The founder and CEO of a California-based digital health company and its clinical president were just arrested in connection with their alleged participation in a scheme to distribute Adderall over the internet, conspire to commit health care fraud in connection with the submission of false and fraudulent claims for reimbursement for Adderall and other stimulants, and obstruct justice. Ruthia He,also known as Rujia He, the founder and CEO of Done Global Inc., was arrested in Los Angeles and was expected to make her initial appearance in a Los Angeles federal court. David Brody M.D., the clinical president of Done Health P.C. (collectively, Done), was arrested in San Rafael, California, and will make his initial appearance in San Francisco, California. Brody is a psychiatrist who maintained a DEA registration number and was authorized to prescribe controlled substances in the State of California. The charges coincide with an ongoing shortage of several stimulant medications commonly prescribed to treat ADHD, according to the U.S. Centers for Disease Control and Prevention. A disruption "involving this large telehealth company could impact as many as 30,000 to 50,000 patients ages 18 years and older across all 50 U.S. states," the agency said. Back in September 2022 The Wall Street Journal and people familiar with the inquiries claimed that U.S. Drug Enforcement Administration agents have questioned people about telehealth company Done Global Inc.’s practices for prescribing controlled substances. According to court documents, He and Brody allegedly conspired with others to provide easy access to Adderall and other stimulants in exchange for payment of a monthly subscription fee. The indictment alleges that the conspiracy’s purpose was for the defendants to unlawfully enrich themselves by, among other things, by increasing monthly subscription revenue and thus increasing the value of the company. Done allegedly arranged for the prescription of over 40 million pills of Adderall and other stimulants, and obtained over $100 million in revenue. He and Brody allegedly obtained subscribers by targeting drug seekers and spending tens of millions of dollars on deceptive advertisements on social media networks. They also allegedly intentionally structured the Done platform to facilitate access to Adderall and other stimulants, including by limiting the information available to Done prescribers, instructing Done prescribers to prescribe Adderall and other stimulants even if the Done member did not qualify, and mandating that initial encounters would be under 30 minutes. To maximize profits, He allegedly put in a place an "auto-refill" function that allowed Done subscribers to elect to have a message requesting a refill be auto-generated every month. He wrote that Done sought to "use the comp structure to dis-encourage follow-up" medical care by refusing to pay Done prescribers for any medical visits, telemedicine consultation, or time spent caring for patients after an initial consultation, and instead paying solely based on the number of patients who received prescriptions. He and Brody allegedly persisted in the conspiracy even after being made aware that material was posted on online social networks about how to use Done to obtain easy access to Adderall and other stimulants, and that Done members had overdosed and died. They also allegedly concealed and disguised the conspiracy by making fraudulent representations to media outlets to forestall government investigations and action and induce third parties to continue doing business with Done. He, Brody, and others also conspired to defraud pharmacies and Medicare, Medicaid, and the commercial insurers to cause the pharmacies to dispense Adderall and other stimulants to Done members in violation of their corresponding responsibility; Medicare, Medicaid, and the commercial insurers to pay for the cost of these drugs; and Done members to continue to pay subscription fees to Done. He and others allegedly made false and fraudulent representations about Done’s prescription policies and practices to induce the pharmacies to fill Done’s prescriptions. As a result, Medicare, Medicaid, and the commercial insurers paid in excess of approximately $14 million. The indictment also alleges that He and Brody conspired to obstruct justice after a grand jury subpoena was issued to another telehealth company and in anticipation of a subpoena being issued to Done, including by deleting documents and communications, using encrypted messaging platforms instead of company email, and ultimately failing to produce documents in response to a subpoena issued to Done by a federal grand jury. If convicted, He and Brody each face a maximum penalty of 20 years in prison on the conspiracy to distribute controlled substances and distribution of controlled substances counts. Any patient of Done or medical professional who has been involved with the allegedly illegal conduct should call to report this conduct to the DEA hotline at 646-466-5159 ...

