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An Anaheim man who plead guilty to multiple felonies for impersonating a medical doctor and performing medical procedures including Botox injections, lip and face fillers, and thread-lift procedures on numerous unsuspecting victims has been charged with attempting to start another Botox and thread lift business less than two weeks after he was released from prison. The fake doctor targeted Spanish-speaking women to perform the unlicensed procedures. Elias Segoviano, 63, of Brea, pleaded guilty in April 2023 to 13 felony counts of the unauthorized practice of medicine, one felony count of false indication of a medical license, and one felony count of perjury. He also pled guilty to one misdemeanor count of misrepresenting himself as a licensed medical practitioner, one misdemeanor count of representation of license not issued to him or her, one misdemeanor count of misrepresentation of qualifications, and one misdemeanor count of impersonating a professional nurse or pretending to be licensed to practice nursing. Segoviano was arrested on July 19, 2022 at his business, Botox in Anaheim, within the Phenix Salon Suites, located at 935 S. Brookhurst St. in Anaheim, California. Segoviano used various social media platforms to advertise his services to potential clients, including videos and postings on Facebook, Tiktok, and other social media platforms. Segoviano used various aliases including "Dr. Elias", "Dr. Elias Renteria", "Dr. Elias Renteria M.D." and used "ELIASMD" on his vehicle license plate. Segoviano is believed to have utilized other locations for his unlawful medical practice since 2019 including 339 La Habra Blvd, La Habra, CA. Various business names were used for his unlicensed practice including "Botox in Anaheim," "Botox in Anaheim- Health and Beauty," "Neurotoxina Botulinica- Massage Service," "Threads in Anaheim, -Threads La Habra", "Botox La Habra," and "OC Threads, Botox & Fillers." Segoviano admitted performing invasive procedures and injecting victims with potentially counterfeit Botox, fillers, anesthetics, and other medical drugs that placed the public at extreme risk. The charges involved the illegal practice of medicine involving 28 victims. He was sentenced to four years in state prison, but served just one year and four months before being released on December 22, 2023. Less than two weeks later, on January 4, 2024, while on Post-Release Community Supervision following his release from prison, Segoviano is accused of attempting to sublet a space at the Phenix Salon in Brea. He also applied for a business license in the city of Brea, but his application was rejected. Based on a tip from the Probation Department about Segoviano’s attempt to rent the space in Brea, investigators with the Orange County District Attorney’s Office immediately opened an investigation. OCDA investigators interviewed multiple witnesses and located the rejected business license application, substantiating the charges filed in this case. Segoviano is accused of providing the two suite owners with a fake name and stating that he performs Botox injections and face thread lifting procedures, both of which require valid medical authorizations which Segoviano doesn’t have. One of the suite owners initially entered into a sublease agreement with Segoviano, but after learning of news coverage about his prior criminal conduct the owner cancelled the agreement and demanded the keys be returned. Segoviano has been charged with two felony counts of the unauthorized practice of medicine and one misdemeanor count of falsely representing himself as a licensed medical practitioner. "This man walked the walk and talked the talk of being a licensed medical professional, but he was anything but what he pretended to be," said Orange County District Attorney Todd Spitzer. "These women trusted this individual to have the training and the expertise required to perform these medical procedures, and instead they unknowingly put their very lives in the hands of someone who was never licensed to perform the kind of work he was doing. The fact that he was out of prison less than two weeks - and while under supervision - when he returned right back to a life of crime makes it painfully obvious that he has no intention of changing his behavior and he will continue to try to make money off unsuspecting women every chance that he gets." Anyone who was treated by Elias Renteria Segoviano is encouraged to report those procedures to the Orange County District Attorney’s Bureau of Investigation by contacting Investigator Jesse Alfonzo at 714-834-6538. Deputy District Attorney Michael Chay of the Consumer and Environmental Protection Unit is prosecuting this case ...
/ 2023 News, Daily News
UC San Francisco will launch the world’s first tissue bank with samples donated by patients with long COVID. The move follows research indicating that the virus can continue to linger throughout the body and may hold the key to understanding the cause of the debilitating disorder and lead to effective treatments. By October 2023, an estimated 14% of Americans had or had had long COVID, according to the Centers for Disease Control and Prevention. The disorder may appear as a continuation of the original COVID symptoms or manifest as new symptoms affecting any part of the body. In serious cases multiple body systems are affected, including the brain, heart, lungs, kidneys and skin. Recent studies have shown that in patients with long COVID, the SARS-CoV-2 virus may not fully clear after the initial infection. Instead, the virus remains in what scientists have termed "viral reservoirs," identified in patient tissue months or even years later. These reservoirs are now believed to be a primary driver of long COVID, provoking the immune system to respond by prompting conditions like blood clotting disorders and inflammation and cognition dysfunction. "Based on our work so far, we believe that long COVID is a tissue-based disease," said Michael Peluso, MD, principal investigator of the UCSF Long COVID Tissue Program and an infectious disease physician-scientist in the UCSF School of Medicine. "This program will allow us to comprehensively study the biological processes occurring across tissue compartments - in the blood, gut, lymph nodes, spinal fluid and bone marrow - in people living with long COVID. This will help us better understand the underlying mechanisms of long COVID,” said Peluso, who co-led recent research with Timothy Hendrich, MD, a UCSF physician-scientist, that showed the virus was present in colon tissue up to 676 days following infection. Tissue specimens will be acquired from existing and future participants enrolled in UCSF’s LIINC study, and shared with non-UCSF scientists conducting complementary research. The study, which was launched in April 2020 before long COVID was recognized, is open to all adults who have ever tested positive for COVID-19. "The persistence of SARS-CoV-2 in tissue is a major target for our rapid research and clinical trials," said Steven Deeks, MD, co-principal investigator of LIINC, professor of medicine in residence at UCSF and an internationally recognized HIV expert. Current clinical trials include a monoclonal antibody - a lab-made protein that effectively attacks viruses - and an antiviral therapy that blocks viral replication. The UCSF Long COVID Tissue Program is supported by a $3 million grant from the Long Covid Research Consortium of the PolyBio Research Foundation, a nonprofit dedicated to complex chronic conditions, which also funded for the LIINC study. "The UCSF team includes people who helped make HIV and AIDS a treatable disease," said Amy Proal, PhD, president of PolyBio. "These researchers rapidly pivoted into long COVID research at the outset of the pandemic, leveraging years of experience performing similar research with patients with HIV and AIDS." An additional $1.7 million funding from PolyBio will also enable Henrich, and UCSF cardiologist Zian Tseng, MD, to expand their study of sudden cardiac death. Advanced technologies will be used to examine traces of SARS-CoV-2 and related immune changes in tissue samples. Findings may result in recommendations for antiviral treatments for patients who have been exposed to the COVID virus and are at risk for sudden cardiac death ...
