.S. market in 2009, but generic versions are still available. Nelson was a U.S. military service member who was prescribed Mefloquine when deployed to Afghanistan. Upon taking the drug, he immediately began suffering severe and irreversible side effects, which continue to this day. But he had no knowledge that the neuropsychiatric side effects he was experiencing could be due in any way to Mefloquine. The drug insert did not adequately warn of the drug’s toxicity, and U.S. military service members are not typically provided with the drug insert and would be unlikely to receive any such information. The suit alleges that at at the time they sold the drug to the U.S. military, defendants knew of the substantial danger of severe and irreversible neuropsychiatric side effects of Mefloquine. At that time, there were already widespread reports in the pharmaceutical industry of Mefloquine causing adverse reactions, including symptoms of paranoia, hallucinations, and suicidal ideations. By 1994, Defendants knew or should have known that these adverse reactions were permanent and irreversible. Since that time, numerous scientific studies have confirmed the causal link between Mefloquine and permanent neuropsychiatric effects. Defendants concealed the scope and nature of the danger and recklessly sold the drug as a safe and effective first-line treatment for malaria prevention. Safer and effective drugs for malaria prevention existed on the market. But defendants allegedly had no desire to re-brand Mefloquine as a mere secondary or alternative option for malaria prevention, as that would have extinguished its hold on the market and strong demand for it by the U.S. military. Medical monitoring is a recognized form of relief that allows a plaintiff and class members to obtain diagnostic medical examinations that are funded and/or reimbursed by a defendant when the defendant’s tortious conduct has exposed the plaintiff and class members to harm that proximately causes the need for the comprehensive diagnostic examinations. Plaintiff, individually and on behalf of the Class, seeks medical monitoring as a result of their common exposure to Mefloquine. In a 2007 Journal article "A lesson learnt: the rise and fall of Lariam and Halfan" the author reviewed the history of the development and distribution of Melfooquine and concluded that it " seems probable that in the late 1980s and early 1990s the FDA and other national licensing bodies were influenced, perhaps subliminally, by the powerful military-industrial-governmental lobby into over-hasty decisions to approve the marketing of both Lariam and Halfan. These two drugs were authorized for public use on the basis of an incomplete knowledge base, and at too early a stage in the normal cycle of drug development." The take-away here - will there be similar litigation, and after-the-fact reports, of similar problems with the current "mandated" COVID vaccines a few decades from now? ...

Amid the COVID-19 crisis, the global market for Insurance Fraud Detection estimated at$3 Billion in the year 2020, is projected to reach a revised size of $12.8 Billion by 2027, growing at a compound annual growth rate (CAGR) of 22.8% over the analysis period 2020-2027. Fraud Analytics, one of the segments analyzed in the report, is projected to record a 24.4% CAGR and reach US$4.9 Billion by the end of the analysis period. After an early analysis of the business implications of the pandemic and its induced economic crisis, growth in the Authentication segment is readjusted to a revised 23% CAGR for the next 7-year period. The Insurance Fraud Detection market in the U.S. is estimated at $912.3 Million in the year 2020. China, the world`s second largest economy, is forecast to reach a projected market size of US$2.2 Billion by the year 2027 trailing a CAGR of 22.2% over the analysis period 2020 to 2027. Among the other noteworthy geographic markets are Japan and Canada, each forecast to grow at 20.4% and 19.3% respectively over the 2020-2027 period. Within Europe, Germany is forecast to grow at approximately 15.9% CAGR. In the global Governance, Risk & Compliance segment, USA, Canada, Japan, China and Europe will drive the 21.9% CAGR estimated for this segment. These regional markets accounting for a combined market size of US$486.3 Million in the year 2020 will reach a projected size of US$1.9 Billion by the close of the analysis period. China will remain among the fastest growing in this cluster of regional markets. Led by countries such as Australia, India, and South Korea, the market in Asia-Pacific is forecast to reach US$1.5 Billion by the year 2027. Some of the major competitors in the market are: - - ACI Worldwide, Inc. - - BAE Systems, PLC - - Bridgei2i Analytics Solutions - - Datawalk, Inc. - - DXC Technology Co. - - Experian PLC - - Fair Isaac Corp. - - Fiserv, Inc. - - FRISS - - IBM Corp. - - Infogix, Inc. - - Kount, Inc. - - LexisNexis Risk Solutions, Inc. - - NCR Corp. - - Oracle Corp. - - SAP SE - - SAS Institute, Inc. - - Scorto, Inc. - - TransUnion, LLC - - Wipro, Ltd ...

Riot Games announced that it has reached a global settlement agreement with the California Department of Fair Employment and Housing (DFEH), California Division of Labor Standards Enforcement (DLSE), and several private Plaintiffs to resolve the class-action gender discrimination litigation originally initiated as "McCracken vs Riot Games" in 2018. Riot is headquartered in Los Angeles, California, and has 3,000+ employees in 20+ offices worldwide. The company was founded by Brandon Beck and Marc Merrill in 2006, and is currently led by CEO Nicolo Laurent. The settlement covers a 2018 class action lawsuit filed by current and former Riot employees in the wake of a Kotaku report detailing systemic sexism and unfair treatment. The suit described an environment where male employees made derogatory sexual comments about female colleagues and passed them over for promotion, creating a company-wide "unwritten policy and practice of preferring men to women in the hiring, promotion, and compensation of its employees." Under the proposed consent decree, Riot will pay over $100 million to remedy violations against approximately 1,065 women employees and 1,300 women contract workers. The decree requires comprehensive injunctive relief in the form of workplace reforms, independent expert analysis of Riot’s pay, hiring, and promotion practices, and independent monitoring of sexual harassment and retaliation at Riot’s California offices for three years. The decree will also resolve claims brought by the California Division of Labor Standards Enforcement (DLSE) in the first case jointly prosecuted by DFEH and DLSE. In November 2018, former Riot employees filed a putative class action in Los Angeles Superior Court with private counsel and entered a proposed $10 million settlement of that action soon thereafter. In January 2020, both DFEH and DLSE objected to the proposed $10 million settlement. Both state entities then successfully intervened in the pending private action to protect the interests of the State and the women workers, and ensure the fairness of the resolution of the claims. Both the DLSE and DFEH have jurisdiction to enforce the Equal Pay Act. This is the first case DFEH has litigated involving claims under that law, which the California Legislature authorized -DFEH to enforce starting January 2021 under SB 973 (Jackson). Under the consent decree, Riot has agreed to: - - Pay $100 million, of which a minimum of $80 million is dedicated to compensating workers. This amount includes $4 million in penalties under the Private Attorney General Act (PAGA), one of the largest such penalties assessed by the DLSE in its history. - - Create a $6 million dollar cash reserve for each year of the three-year term of the consent decree (for a total of $18 million) to make pay adjustments and to fund diversity, equity, and inclusion programs. - - Make available 40 full-time positions in engineer, quality assurance, or art-design roles to qualified class members who worked as temporary contractors in a competitive process. - - Hire and pay for an independent third-party expert approved by DFEH to conduct a gender-equity analysis of employee pay, job assignments, and promotions each year for three years and remedy disparities that cannot be explained by bona fide, legitimate reasons. - - Hire and pay for an independent third-party monitor approved by DFEH to audit compliance with workplace protections, including a review of complaint investigations and outcomes, each year for three years. Women who worked as employees or contractors for Riot since November 6, 2014 may be eligible to receive compensation. Additional information will be posted on DFEH’s website following entry of the consent decree by the court. Final approval of the settlement by the court is pending, with a hearing expected in the coming months ...