Last April, the California Chamber of Commerce released its initial 2024 job killer list which, at the time, included nine bills dealing with labor and employment, taxation, unemployment insurance, environmental and health care issues. Subsequently, additions and deletions were made to the list as legislative activity progressed. Three of the five remaining California Chamber of Commerce Job Killer bills missed the end of May deadline to pass the house in which they were introduced. Stalled Bills: The following job killer bills failed to pass before Friday’s deadline: - - ACA 16 (Bryan; D-Los Angeles): Has far-reaching negative consequences that would impair government operations, stunt development for new housing, infrastructure and clean energy project development and the strong potential to destabilize California’s economy. This constitutional amendment still is likely to come up for a vote in the next couple of weeks. - - SB 1327 (Glazer; D-Contra Costa): Implements a discriminatory 7.25% tax on the revenue generated from the sale of digital advertising. The bill is likely unconstitutional and will lead to costly litigation for the state. - - SB 1497 (Menjivar; D-Los Angeles): Imposes an ill-defined tax on a broad set of entities that will increase costs for goods and services in California. Amended to Remove Job Killer Tag AB 2499 (Schiavo; D-Chatsworth) will be amended to remove certain qualifying reasons for leave that are not related to safety, narrow the accommodations provisions, and limit the amount of time off an employee can take for certain reasons. The Appropriations Committee had also amended the threshold of applicability to apply to employers with 25 or more employees, which is consistent with existing law. Before amendments, it significantly expanded the 12-week leave related to crimes and lowered the threshold of applicability to employers with just five employees. Opposed Bills Stopped: Additionally, three CalChamber-opposed bills also failed to pass their house of origin on time. The following bills are dead for the year: - - AB 2648 (Bennett; D-Ventura): Prohibits the state from purchasing and all food services inside state facilities from offering any single-use plastic bottled beverages despite this packaging having one of the highest recycling rates in the country and despite the negative impacts to both the environment and state budget from using less efficient and more expensive packaging. - - AB 3155 (Friedman; D-Glendale): Sets disturbing precedent by creating liability without proof for oil well owners/operators if individuals who lived within 3,200 feet of a wellhead develop certain health conditions. - - SB 1494 (Glazer; D-Contra Costa): Eliminates an important economic development tool by prohibiting local governments from entering into sales tax sharing agreements with businesses. SB 1494 failed passage on a vote of 17-11 on May 23; reconsideration was granted. What Remains: - - SB 1116 (Portantino; D-Burbank) Increased Unemployment Insurance Taxes to Subsidize Striking Workers. SB 1116 will allow striking workers to claim UI benefits when they choose to strike. Because the UI Fund is paid for entirely by employers, SB 1116 will effectively add more debt onto California employers. Moreover, SB 1116 will effectively force employers to subsidize strikes at completely unrelated businesses because the UI Fund’s debt adds taxes for all employers, regardless of whether they’ve had a strike. - - SB 1327 (Glazer; D-Contra Costa) Tax on Digital Advertising Revenue. Implements a discriminatory 7.25% tax on the revenue generated from the sale of digital advertising. The bill targets taxpayers that annually make at least $2.5 billion of revenue from these services ...