/ 2023 News, Daily News
Edward Younan began working in the food truck business in 1975 as a driver. He and his wife eventually owned between 50 and 60 trucks. Younan acquired Avalon Foods, Inc, a food truck commissary, in 1999. Food trucks are required to park at a "certified commissary," such as Avalon, and Avalon charges its customers for "housing space" (i.e., a parking spot), electricity, security, and ice. At the time of trial, Avalon owned only "maybe a couple" food trucks, which were not usually on the road, but served as spares. Jorge GuzmanJr. began working on food trucks in approximately 1992. He was the driver and cashier. His job duties included "driv[ing to] the stops where they go, sell[ing] food, . . . tak[ing] the money, get[ting] change" and "driv[ing] to the next stop." At the time of the accident, Guzman drove a food truck owned by Philma Alvarez. Philma parked her trucks at Avalon during the relevant time period. On January 11, 2014, after the truck completed its business at one of its stops, the cook on the truck asked Guzman to retrieve a table from outside. When Guzman stepped outside, a car hit him, resulting in serious injuries. Following the accident, Guzman filed a civil complaint against Philma and Hector Chavez. Guzman later named Avalon and Younan as defendants. The operative complaint alleged that, on January 11, 2014, while Guzman was employed by "defendants," "[t]he employee manager negligently instructed [Guzman] to retrieve a serving table in a manner that subjected [Guzman] to extreme danger of, and resulted in, [Guzman] being struck by a car and severely injured." Guzman brought the lawsuit under Labor Code section 3706, which permits an injured employee to file a civil complaint for damages against an employer who "fails to secure the payment of compensation" to the injured employee. Avalon and Younan answered the complaint, and, as relevant here, asserted no employment relationship existed between them and Guzman. At the close of plaintiff’s case-in-chief, defendants orally moved for nonsuit and the court took the motion "under advisement". On October 24, 2019, the jury returned a verdict finding both Younan and Avalon were Guzman’s employers at the time of the accident. Phase 2 of the trial was for damages, and a second jury awarded Guzman $8,245,034.00. Following trial, Avalon and Younan moved for JNOV and a new trial, and the trial court denied the JNOV, and granted a new trial on allocation of damages between defendants. The Court of Appeal reversed the order denying Avalon and Younan’s JNOV motion, and direct the trial court to enter judgment in favor of Avalon and Younan in the unpublished case of Guzman v Younan -B317573 (February 2024). During trial, Guzman repeatedly and unambiguously testified he worked exclusively for Philma at the time of the accident. For example, in response to defendants’ counsel’s question, "But you stopped " at least your testimony is you stopped working for [Younan] in 2013 and worked exclusively with Philma, is that not correct?" Guzman replied that was correct. Guzman testified that, before the accident, in 2013, he worked for Younan doing the "same thing I did with Philma." When Guzman worked for Philma at the end of 2013 through the time of his injury in 2014, Philma told Guzman what to do and where to go. If the truck broke down, or Guzman was sick and he could not work, he called Philma. Neither Avalon nor Younan paid Guzman when he worked for Philma, and he never reported to anyone at Avalon while working for Philma. Guzman further testified that he did not wear a uniform when he worked for Philma, but when he worked for Younan he was required to wear a shirt Younan provided him. The Court of Appeal concluded that "the record contains no evidence that Guzman was employed by Avalon or Younan on the date of the accident; rather, the evidence merely demonstrates that Guzman may have driven a truck for Avalon and Younan at some point in 2013, before the accident occurred." ...
/ 2023 News, Daily News
Seven restaurant owners have been sentenced and ordered to pay nearly $12 million dollars in restitution to their victims. A California Department of Justice led Task Force executed 27 search warrants at multiple locations in Los Angeles County, and seven individuals were charged in separate complaints with wage theft, tax evasion, insurance fraud, and/or commercial burglary. California Department of Justice’s (DOJ) Tax Recovery in the Underground Economy (TRUE) Task Force prosecuted the cases in partnership with multiple state agencies including the California Department of Tax and Fee Administration (CDTFA), Employment Development Department (EDD), Franchise Tax Board (FTB), California Department of Insurance (CDI), and the Department of Industrial Relations (DIR). The details on the cases are as follows: - - Xu Dong, the owner of Asia Buffet and Americana Buffet and Grill, pleaded guilty to wage theft, sales tax evasion, income tax evasion, payroll tax evasion, and insurance fraud. He paid more than $3.94 million restitution and was sentenced to 32 months in prison. - - Yan Zheng, the owner of China Great Buffet, pleaded guilty to sales evasion, income tax evasion, payroll tax evasion, and insurance fraud. She paid more than $2.81 million restitution and was sentenced to 24 months in prison. - - Jiahan Zheng, the owner of Tropical Buffet and Grill, pleaded guilty to sales tax evasion, income tax fraud evasion, and payroll tax fraud evasion. He paid $599,508 restitution and was sentenced to one year probation and ordered to complete 60 days of community service - - Elva Chen, Ya Lu, and Yituan Chen owned and operated Gold Hibachi Buffet. Elva Chen pleaded guilty to sales tax evasion, income tax evasion, payroll tax evasion and insurance fraud. She paid over $1.67 million in restitution and was sentenced to 32 months in prison. Defendant Ya Lu pleaded guilty to grand theft and commercial burglary. She paid nearly $1.7 million restitution and was sentenced to 32 in prison. Defendant Yituan Chen pleaded guilty to sales tax evasion. He paid $428,226 restitution, and was sentenced to two years formal probation and ordered to serve 364 days in prison. - - Jian Zhang, the owner of Kami Buffet and Grill, pleaded guilty to sales tax evasion and income tax evasion. He paid $785,177 restitution and was sentenced to 32 months in prison. The sentences were the result of an investigation by DOJ, CDTFA, EDD, FTB, CDI and DIR. DOJ, CDTFA, FTB and EDD are a part of the (TRUE) Task Force. The TRUE Task Force was created to ensure multiagency collaboration and to combat wage theft, tax evasion, and other crimes in the underground economy. The task force consists of attorneys, investigators, and special agents from the member agencies ...
/ 2023 News, Daily News
Taylor Capito received treatment in the emergency room of San Jose Healthcare System LP dba Regional Medical Center San Jose on two occasions. Regional is a major hospital in San Jose with an emergency room. Regional initially billed Capito $41,016 for her two visits, including two "`Level 4' Evaluation and Management Services Fee" charges of $3,780. Regional thereafter reduced Capito's total bill to $8,855.38, after deducting adjustments and discounts. Capito alleges she did not receive advance notice that Regional would charge the EMS fee in addition to each item of service and treatment provided by the hospital. Capito claims that had she been informed that she would be charged the EMS fee before incurring treatment, she would have left Regional and sought less expensive treatment elsewhere. n Capito filed a complaint against on behalf of herself and all others similarly situated in June 2020, under the Consumer Legal Remedies Act (CLRA), which she amended shortly thereafter, challenging Regional's "unfair, deceptive, and unlawful practice of charging [an EMS fee] without any notification of its intention to charge a prospective emergency room patient such a Fee for the patient's emergency room visit." Capito claimed that Regional charged the EMS fee simply for seeking care in the emergency room - describing it as designed to cover overhead' type expenses of operating an emergency room without correlating the fee to the individual items of treatment and service that a patient received, and that the EMS fee "invariably comes as a complete surprise to unsuspecting emergency room patients." Regional demurred and moved to strike the class allegations. In doing so, it briefed the legislative history behind the Payers' Bill of Rights (Health & Saf. Code, § 1339.50 et seq.) and other federal and state regulations governing its pricing disclosures.The trial court sustained the demurrer and dismissed the case. And the Court of Appeal affirmed the dismissal in the unpublished case of Capito v. San Jose Healthcare System, LP - H049022, - H049646 (April 2023). In another case, Joshua Naranjo filed a class action lawsuit against the Doctors Medical Center of Modesto Inc., seeking declaratory and injunctive relief, and alleging violations of the unfair competition law (UCL) and the Consumer Legal Remedies Act (CLRA) in connection with Medical Center’s emergency room billing practices. The Medical Center charged Naranjo a total of $12,889.93 before any discounts or adjustments were applied. The gross charge included a "Level 4" EMS Fee in the amount of $8,833.35. The trial court dismissed his case, however the Court of Appeal reversed and reinstated his class action against the Medical Center. On July 26, the California Supreme Court granted review in the two different cases in which appellate courts had addressed the same issue and come to different conclusions. The first is Naranjo v. Doctors Medical Center of Modesto (2023) 90 Cal.App.5th 1193, a published decision of the Fifth Appellate District in which the court had ruled that the hospital was required to further disclose the EMS fee prior to treating ER patients. The second case is Capito v. San Jose Healthcare System, an unpublished decision of the Sixth Appellate District holding that no additional disclosure was required. This month the California Attorney General filed an Amicus Brief in Capito urging the California Supreme Court to reverse the Court of Appeal. He urges the Supreme Court to "ensure that lower courts have clear guidance in deciding cases alleging fraudulent practices, and to adopt a standard definition of unfairness under the Unfair Competition Law, as the current lack of clarity inhibits effective enforcement and creates confusion." The California Hospital Association points out that for "over a decade, at least 15 different class action lawsuits have been filed against California hospitals for failing to disclose their facility fees before patients were treated." "These lawsuits were brought even though each hospital had fully complied with both state and federal pricing transparency laws by disclosing the EMS fee in their chargemaster. While some of these lawsuits were settled or dismissed by the plaintiff after losing important rulings, other cases are on appeal or proceeding to trial." The California Hosptial Association has filed as amicus in both Captio and Narango ...