Title VII of the Civil Rights Act of 1964 mandated employers to maintain records that could be used to identify potential discrimination in hiring practices.Following this, in 1966, the Equal Employment Opportunity Commission (EEOC) implemented a requirement for certain employers to report employee data categorized by job category, race, ethnicity, and sex. This data collection became known as "EEO-1." While EEO-1 data collection has been in place for decades, it wasn't until 2020 that the current EEO-1 Component 1 report format was finalized. In 2016, the EEOC sought approval to collect this specific data set, which focuses on workforce demographics. After receiving final approval from the Office of Management and Budget (OMB) in June 2020, the EEO-1 Component 1 report became the official format for this mandatory data collection. The EEO-1 Component 1 report is a mandatory annual data collection that requires all private sector employers with 100 or more employees, and federal contractors with 50 or more employees meeting certain criteria, to submit demographic workforce data to the EEOC. The EEOC has the authority to compel employers to file EEO-1 reports through court order pursuant to Section 709(c) of Title VII of the Civil Rights Act. The U.S. Equal Employment Opportunity Commission (EEOC) just announced it has filed suit against 15 employers in 10 states this week, alleging the companies failed to comply with mandatory federal reporting requirements. The list of employer includes companies from the retail, construction, restaurant, manufacturing, logistics, and service industries. Federal law requires employers with 100 or more employees to submit workforce data to the EEOC. The data collected includes workforce information by job category and sex, race, or ethnicity. This workforce demographic data is used for a variety of purposes including enforcement, analytics and research, and employer self-assessment. "This data collection is an important tool for ensuring compliance with Title VII’s prohibition on workplace discrimination," said EEOC General Counsel Karla Gilbride. "Not only did Congress authorize the EEOC to collect this data, Congress also authorized the agency to go to court to obtain compliance when employers ignore their obligation to provide the required information." The 2023 EEO-1 Component 1 data collection is currently underway. The EEOC began collecting EEO-1 Component 1 data from employers for the 2023 reporting cycle on April 30, 2024. The published deadline to file the 2023 EEO-1 Component 1 report was June 4, 2024. The EEOC publishes an Instruction Booklet for employers to assist them in complying with this mandatory reporting requirement, which is available at https://www.eeocdata.org/eeo1 For more information on EEO data collection, please visit https://www.eeoc.gov/data/eeo-data-collections ...

In Oklahoma, a law called the Patient's Right to Pharmacy Choice Act aimed to give patients more control over where they could get their prescriptions filled. This act clashed with the federal Employee Retirement Income Security Act (ERISA) and Medicare Part D. The Pharmaceutical Care Management Association (PCMA), an industry group representing pharmacy benefit managers (PBMs), sued to block the Oklahoma law. In Pharmaceutical Care v. Mulready, et al., No. 22-6074 (10th Cir. 2023), PCMA alleged that federal laws, Medicare Part D and the Employee Retirement Income Security Act (ERISA), preempt Oklahoma’s laws. The federal district court rejected PCMA’s claims but in August 2023, the Tenth Circuit reversed, holding that ERISA and Medicare preempt Oklahoma’s laws. In an amicus brief to the U.S. Supreme Court, a coalition of 36 state Attorney Generals (including California's) asks the Court to grant Oklahoma’s request that the Court review a decision from the U.S. Court of Appeals for the Tenth Circuit. According to its amicus brief "states have a compelling interest in preserving their traditional authority to protect their residents’ access to healthcare and to regulate business practices in their states. To advance these interests, all states regulate [PBMs] to some degree." PCMA and the Tenth Circuit’s broad approach to federal preemption, however, would "severely and unduly impede states’ abilities to protect their residents and regulate businesses." The challenge to Oklahoma’s laws is the latest of a string of lawsuits by the PBM industry’s national lobbying association, Pharmaceutical Care Management Association (PCMA). Mulready marked the second case to reach a federal court of appeals since the U.S. Supreme Court addressed state regulation of PBMs in Rutledge v. Pharmaceutical Care Management Association 592 U.S. 80 (2020). SCOTUS ruled 8-0 that the Employee Retirement Income Security Act (ERISA) did not preempt Arkansas’s law regulating pharmacy benefit managers (PBMs), the intermediaries that administer prescription drug benefits for health plans. In Rutledge, Justice Sonia Sotomayor spoke for the unanimous Court in holding that a state law requiring PBMs to pay pharmacies no less than their acquisition costs for prescription drugs was not preempted by ERISA, the federal statute governing employee benefits. The Court concluded, "ERISA does not pre-empt state rate regulations that merely increase costs or alter incentives for ERISA plans without forcing plans to adopt any particular scheme of substantive coverage." In their current brief to the Supreme Court, the states argue that the "Court should grant certiorari review for two key reasons. First, the Tenth Circuit decided important questions of federal law in a manner that conflicts with the Eighth Circuit’s resolution of the same issues. Sup. Ct. R. 10(a). Second, the Tenth Circuit’s decision conflicts with this Court’s precedent. Id. 10(c). States have a significant interest in knowing the extent to which ERISA and Medicare may preempt their regulations of PBMs. By contradicting the Eighth Circuit’s holdings and adopting a substantially broader view of ERISA preemption than what this Court endorsed in Rutledge, the Tenth Circuit’s decision throws that knowledge into substantial doubt. The result is nationwide uncertainty for regulators, a corresponding increase in consumer harms, and a substantial likelihood of continued litigation on the topic in light of the deep circuit split. The Court should grant review to put an end to that uncertainty and its corresponding harms." ...

Ruben Perez Mireles Jr., 49, of Clovis, and his business associate, John Mena, 29, of Lemoore, were arraigned on multiple felony counts including insurance fraud, grand theft, and tax fraud after a task force investigation led by the California Department of Insurance found they allegedly underreported over $29.2 million in payroll for multiple businesses to illegally save on workers’ compensation insurance premium and taxes. Mireles and Mena operated two Kings County farm labor contracting companies, Vista Pacific Labor Solutions, Inc. and Calzona Ag Management, Inc. The investigation by the Central Valley Workers’ Compensation Fraud Task Force found that Mireles, owner of Vista Pacific Labor Solutions, Inc, underreported $7.6 million in employee payroll to his workers’ compensation insurance carrier for the period of September 2019 through August 2020. This underreporting resulted in a premium loss of $1.7 million. The investigation revealed Mireles then created another farm labor contracting company, Calzona Ag Management, Inc. Mireles recruited Mena and together they shifted payroll to this new company to avoid an increased assessment of the business’ workplace safety, which would have more than doubled the insurance premium. Together, they underreported $8.8 million in employee payroll for the period of December 2019 through December 2021, resulting in an additional premium loss of $1.8 million. Additionally, the task force investigation found Mireles underreported $12.8 million in employee payroll to the Employment Development Department and failed to report personal income to the Franchise Tax Board. This underreporting resulted in a combined loss of approximately $3 million for unpaid tax liability, penalties, and interest. Mireles and Mena’s fraud scheme defrauded their insurance carries, EDD, and FTB out of over $6.5 million. Investigators also discovered that Mireles fraudulently obtained a COVID-19 Paycheck Protection Program loan. After an investigation led by the FBI, Mireles pleaded guilty and was sentenced to one year in prison. Mireles is also in court today on additional felony charges for his role in an earlier workers’ compensation insurance fraud scheme, also uncovered by the task force. Mireles has been charged with eight felony counts including workers’ compensation insurance fraud, grand theft, unemployment insurance fraud, and tax fraud. Mena has been charged with three felony counts of workers’ compensation insurance fraud and one felony count of grand theft. The Central Valley Workers’ Compensation Fraud Task Force is an inter-agency anti-fraud partnership with members from the California Department of Insurance, the California Employment Development Department, the California Franchise Tax Board, the Kings County District Attorney’s Office, the Fresno County District Attorney’s Office, the Kern County District Attorney’s Office, the Madera County District Attorney’s Office, the Merced County District Attorney’s Office, the San Luis Obispo County District Attorney’s Office, and the Tulare County District Attorney’s Office. The case is being prosecuted by Kings County District Attorney Sarah Hacker ...