/ 2023 News, Daily News
The California Attorney General joined a bipartisan coalition of 39 attorneys general urging Congress to pass legislation that will hold Pharmacy Benefits Managers (PBMs) accountable for what they say are unfair and deceptive practices that drive up the costs of prescription drugs. PBMs act as middlemen between pharmacies, drug manufacturers, health insurance plans, and consumers. Their position gives them an enormous impact on consumers’ access to prescription drugs. In the letter, the coalition asks House Speaker Mike Johnson, Senate Majority Leader Chuck Schumer, House Minority Leader Hakeem Jeffries, and Senate Minority Leader Mitch McConnell to urge Congress to implement reform and regulate PBM business practices. Importantly, the attorneys general note three pieces of pending federal legislation that include proposals that would convey important steps to reform the industry and combat high healthcare costs: DRUG Act (S1542/HR6283), Protecting Patients Against PBM Abuses Act (HR2880), and Lower Costs, More Transparency Act (HR5378).The following are some of the key provisions of these three proposed federal laws. The DRUG Act: - - Eliminates rebates at the point of sale: This practice allows PBMs to receive rebates from drug manufacturers based on the amount of a drug they manage, incentivizing them to select higher-cost drugs even if cheaper alternatives exist. - - Bans spread pricing: This involves charging pharmacies more for a drug than they can bill the patient, creating a profit margin for the PBM. - - Restricts fees on generic drugs: The bill limits the fees PBMs can charge pharmacies for generic drugs, aiming to increase access and affordability. Protecting Patients Against PBM Abuses Act: - - Limits PBM income: Restricts PBMs to receiving flat service fees, prohibiting income based on drug prices, discounts, or rebates, which critics argue incentivizes them to choose pricier drugs. - - Transparency in fees: Requires PBMs to disclose fees to plan sponsors, fostering clearer understanding of pricing structures. - - Fair reimbursement for pharmacies: Prohibits PBMs from reimbursing network pharmacies less than PBM-affiliated pharmacies, aiming to level the playing field and enhance competition. - - No hidden costs: Bans charging plan sponsors for ingredient costs or dispensing fees different from what's reimbursed to pharmacies, addressing potential cost markups. Lower Costs, More Transparency Act (HR5378): - - Hospitals: Requires hospitals to publicly disclose charges for standard procedures and services, including the discounted cash price and negotiated rates with insurers. - - Clinical labs and imaging facilities: Similar transparency requirements for clinical diagnostic labs and imaging facilities. - - Pharmacy Benefit Managers (PBMs): Increased reporting requirements for PBMs to health plan sponsors, revealing details on spending, rebates, and fees associated with covered drugs. - - Employer-sponsored plans: Enhanced access for employers to claims and cost information, allowing them to make more informed choices about health insurance plans. The California Attorney General joins the attorneys general of Alaska, Arizona, Arkansas, Colorado, Connecticut, Delaware, the District of Columbia, Florida, Georgia, Hawaii, Illinois, Kansas, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Nevada, New Hampshire, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virgin Islands, Virginia, Wisconsin, and Wyoming ...
/ 2023 News, Daily News
Detectives with the California Department of Insurance arrested Gina Marie Gregori of Lafayette, for allegedly underreporting payroll and ripping off insurers to the tune of $32 million. Gregori was charged with multiple counts of worker’s compensation insurance fraud and associated thefts. The complaint alleged the white-collar criminal enhancement pursuant to Penal Code section 186.11 and named as criminal defendants several of Gregori’s companies, including Apex Janitorial Solutions. The department’s investigation revealed Gregori was keeping two sets of books, using a payroll processing service to report to Employment Development Department and pay her employees, and keeping a fraudulent set of books that she provided to insurers and insurance auditors, which showed a significantly lower payroll amount. The People moved for appointment of a receiver to manage and preserve Gregori’s assets pursuant to Penal Code section 186.11. The court granted the motion and issued an order appointing the Receiver, identifying the assets subject to the receivership, and specifying the Receiver’s powers. Among other things, the Receiver was authorized to take possession of, collect income from, and otherwise operate, manage, preserve, and control Gregori’s properties. The order also authorized the Receiver to request court approval and confirmation of all fees and expenses incurred by the receivership in executing its duties. The court "reserve[d] jurisdiction to allocate the receivership costs of administration as between the parties." One of the real properties in the receivership estate was located on Dolores Street in San Francisco and owned by Gregori’s former romantic partner, Richard Bertero,with whom Gregori had commingled funds. Bertero used the Dolores Street property as collateral for a loan from Avalon Funding Corporation. Later, Bertero filed for Chapter 11 bankruptcy; the Dolores Street property became part of the bankruptcy estate. The bankruptcy court released the Dolores Street property from the automatic bankruptcy stay to allow foreclosing lenders to sell it. When both Avalon and the Receiver made claims to the surplus proceeds from that sale, the trial court ordered the surplus turned over to it to resolve the priority of their claims. Relying on section 186.11, the court ordered that the bulk of the surplus be used to pay the Receiver’s fees and expenses incurred in administering the receivership estate which was roughly $148,000. The Court of Appeal Affirmed in the unpublished case of People v. Gregori -A164081 (February 2024) On appeal, Avalon argues that the Receiver had no valid claim to the surplus; that the court erred by applying section 186.11 rather than the nonjudicial foreclosure statute, Civil Code section 2924k; that the court lacked jurisdiction over the surplus; and that the court misapplied section 186.11. The Receiver argues that the trial court had jurisdiction over the surplus as part of the receivership estate and that the court properly exercised its discretion by finding that section 186.11 authorized it to pay the Receiver before paying Avalon. Penal Code section 186.11, the "Freeze and Seize' statute, authorizes a trial court to appoint a receiver to preserve the assets of a criminal defendant subject to an "aggravated white collar crime enhancement' because the defendant was "charged with having committed two or more related felonies involving fraud . . ., a pattern of related felony conduct, and the taking of more than $100,000." The court’s goal in the pendent receivership proceedings is to prevent defendants from "dissipat[ing] or secreting [their] assets or property" while the criminal proceedings are pending, and then to use "those assets to pay restitution to victims if the People secure a conviction." Subdivision (b) of Civil Code section 2924j specifies that "[n]othing in this section shall preclude any person from pursuing other remedies or claims as to surplus proceeds." Thus the trial court did not abuse its discretion in declining to adhere to the claim priorities in Civil Code section 2924k. The trial court’s interpretation of section 186.11 to permit compensation to the Receiver was not an abuse of discretion or contrary to law. The court reviewed the plain language of section 186.11, harmonized the language of the statute to give force and effect to its distinct provisions, and interpreted it to further the policy interests embodied therein ...