On June 10, 2024, the Appeals Board issued a combined en banc decision and panel decision clarifying the known methods of rebutting the Combined Values Chart (CVC). In this case Sammy Vigil was employed by the County of Kern as a maintenance painter, and he claimed injury to his hips and back on December 7, 2017 and also injury caused by continuous trauma. Following trial, his cumulative injury was found to be industrial, and the WCJ found, that applicant sustained 68% permanent partial disability by adding the impairment to applicant’s left and right hip pursuant to East Bay Municipal Utility District v. Workers’ Compensation Appeals Board (Kite) (2013) 78 Cal.Comp.Cases 213 (writ den.). The WCJ further found that apportionment to the hips was not permissible pursuant to Hikida v. Workers’ Comp. Appeals Bd. (2017) 12 Cal.App.5th 1249 [82 Cal.Comp.Cases 679] because the disability was caused by hip replacement surgery. The employer filed a Petition for Reconsideration and argued that the WCJ misapplied the analysis in the Kite decision because the opinion of the qualified medical evaluator (QME) was not substantial evidence and does not support rebuttal of the Combined Values Chart (CVC). Next, it contends that the WCJ erred in applying Hikida, because applicant’s hip surgeries were successful and did not cause any increase in impairment. In its Decision After Reconsideration (En Banc), the WCAB rescinded the WCJ’s F&A and returned this matter to the trial level for further proceedings consistent with the opinion in the case of Vigil v County of Kern 2024-EB-03 (June 2024) Applicant was evaluated by QME Peter Newton, M.D., who authored four reports in evidence and was deposed. He assigned 15% whole-person impairment (WPI) to the right hip, 15% WPI to the left hip, and 7% WPI to applicant’s lumbar spine. 15% of this applicant's lumbar spine and right and left hip condition/disability/impairment was apportioned to age-appropriate and age-related degenerative changes and 85% to the continuous trauma of his work through 03/26/18. In his deposition he applied Kite when he said "Somebody with limitations due to both hips is going to have significantly more limitations than if somebody had one normal hip and one hip that they had surgery on." Impairments to two or more body parts are usually expected to have an overlapping effect upon the activities of daily living, so that generally, under the AMA Guides and the PDRS, the two impairments are combined to eliminate this overlap.As an element of the PDRS, the CVC may also be rebutted, and when the CVC is rebutted, those impairments may simply be added. "In our panel decisions, two methods have been used to rebut the CVC to date. In the first approach, the CVC has been rebutted where there was evidence showing no actual overlap between the effects on ADLs as between the body parts rated. In the second approach, the CVC has also been rebutted where there is overlap, but the overlap creates a synergistic effect upon the ADLs." "We believe that one significant point of confusion on the issue of overlap is that the analysis should focus on overlapping ADLs, not body parts." "The Combined Values Chart (CVC) in the Permanent Disability Ratings Schedule (PDRS) may be rebutted and impairments may be added where an applicant establishes the impact of each impairment on the activities of daily living (ADLs) and that either: (a) there is no overlap between the effects on ADLs as between the body parts rated; or (b) there is overlap, but the overlap increases or amplifies the impact on the overlapping ADLs." The Appeals Board emphasized that rebuttal of the CVC requires a critical analysis of the impacts upon applicant’s ADLs and is not automatically triggered by use of the word "synergy". "Here, Dr. Newton’s testimony does not appear to be based upon no overlap, but instead appears to argue for CVC rebuttal based upon a synergistic effect between the two hips." "The term ‘synergy’ is not a 'magic word' that immediately rebuts the use of the CVC. Instead, a physician must set forth a reasoned analysis explaining how and why synergistic ADL overlap exists. If parties are searching for a magic word to use during a doctor’s deposition, that word is "Why?' ". Rather than focusing on whether a specific term, including the term synergy, was used, it is imperative that parties focus on an analysis that applies critical thinking based on the principles articulated in Escobedo to support a conclusion based on the facts of the case. Such an analysis must include a detailed description of the impact of ADLs and how those ADLs interact." After reviewing the record and noting that the qualified medical evaluator failed to discuss the impact of applicant’s impairments upon the ADLs, the Appeals Board reversed the finding of the workers’ compensation judge and returned the matter for further development of the record. Section III of this decision is not en banc and is not citeable as an en banc opinion ...