/ 2023 News, Daily News
The California Department of Industrial Relations (DIR) and the Labor Commissioner’s Office have launched an $18 million Workers’ Rights Enforcement Grant Program creating opportunities for local prosecutors to obtain funding for wage theft prosecutions. In 2024-2025 (Year 1) and 2025-2026 (Year 2), there will be two annual grant award cycles amounting to a total of $8,550,000 each. The funding for this program was provided in Assembly Bill No. 102 amendment to the Budget Act of 2023 The Workers’ Rights Enforcement Grant is a new funding source to protect workers from wage theft and other exploitative practices in the workplace. Grants will be competitively awarded to California "public prosecutors" to develop and implement a wage theft enforcement program. A "public prosecutor" is a district attorney, city attorney, county council or any other city or county prosecutor who has established a workers’ rights enforcement program. This funding will enhance the capacity of public prosecutors to take action against wage theft - ensuring that labor laws are enforced, violators are prosecuted, and employers are deterred from engaging in practices such as unpaid overtime and minimum wage violations. This investment sends a strong message to employers about the State of California’s commitment to ensuring every Californian is fairly compensated for their labor. Grant funds can only be used for staff salaries and benefits. No other items will be funded, other than the noted annual audit costs. The year 1 Grant Application Timeframe is August 1, 2024 to July 31, 2025, and the year 2 Grant Application Timeframe is August 1, 2025 to July 31, 2026. Application, Eligibility, and Funding Essential Details - - Grant Uses: Staff Salaries/Benefits and Annual Audit Costs - - $750,000: Maximum per applicant per year - - Eligible Recipients: Public Prosecutors Register Today: Wage Theft Grant Informational Webinar scheduled for February 22, 2024 @ 11 am PST ...
/ 2023 News, Daily News
The nation’s toughest rules for on-the-job lead exposure has just been passed by California workplace safety regulators.The Cal/OSHA Standards Board passed the sweeping update to California’s lead regulation despite heavy concerns of feasibility and inaccurate cost estimates from the construction and battery industries. In a 5-2 vote, the Standards Board expressed concerns over the timeline for implementation, despite supporting the regulation’s substantive goals and ultimately approving the regulation. In addition to training and blood lead monitoring of exposed employees, California’s present regulation regarding workplace lead exposure (Title 8, Section 5198) requires employers to ensure that no employees have lead exposure over a Permissible Exposure Limit (PEL) of 50 micrograms in a cubic meter of air. The California Chamber of Commerce reports that this new update would, among other changes, drastically lower the threshold for testing (from 30 micrograms of exposure to 2 micrograms) and the PEL (from 50 micrograms to 10 micrograms). Importantly, the new update covers both construction and non-construction worksites. Because of the extreme lowering of the relevant thresholds, even industries that do not consider themselves to be lead-based should be aware of this regulation. For example, any workplaces working with brass (of which lead is a component) or containing brass fixtures may want to examine whether their activities (such as polishing brass) would now be covered by the regulation. Although no opposition groups debated the hazards of lead, extensive testimony from opposition groups criticized the cost estimates in the Standardized Regulatory Impact Assessment (SRIA) as grossly inaccurate. In addition, strong opposition from battery manufacturers focused on the unrealistic nature of Cal/OSHA’s implementation timeline, noting that their facilities would need years to come into compliance given the time required to obtain permits and complete construction. Notably, the Standards Board and staff did acknowledge these implementation timing concerns, and the rulemaking took the rare step of asking the Office of Administrative Law to delay its approval by six months, which will functionally delay enforcement until January 2025. The Board adopted amendments to title 8, California Code of Regulations (CCR), section 1532.1 of the Construction Safety Orders (CSO) and sections 5155 and 5198 of the General Industry Safety Orders (GISO) ...
/ 2023 News, Daily News
A California pharmaceutical company has agreed to pay $750,000 to resolve allegations that it violated the False Claims Act by causing the submission of claims for certain opioids in violation of the federal Anti-Kickback Statute. From Dec. 1, 2015, through Aug. 31, 2016, Sentynl Therapeutics Inc., of Solana Beach, California, a specialty pharmaceutical company, marketed and sold prescription opioids Abstral and Levorphanol Tartrate (Levorphanol). The settlement resolves allegations that, during the relevant time period, Sentynl knowingly caused the submission of claims for Abstral and Levorphanol medications to Medicare in violation of the federal Anti-Kickback Statute. These allegedly false claims resulted from Sentynl’s alleged indirect payment of kickbacks to a physician. Specifically, the United States contends that Sentynl hired the girlfriend of a physician who was a top prescriber of Transmucosal Immediate Release Fentanyl (TIRF) medications to act as a sales representative in South Florida - the same region in which the physician practiced. Sentynl hired, employed, and made salary and bonus payments to the physician’s girlfriend to induce the physician to prescribe its Abstral and Levorphanol medications. "Pharmaceutical companies that sold opioids are being held accountable for improper inducements offered to prescribers," FBI - Newark Special Agent in Charge James E. Dennehy said. The Newark FBI and our law enforcement partners will continue our pursuit of those who continue to believe the rules don’t apply to them." "Pharmaceutical companies are not exempt from their responsibilities to operate within the confines of the law," Special Agent in Charge Cheryl Ortiz of the Drug Enforcement Administration’s New Jersey Field Division said. "We are glad our diversion investigators were able to assist efforts to bring this matter to a resolution." "Some violations of the Anti-Kickback Statute, like those alleged here, can induce physicians’ imprudent prescribing of controlled substances," stated Special Agent in Charge Naomi Gruchacz with the U.S. Department of Health and Human Services Office of Inspector General. "Individuals and entities that participate in the federal health care system are required to obey the laws meant to preserve the integrity of program funds and the provision of appropriate, quality services to patients." U.S. Attorney Sellinger credited special agents of the FBI, under the direction of Special Agent in Charge James E. Dennehy in Newark; investigators of the U.S. Drug Enforcement Administration (DEA), under the direction of Special Agent in Charge Cheryl Ortiz; special agents of the U.S. Department of Health and Human Services Office of Inspector General, under the direction of Special Agent in Charge Naomi Gruchacz, with the investigation leading to the settlement. The government is represented by Assistant U.S. Attorney Susan J. Pappy of the U.S. Attorney’s Office, District of New Jersey’s Health Care Fraud Unit and Robert L. Toll of the Office’s Opioid Abuse Prevention and Enforcement Unit, and Trial Attorney Douglas J. Rosenthal of the Department of Justice’s Civil Division, Commercial Litigation Branch (Fraud Section). The government’s pursuit of this matter illustrates its efforts to combat healthcare fraud. One of the strongest tools in this effort is the False Claims Act. 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 claims resolved by the settlement are allegations only and there has been no determination of liability ...
/ 2023 News, Daily News
Quest Diagnostics is an American clinical laboratory and Fortune 500 company. It operates in the United States, Puerto Rico, Mexico, and Brazil.Quest also maintains collaborative agreements with various hospitals and clinics across the globe. As of 2020 the company had approximately 48,000 employees, and it generated more than $7.7 billion in revenue in 2019. The California Attorney General announced a settlement with Quest Diagnostics, Inc., resolving allegations that the diagnostic laboratory company unlawfully disposed of hazardous waste, medical waste, and protected health information at its facilities statewide. As part of the settlement, Quest Diagnostics will be required to pay nearly $5 million for penalties, costs, and supplemental environmental projects and make significant changes to its operations and practices at its California facilities. The Attorney General was joined by the district attorneys of Alameda, Los Angeles, Monterey, Orange, Sacramento, San Bernardino, San Joaquin, San Mateo, Ventura, and Yolo Counties in the settlement. The settlement is the result of over 30 inspections conducted by the district attorneys' offices at Quest Diagnostics laboratories and Patient Service Centers (PSCs) statewide. During those inspections, the district attorneys' offices reviewed the contents of Quest Diagnostics’ compactors and dumpsters and found hundreds of containers of chemicals, as well as bleach, reagents, batteries, and electronic waste; unredacted medical information; medical waste such as used specimen containers for blood and urine; and hazardous waste such as used batteries, solvents, and flammable liquids. The unlawful disposals are alleged to violate the Hazardous Waste Control Law, Medical Waste Management Act, Unfair Competition Law, and civil laws prohibiting the unauthorized disclosure of personal health information. After being notified of the investigations, Quest Diagnostics implemented numerous changes to bring its facilities into compliance with California law, including hiring an independent environmental auditor to review the disposal of waste at its facilities and modifying its operating and training procedures to improve its handling, storage, and disposal of hazardous waste, medical waste, and personal health information at all four laboratories and over 600 PSCs in California. The settlement resolves the allegations above and requires Quest Diagnostics to pay $3,999,500 in civil penalties, $700,000 in costs, and $300,000 for a Supplemental Environmental Project to support environmental training and enforcement in California. The settlement also imposes injunctive terms, including requirements that Quest Diagnostics maintain an environmental compliance program, including hiring a third-party waste auditor, and report annually on its progress. Quest Diagnostics set a record in April 2009 when it paid $302 million to the government to settle a Medicare fraud case alleging the company sold faulty medical testing kits. It was the largest qui tam (whistleblower) settlement paid by a medical lab for manufacturing and distributing a faulty product. In May 2011, Quest paid $241 million to the state of California to settle a False Claims Act case that alleged the company had overcharged Medi-Cal, the state's Medicaid program, and provided illegal kickbacks as incentives for healthcare providers to use Quest labs. It is also worthy of note that in 2017 Quest Diagnostics Inc. agreed to pay $6 million to resolve a lawsuit by the United States alleging that Berkeley HeartLab Inc., of Alameda, California, violated the False Claims Act by paying kickbacks to physicians and patients to induce the use of Berkeley for blood testing services and by charging for medically unnecessary tests. Quest, which is headquartered in Madison, New Jersey, acquired Berkeley in 2011, and ended the conduct that gave rise to the settlement. And in 2019 Quest Diagnostics confirmed a third-party billing company has been hit by a data breach affecting 11.9 million patients. The laboratory testing company revealed the data breach in a filing with the Securities and Exchange Commission ...
/ 2023 News, Daily News
The Federal Trade Commission (FTC) and the U.S. Department of Health and Human Services (HHS) jointly issued a Request for Information to understand how the practices of two types of pharmaceutical drug middlemen groups - group purchasing organizations (GPOs) and drug wholesalers - may be contributing to generic drug shortages. In the Request for Information (RFI), the FTC and HHS are seeking public comment regarding market concentration among large health care GPOs and drug wholesalers, as well as information detailing their contracting practices. The joint RFI seeks to understand how both GPOs and drug wholesalers impact the overall generic pharmaceutical market, including how both entities may influence the pricing and availability of pharmaceutical drugs. The joint RFI is asking these questions to help uncover the root causes and potential solutions to drug shortages. "For years Americans have faced acute shortages of critical drugs, from chemotherapy to antibiotics, endangering patients," said FTC Chair Lina M. Khan. "Our inquiry requests information on the factors driving these shortages and scrutinizes the practices of opaque drug middlemen. We look forward to public input as we assess how enforcers and policymakers can best address chronic drug shortages and promote a resilient drug supply chain." GPOs serve as intermediaries in the pharmaceutical industry by negotiating deals for generic drugs and other medical supplies between health care providers - including hospitals, physicians, nursing homes, and home health agencies - and manufacturers, distributors, and others who sell to health care providers. Drug wholesalers are another type of intermediary group which purchase drugs directly from manufacturers and deliver them to health care providers. The joint RFI is the latest effort by the FTC and HHS to promote competition in pharmaceutical markets to ensure that every consumer has access to high-quality, affordable care. As announced in December 2023, the FTC, HHS and the Department of Justice are partnering on new initiatives which will include a forthcoming joint RFI to seek input on how private-equity and other corporations’ control of health care is impacting Americans. The joint FTC and HHS RFI is requesting public input via comments, documents, and data regarding several topics with respect to generic drug markets and the potential causes of generic drug shortages, including: - - Whether and to what extent manufacturers, GPOs, and drug wholesalers are complying with their legal obligations under Section 3 of the Clayton Act and the Robinson-Patman Act. - - Whether and to what extent do the available protections for GPOs under the Federal Anti-Kickback Statute affect market concentration and contracting practices by GPOs, as well as drug shortages. - - Whether and to what extent market concentration among GPOs and drug wholesalers has impacted smaller health care providers and rural hospitals. - - Whether and to what extent concentration among GPOs and drug wholesalers has disincentivized suppliers from competing in generic drug markets. - - The impact of the prevailing GPO compensation model, which may rely on rebates, chargebacks, and administrative fees from manufacturers and suppliers in exchange for favorable treatment, on generic manufacturers and other suppliers. The public will have 60 days to submit comments at Regulations.gov. Once submitted, comments will be posted to Regulations.gov ...