Concerned with the widespread misclassification of workers, the legislature enacted A.B. 5 in 2019. A.B. 5 codified the California Supreme Court’s Dynamex Operations W., Inc. v. Superior Ct., 416 P.3d 1, 5 (Cal. 2018) decision and extended the application of the ABC test beyond wage orders to other labor and employment legislation, including workers’ compensation, unemployment insurance, and disability insurance. On December 30, 2019, Lydia Olson, Miguel Perez, Uber Technologies, Inc., and Postmates, Inc.jointly filed a complaint against the State of California and the Attorney General of California (collectively seeking declaratory, injunctive, and other relief based on their allegations that A.B. 5 violates the Equal Protection Clauses, the Due Process Clauses, and the Contract Clauses of the United States and California Constitutions. They sought a preliminary injunction to prevent Defendants from enforcing A.B. 5. The district court denied Plaintiffs’ motion for preliminary injunctive relief. Plaintiffs appealed the district court’s denial of the preliminary injunction. In November 2020, shortly before the 9th Circuit Court of Appeals heard argument in that appeal, California voters approved Proposition 22, a ballot initiative that classifies rideshare and delivery drivers - like Plaintiffs Olson and Perez - as independent contractors, notwithstanding A.B. 5 or any other provision of law. Prop. 22 took effect on December 16, 2020, in accordance with the default rule provided by the California Constitution. After Prop. 22 passed, but before the Court of Appeals issued a decision in the appeal of the preliminary injunction, Plaintiffs filed the operative Second Amended Complaint. Defendants moved to dismiss the Second Amended Complaint for failure to state a claim. The district court granted the motion. The district court determined that Plaintiffs’ new allegations concerning the amendments to A.B. 5 and Prop. 22 did not rescue their claims.Plaintiffs timely appealed that order. A three-judge panel reversed in part, concluding that the district court erred by dismissing Plaintiffs’ Equal Protection claims. The panel concluded that Plaintiffs plausibly alleged that "the exclusion of thousands of workers from the mandates of A.B. 5 is starkly inconsistent with the bill’s stated purpose of affording workers the 'basic rights and protections they deserve.' " Upon the vote of a majority of nonrecused active judges, a rehearing en banc was granted and the three-judge panel decision. Olson v. California, 88 F.4th 781 (9th Cir. 2023).was vacated It then conducted a review de novo of the district court order granting a motion to dismiss for failure to state a claim. "We must decide whether A.B. 5’s differential treatment of app-based work arrangements in the transportation and delivery service industry, on the one hand, and app-based work arrangements in other industries, on the other hand, survives rational basis review. In other words, we must determine whether it was rational for the California legislature to apply one test to determine the classification of Uber drivers and a different test to determine the classification of dogwalkers who provide services through Wag!, the "Uber for dogs." Under the deferential rational basis standard, the Court was required to approach A.B. 5 with "a strong presumption of validity," and will invalidate it only if Plaintiffs negate "every conceivable basis" which might justify the lines it draws. "Plaintiffs have failed to carry that burden here. There are plausible reasons for treating transportation and delivery referral companies differently from other types of referral companies, particularly where the legislature perceived transportation and delivery companies as the most significant perpetrators of the problem it sought to address - worker misclassification." Under the deferential rational basis standard, the en banc court in the published opinion of Olson et.,al, v State of California et. al. 21-55757 (June 2024) concluded that there were plausible reasons for treating transportation and delivery referral companies differently from other types of referral companies, particularly where the legislature perceived transportation and delivery companies as the most significant perpetrators of the problem it sought to address- worker misclassification. That A.B. 5 may be underinclusive because it does not extend the ABC test to every industry and occupation that has historically contributed to California’s misclassification woes does not render it unconstitutionally irrational. The en banc court did not disturb the prior panel’s disposition of plaintiffs’ Due Process, Contract Clause, and Bill of Attainder claims. Accordingly, the en banc court reinstated Parts III.B, III.C, and III.D of Olson v. California, 62 F.4th 1206, 1220–23 (9th Cir. 2023) ...