/ 2023 News, Daily News
Jeffrey Mazik is the former "Senior Practice Leader for Kaiser’s National Compliance Office" and has over 25 years of experience in fraud control, auditing, and compliance. He was "employed by Kaiser" from 2008 to 2017, joining as an "Information Technology Audit Specialist" in May 2008 and transitioning to the role of "Senior Practice Leader in the Fraud Control Program" in March 2012. His duties included working with regional compliance leadership to implement compliance and fraud control initiatives, using data analytics to improve compliance and fraud-mitigation initiatives, investigating potential fraud, and developing corrective action plans to address fraud risks. He has filed federal lawsuit in the United States District Court tor the Eastern District of California against Kaiser Foundation Health Plan, Inc. ("KFHP"), Kaiser Foundation Hospitals ("KF Hospitals"), The Permanente Medical Group, Inc., Southern California Permanente Medical Group, and Colorado Permanente Medical Group, P.C. ("the PMG defendants"). The PMG defendants are groups of physicians that "contract with the other Kaiser entities" to provide medical services Each PMG defendant operates within its individual territory and is funded primarily by reimbursements from its respective regional Kaiser Foundation Health Plan entity. Defendant KF Hospitals is a nonprofit corporation headquartered in California that operates hospitals and provides facilities for the benefit of the PMG defendants. (Id.) It also receives its funding from defendant KFHP. (Id.) Defendant KFHP is a nonprofit corporation headquartered in California that enrolls members in health plans and provides medical services for its members through contracts with defendant KF Hospitals and the PMG defendants. On April 2, 2021 Mazik filed his operative first amended complaint under seal on behalf of the United States of America and the states of California, Colorado, Georgia, Hawaiʻi, Maryland, Virginia,, and Washington pursuant to the federal False Claims Act, He alleges defendants have schemed to defraud the federal government by allowing external, i.e., "non-Kaiser," healthcare providers to submit false diagnosis codes, which defendants in turn submit to CMS in order to inflate their capitation rates. In particular, defendants intentionally fail to properly use fraud-detection tools to monitor claims errors. Defendants contract with data analytics vendors to review their external provider claims for each region. The vendors provide software applications that perform various types of reviews. For instance, some programs"detect claims that are incorrectly billed . . . [while] other programs identify intentionally manipulated claims that technically fall within plan rules . . . ." However, he alleges defendants intentionally misused these programs and used them at minimum capacity, such as by disabling key features, in order to reduce the chances of detecting claims errors. In this way, defendants were actively working to avoid detecting and correcting fraudulent claims. In late 2015, Mazik was tasked with comparing the functionalities offered by two claims analytics vendors, McKesson and Verisk, with which defendants routinely contracted. McKesson offers auditing software called ClaimsXten that detects fraudulent billing practices using "a robust set of rules." However, defendants chose to deactivate 25 of the 54 rules used by ClaimsXten - "the principal software program that they were supposedly relying on [to] detect such billing fraud." When a group of employees including Mazik used a Verisk program to double-check data from "the Georgia region" produced by ClaimsXten, the group found $5.3 million in overpayments stemming from defendants’ decision to deactivate nearly half the rules in ClaimsXten. Defendants neither reactivated the disabled rules nor rectified the $5.3 million in overpayments. When Mizak audited regional office claims from August 2010 through July 2016, he discovered that inflated diagnosis codes caused $209 million in Medicare Advantage overpayments, $181 million in Medi-Cal overpayments and $181 million in other Medicaid programs.Additional allegations similar to the above were made in the lawsuit, and Mazik claims that ultimately he was "stripped of his duties and responsibilities" On January 5, 2017, Mazik was fired. On July 13, 2022, defendants filed their motion to dismiss Mazik's First Amended Complaint. In their pending motion, defendants argued that Mazik's federal FCA claim is barred by the first-to-file rule and the first amended complaint filed by the relator, Dr. James Taylor, in United States ex rel. Taylor v. Kaiser Permanente, No. 21-cv-03894-EMC (N.D. Cal.) ("the Taylor Complaint"). The Court compared the allegations in both cases and concluded that Mazik's FCA claim was barred by the first-to-file rule except to the extent relator alleges that defendants deliberately tampered with compliance software to ensure that it did not identify erroneous diagnosis codes. And on February 13, 2024 the Court issued its ruling granting in part and denying in part the Motion to Dismiss. Thus parts of the Mazik case will proceed, and there is additionally the Taylor case proceeding in another California Federal District Court based upon similar allegations ...
/ 2023 News, Daily News
San Jose based Lykos Therapeutics announced that the U.S. Food and Drug Administration ("FDA") has accepted its new drug application ("NDA") for midomafetamine capsules ("MDMA") used in combination with psychological intervention, which includes psychotherapy (talk therapy) and other supportive services provided by a qualified healthcare provider for individuals with post-traumatic stress disorder ("PTSD"). MDMA is commonly known as ecstasy (tablet form), and molly or mandy (crystal form). MDMA was first synthesized in 1912 by Merck. It was used to enhance psychotherapy beginning in the 1970s and became popular as a street drug in the 1980s. [ The FDA has granted the application priority review and has assigned a Prescription Drug User Fee Act ("PDUFA") target action date of August 11, 2024. If approved, this would be the first MDMA-assisted therapy and psychedelic-assisted therapy. The NDA submission included results from numerous studies including two randomized, double-blind, placebo-controlled Phase 3 studies (MAPP1 and MAPP2) evaluating the efficacy and safety of MDMA used in combination with psychological intervention versus placebo with therapy in participants diagnosed with severe or moderate to severe PTSD, respectively. Both MAPP1 and MAPP2 studies met their primary and secondary endpoints and were published in Nature Medicine.The primary endpoint for both studies was to assess changes in PTSD symptom severity as measured by the change from baseline in Clinician-Administered PTSD Scale for DSM-5 ("CAPS-5"). The key secondary endpoint of both studies was to assess improvement in functional impairment associated with PTSD as measured by the change from baseline in the Sheehan Disability Scale ("SDS"). No serious adverse events were reported in the MDMA group in either study. The FDA grants priority review for drugs that, if approved, would represent significant improvements in the safety or effectiveness of the treatment, diagnosis, or prevention of serious conditions when compared to standard applications. MDMA-assisted therapy has not been approved by any regulatory agency. The safety and efficacy of MDMA-assisted therapy has not been established for the treatment of PTSD. Investigational MDMA-assisted therapy is also being studied in other indications. PTSD is a serious mental health condition that can develop when a person experiences or witnesses a traumatic event. PTSD affects approximately 13 million Americans each year with women and disadvantaged or marginalized groups more likely to be affected. Military personnel also have a greater prevalence of PTSD than the general population however, it may not be as widely known that that the largest cause of PTSD is non-combat-related trauma (e.g., sexual violence, unexpected death of a loved one, life-threatening traumatic event or interpersonal violence). In addition to the significant personal impact, PTSD has an enormous economic impact resulting in an annual cost of over $232 billion in the United States. Trauma-focused talk therapy, which concentrates on memories of the traumatic event or thoughts and feelings associated with the traumatic event is first-line treatment for PTSD , which can be used alone or in combination with medication. There are two SSRIs approved for the treatment of PTSD (sertraline and paroxetine). Studies have shown talk therapy lessens the severity of PTSD symptoms, however improvements in functioning and quality of life have been modest. Trauma-focused talk therapy is associated with a high risk of dropout and lingering symptoms which occur in as many as two-thirds of people who complete treatment. Current treatments for PTSD are "reasonably efficacious" however many people don't respond to treatment or stop treatment early, underscoring the urgent need for new evidence-based therapies and approaches to address this important public health issue. While there have been advancements in the management of PTSD, there have been no new drug treatments approved by the FDA in over twenty years. In the 1970's and early 1980's MDMA was used in conjunction with talk therapy by mental health providers to enhance patients' access, processing, and communication of difficult emotions and experiences. However, in 1985, the U.S. Drug Enforcement Administration ("DEA") made MDMA a Schedule I drug under the Controlled Substances Act preventing it from being used for recreational or medical use. Since then, research has shown the unique properties of MDMA allow it to act as a powerful catalyst to support psychotherapy by helping diminish the brain's fear response allowing people to access and process painful memories without being overwhelmed. However, additional clinical trials would be needed to secure regulatory review and potential approval. Lykos pioneered the first randomized, double-blind, placebo controlled clinical trials evaluating the efficacy and safety of MDMA-assisted therapy as an investigational modality using midomafetamine (MDMA) in combination with psychological intervention to treat PTSD ...
/ 2023 News, Daily News
The American Property Casualty Insurance Association (APCIA) is the primary national trade association for home, auto, and business insurers. APCIA promotes and protects the viability of private competition for the benefit of consumers and insurers, with a legacy dating back 150 years. APCIA members represent all sizes, structures, and regions—protecting families, communities, and businesses in the U.S. and across the globe. The APCIA just announced special award winners among the 2024 Class of Emerging Leaders during the Emerging Leaders Conference in San Antonio, Texas. This year, 13 individuals were recognized among a class of 201 insurance professionals with an award for their exceptional work and outstanding impact in 2023. "I am thrilled to congratulate the exceptional industry leaders who were honored with awards at this year’s Emerging Leaders Conference," said David A. Sampson, president and CEO of APCIA. "It is a privilege for APCIA to recognize the industry’s top talent and provide meaningful opportunities for networking and professional development. I also want to congratulate the entire 2024 Class of Emerging Leaders for being nominated and selected to participate in this prestigious conference." The awards announced during the 2024 Emerging Leaders Conference include: Business Excellence Award; Business Impact Award; Business Leadership Award; Exceptional Philanthropic Impact Award; Innovation Leadership Award; Leadership Award; Outstanding Diversity, Equity, and Inclusion Leadership Award; and Talent Leadership Award. "This year’s winners reflect the innovation and collaboration of the industry’s best and brightest future leaders," said Marguerite Tortorello, managing director of the Insurance Careers Movement. "The diverse categories of awards also demonstrate the significant impact the winners are having across their organization and in their community through their leadership." "The stellar 2024 Class of Emerging Leaders included rising stars from 80 different companies," said Jessica Hanson Hanna, APCIA’s senior vice president of public affairs. "The incredible participation in this elite conference demonstrates a true commitment among the industry to recognize and cultivate talent. I want to congratulate the award winners for their special and well-deserved recognition." Class of 2024 Emerging Leaders Award Winners - - Business Excellence Award: Michelle Page, The Hartford - - Business Impact Award: Mukund Nair, CSAA Insurance Group and Kenji Swepson, Everest - - Business Leadership Award: Joe Alessi, Universal Shield Insurance Group, Enjonli Hutchison, Amerisure Insurance and Craig Woodworth, Argo Group - - Exceptional Philanthropic Impact Award: Megan Williams, Auto Club Group - - Innovation Leadership Award: Wendy Coffing, Great American Insurance Group, Jonathan Macenski, Ally Insurance, and Glen Norton, Illinois Casualty Company - - Outstanding Diversity, Equity, and Inclusion Leadership Award: Shameem Awan, Amica Mutual Group and Sandra Polanco, Zurich North America - - Talent Leadership Award: Jon O’Camb, ERIE Insurance Group. The Emerging Leaders Conference provides candid insights by industry executives, networking, and tools and resources for emerging leaders to succeed in this fast-changing world. After the Emerging Leaders Conference, the rising stars will join their fellow alumni in serving as ambassadors for the industry and in helping expand career opportunities in insurance ...
/ 2023 News, Daily News
Shannon Ninio, 60, of North Hills, was arraigned on charges related to insurance fraud after a California Department of Insurance (CDI) investigation found she and her husband, Moshe Ninio, allegedly stole their rental car company’s customers’ personal information and used that information to file more than 40 fraudulent auto insurance claims and collect nearly $200,000 in undeserved payouts. Moshe Ninio was arraigned in Los Angeles County Superior Court on 18 felony counts of insurance fraud. The Ninios’ son-in-law, Ivan Lebedynets, 33, of Winnetka, was also arraigned for his alleged involvement in the scheme. CDI began its investigation after an insurance company alleged that Moshe Ninio, owner of AT Car Rental, stole the identities of his customers to obtain auto insurance policies in their name to insure his fleet of rental cars. Shannon Ninio was also owner of the company and Lebedynets was their employee. The investigation found that when their customers would get into legitimate accidents, Moshe Ninio would file insurance claims impersonating his identity theft victims who were listed as the policyholder. While posing as that policyholder, he would claim he gave permission to a "friend," who was actually the current vehicle renter, to drive the vehicle, all to disguise their rental car business. Shannon Ninio and Lebedynets also allegedly posed as policyholders for many of the claims. Between September 2018 and July of 2020, 47 auto insurance claims were filed under the fraudulent policies. The total paid loss for the claims was $192,282. During the course of this investigation, 15 individuals who were listed as policyholders were interviewed and the majority of the identity theft victims stated they had previously rented vehicles from Moshe Ninio. They also stated that they never opened any of the fraudulent insurance policies and that their personal information was used without their permission. Moshe and Shannon Ninio were arrested December 21, 2023. Lebedynets self-surrendered and was arraigned on January 29, 2024. All three are scheduled to return to court on April 10, 2024. This case is being prosecuted by the Los Angeles County District Attorney’s Office ...
/ 2023 News, Daily News
The Association of Independent Judicial Interpreters of California (AIJIC) is a nonprofit trade association that represents the voice of independent court interpreters in California in matters that have, or could have, a significant impact on the independent interpreting profession in the private sector.Its principal office located in Studio City, Los Angeles County, California. One Call Corporation dba One Call, One Call Care management, and/or One Call Care Transport & Translate is a corporation registered with the Florida Secretary of State, with its principal office located in Jacksonville, California. ONE CALL provides care coordination services to the workers’ compensation industry, which services include providing interpreters. Interpretation services which are provided nationwide. On January 31, 2024, AIJIC sued One Call in the Los Angeles Superior Court. The lawsuit stems from allegations of multiple cases of identity theft of court interpreters' names and credentials in Workers Compensation depositions. The AIJIC lawsuit was brought pursuant to California’s Unfair Competition Law, Business & Professions Code sections17200 et seq., to enjoin defendants from unlawful, fraudulent, and unfair business practices and false advertising. The plaintiffs allege One Call employs individuals and businesses that are impersonating certified court interpreters in California worker’s compensation cases, resulting in harm to workers alleging industrial injuries who cannot proficiently speak or understand English, However AIJIC alleges that One Call "has publicly disseminated untrue or misleading statements and advertising as regards the company’s ability to provide certified interpreters for worker’s compensation cases." AIJIC also alleges on "numerous occasions, individuals employed by defendants appeared in California worker’s compensation cases, and these individuals have falsely impersonated certified California interpreters. Some of these individuals have falsely impersonated certified California interpreters in more than one instance." And that "defendants not only impersonated others, but these individuals also were not certified to interpret in California for worker’s compensation proceedings." The lawsuit goes on to allege that "On or about December 1, 2022, Plaintiff sent a letter to ONE CALL to inform it that California certified interpreters were being impersonated by unknown individuals employed through ONE CALL at Zoom depositions based in California. This letter, which was supported by sworn declarations from court reporters and impersonated interpreters, identified nine specific instances where impersonations had occurred in 2021 and 2022." "ONE CALL responded by stating it would no longer do business with the individuals or contractors who had provided interpreters for the Zoom depositions addressed in the December 1, 2022 letter. ONE CALL, however, refused to identify any of the individuals or contractors by name." However AIJIC continues to allege that "ONE CALL again employed one of the individuals previously involved in impersonating certified California interpreters. On this occasion, the individual appeared for a pre- deposition meeting with a worker and his attorney. On or about July 14, 2023, Plaintiff notified ONE CALL of this impersonation and asked that the impersonator’s true name be provided. ONE CALL did not respond to Plaintiff’s request." "Since July 14, 2023, individuals employed through ONE CALL and/or DOE defendants have continued to appear in California worker’s compensation cases, and these individuals have falsely impersonated others in their official capacity as certified California interpreters. In some instances, these individuals also have provided fake Judicial Council of California badges bearing the names of the certified court interpreters they were impersonating " Plaintiff seeks "an accounting of all defendants for any and all profits derived by defendants from their business acts and practices in violation of the UCL" among other relief.; One Call will have 30 days from the date they are served with this lawsuit to respond, and the parties will then conduct discovery followed by law and motion activities. This lawsuit has now had nationwide attention in the media including Bloomberg Law and the Daily Journal in California ...
/ 2023 News, Daily News
Advancing hisSustainable Insurance Strategy announced last September, Insurance Commissioner announced the first of several regulatory rule change packages aimed at streamlining the Department’s rate approval process. The California Office of Administrative Law published that rulemaking today and the Department invites public comment in advance of a public hearing on March 26. These proposed changes are intended to modernize the submission requirements for auto, home, business, and other property and casualty insurance rate applications, ensuring that insurance companies adhere to clear guidelines and provide comprehensive information from the outset for the Department’s review. The proposed amendments aim to address critical issues surrounding insurance companies’ rate application submissions under Proposition 103. The existing regulations, created in an age of pagers and payphones, lack clarity and fail to specify the exact materials and information required in a complete rate filing application given the change in times and increased complexity of filings. This ambiguity can lead to confusion among insurance companies and delays in the review process, ultimately impacting consumers’ access to fair and appropriate insurance rates and insurers’ level of certainty on their filings and the review process. Key highlights of the proposed regulations include: - - Clarity in Submission Requirements: Insurance companies will now have clearer instructions about what must be submitted with a complete rate application, with necessary materials and information clearly specified by regulations. This clarity will provide insurance companies with certainty regarding the documentation required for initial rate submissions. - - Front-Loading the Delivery of Key Information: The proposed regulation will eliminate lengthy exchanges between the Department and insurers about incomplete applications before the rate review process may actually begin. These amendments will also provide consumer representatives more opportunity to timely review insurer rate applications in order to decide whether to intervene in the rate review process. - - Inclusion of Criteria and Guidelines: The proposed amendments mandate what insurers must provide so the Insurance Commissioner may assess whether requested rates are appropriate and not excessive, inadequate, or unfairly discriminatory. This includes any and all criteria, guidelines, systems, manuals, models, and algorithms used to assess risks or modify coverage options, as set forth in California Insurance Code section 1861.05. The Commissioner emphasized that these regulations are crucial for the effective evaluation of rate applications, enabling the Department’s experts to assess proposed rate changes accurately and promptly without compromising on quality. Moreover, these proposed amendments promote transparency by making all rate application materials public, allowing consumer representatives and regulatory authorities to review submissions in a timely manner, as set forth in California Insurance Code section 1861.07. The Commissioner is now receiving public comment on the regulations. The public may submit written comments to the Department until March 26, 2024, at which time the Commissioner will hold a public hearing ...
/ 2023 News, Daily News
A seven-person jury in Syracuse, New York returned a verdict to resolve a disability discrimination lawsuit filed by the U.S. Equal Employment Opportunity Commission (EEOC). The jury awarded $1.675 million to Shelley Valentino, a deaf individual, who unsuccessfully applied for two positions in McLane’s warehouse located in Lysander, N.Y., for which she was fully qualified. The facility employs approximately 650 people and distributes products to retail businesses throughout the Northeast. On March 12, 2018, Valentino applied online for two open positions with Defendant: Warehouse Selector II and Warehouse Selector IV. Her application indicated two prior work experiences: working as a hostess and busser at Plainville Restaurant between August 2007 and July 2008, and as a filing and data entry clerk between January and October 2003. Her resume indicated that she received her GED in 2005, a certification in medical billing and coding in 2011, and an associate degree in health information technology in 2016. Valentino's application nowhere indicates that she has any disability or requires any accommodation. McLane contacted her the same day she applied for the two jobs, and left a message. She then returned McLane’s call using a Telecommunications Relay Service, which uses an operator to facilitate calls for people with hearing and speech disabilities. After being contacted via the Relay Service, McLane did not return her call and rejected her application the next day. McLane filled the positions with individuals who are not hearing impaired. The reason given in the applicant tracking system was that Valentino did not meet the company's preferred qualifications. McLane received a total of 208 applications for the Warehouse Selector II position and hired 15 individuals. Similarly, they received 209 applications for the Warehouse Selector IV position and hired eight individuals. The EEOC filed suit in the U.S. District Court for the Northern District of New York (EEOC v. McLane/Eastern, Inc. d/b/a McLane Northeast, Civil Action No. 5:20-cv-01628-BKS-ML) after first attempting to reach a pre-litigation settlement through its conciliation process. The EEOC sought back pay, front pay, compensatory damages, and punitive damages for the applicant, as well as injunctive relief designed to remedy and prevent future disability discrimination in the hiring process. In January 2023, the court heard a motion for summary judgment filed by McLane, who pointed out that courts regularly dismiss ADA disability discrimination claims where the plaintiff cannot establish that the employer had knowledge of the plaintiff's disability, on the ground that such a plaintiff cannot establish the causation element of a prima facie case. An employer "cannot be liable under the ADA for firing an employee when it indisputably had no knowledge of the disability," because an employer cannot take an adverse action with respect to an employee or applicant "because of a disability unless it knows of the disability." "[A] plaintiff alleging discrimination on account of his protected status must offer evidence that a decision-maker was personally aware of his protected status to establish a prima facie case of discrimination." Murray v. Cerebral Palsy Ass'ns of N.Y., Inc., No. 16-cv-662, 2018 WL 264112, at *7, 2017 U.S. Dist. LEXIS 213553, at *19-20 (S.D.N.Y. Jan. 2, 2018) ( other citations omitted). McLane argued that the evidence "plainly demonstrates" that it had no knowledge of Valentino's deafness when her applications were rejected, because (1) Defendant's Human Resources Manager, Anne Orr - the decisionmaker -testified that she did not know Valentino is deaf until Valentino filed a charge of discrimination with the EEOC in August 2018; (2) the other three members of the Human Resources Department testified that they were not aware of Valentino's disability at the relevant time, did not speak to Valentino on the phone or recall a TRS call, and played no role in the hiring process; and (3) Valentino herself never expressly informed Defendant of her disability and does not know for sure whether the TRS operator did so. The Court denied the motion for summary judgment, concluding that there is evidence from which a reasonable factfinder could conclude that Defendant had knowledge of Valentino's disability at the time it decided not to interview or hire her in March 2018, based on the transcript of the March 12 Telecommunications Relay Service, that someone in McLane's HR department received. After a 3 ½-day trial, the jury found, following just two hours of deliberation, that McLane Northeast violated the Americans with Disabilities Act (ADA) by first refusing to interview Valentino, once the company learned that the candidate was disabled. Then the company further violated the ADA by refusing to hire the candidate for the two entry-level warehouse jobs that she applied for, the EEOC. The jury awarded Valentino $25,000 in back pay, $150,000 in emotional distress damages, and $1.5 million in punitive damages. Caitlin Brown, one of the EEOC trial attorneys who litigated the case, said, "The jury clearly understood that what McLane did here was wrong " Deaf applicants, and all applicants with disabilities, deserve a fair chance to get jobs to enable them to support themselves and their families." ...
/ 2023 News, Daily News
The Labor Commissioner’s Office (LCO) has reached a $1 million settlement against La Mina De Oro Inc. and related businesses for wage theft violations. The settlement will compensate 107 warehouse and retail workers who were not paid for all hours worked, which resulted in making less than minimum wage. Workers were also not paid for daily overtime and did not receive required rest and meal breaks. LCO is distributing checks to workers who worked at La Mina de Oro, Inc. or related entities KD Distributors, Inc. and Desire Fragrances Inc. between August 1, 2014 and September 30, 2016. These workers should contact the LCO at 833-LCO-INFO (833-526-4636), as they may be entitled to owed wages and damages under this settlement agreement. LCO’s Bureau of Field Enforcement (BOFE) began an investigation of La Mina de Oro around June 2016 after receiving a referral from the Warehouse Workers Resource Center (WWRC), a non-profit community-based-organization that advocates for workplace compliance in the warehouse industry. Workers reported they were not paid for all the hours that they worked and their wage statements did not reflect the required information such as all required overtime pay or late meal-periods. They were not paid overtime after eight hours in a day, but only after 40 hours in a week. Workers also reported that they were not allowed to leave and had to be ready to serve customers during their rest breaks and meal breaks. Citations were issued to La Mina de Oro and related entities on February 24, 2021 and a second citation was issued on May 18, 2021. "My office is committed to stopping wage theft and collecting owed wages for workers," said Labor Commissioner Lilia García-Brower. "Employees who were affected by this case should contact my office, as they may be entitled to owed wages and damages under the settlement agreement." ...
/ 2023 News, Daily News