The Division of Workers’ Compensation (DWC) has issued a notice of public hearing for regulations concerning the utilization review (UR) procedures under Labor Code section 4610. Additional regulatory changes related to physician reporting and coordination of care requirements are also included. The proposed rulemaking primarily implements exemptions to prospective UR created under Senate Bill 1160 (for treatment rendered within the first 30 days from the initial date of injury) and Assembly Bill 1124 (for drugs listed as exempt on the drug formulary). Additionally, the proposal implements the statutory accreditation requirement and DWC’s oversight of UR plans, which includes extensive changes to UR enforcement rules; makes changes to improve or fix issues related to coordination of medical treatment; and would add a physician reporting form, the PR-1, which combines other reports (the Form RFA and the PR-2) to centralize reporting duties of a treating physician. Implementation of these regulations is anticipated to harmonize regulations with statutory changes from SB 1160 and AB 1124, and fix system inefficiencies with respect to the delivery of medical treatment. Members of the public may attend the in-person public hearing on Thursday, July 25, 2024, at 11 a.m. at the: Elihu Harris State Office Building - Auditorium 1515 Clay Street Oakland, CA 94612 Written public comments can be submitted via US mail, facsimile transmission (FAX) or by email until the end of the day on Thursday, July 25, 2024 to the attention of: Maureen Gray, Regulations Coordinator Department of Industrial Relations P.O. Box 420603 San Francisco, CA 94142 Fax: (510) 286-0687 Email: dwcrules@dir.ca.gov DWC will consider all public comments. The notice of rulemaking, text of the regulations, and the initial statement of reasons can be found on the DIR website ...

Six consumer organizations warned state Senate and Assembly leaders that a budget trailer bill proposed by the governor would cut the public out of insurance rate review and cost consumers billions. In a letter sent last night, the groups said the governor’s proposal would gut the consumer intervention process and tie the insurance commissioner’s hands, sacrificing transparent public scrutiny of insurance rate increases for speedy approvals. "Consumer interventions by Consumer Watchdog over the last 22 years have produced $6 billion in savings, and Consumer Federation of California Education Foundation’s interventions over the past 10 years have resulted in over $400 million in savings for California policyholders. These savings are in jeopardy under this proposal," wrote the groups. Consumer organizations signing the letter include: Consumer Watchdog, Consumer Federation of California, Consumers for Auto Reliability and Safety, Consumer Federation of America, Consumer Protection Policy Center, and The Children’s Advocacy Institute. The governor’s trailer bill goes far beyond timelines, said Consumer Watchdog. It would: - - Exclude consumers’ voice in rate increases below 7% - - Force the insurance commissioner to make rate decisions on partial information - - Speed rate hikes so the public cannot meaningfully participate before a rate increase is approved - - Change the rules even in cases - a rate hike above 7% - where public challengers have a right to a public hearing by law - - Encourage insurers to apply for three 7% rate hikes a year to avoid public hearings Nothing in the proposal would stop the clock if insurance companies refuse to provide information the department or a public participant needs to determine if a rate is justified. And nothing in the proposal would ensure the department of insurance has enough staff to complete rate reviews quickly. The plan mirrors a proposal that Insurance Commissioner Ricardo Lara and the insurance industry unsuccessfully tried to jam through the legislature during the final days of session in 2023. "Giving insurers the right to raise rates more quickly will only leave Californians paying higher rates, not get more insurance companies back in the market. The largest insurance companies in California have received double digit rate hikes recently " 20% for State Farm that took effect in March on top of an additional 6.9% last year, three rate hikes adding up to 37% for Farmers in the last year - and the companies still refuse to write new business," said the groups. Insurance companies fear greater liability under the FAIR Plan, the letter continues. The best way to get Californians out of the high-cost, low-benefit FAIR Plan and covered by real home insurance again is to make insurance companies sell to Californians who protect their homes from wildfire. The groups called on lawmakers to require insurers to cover people who meet state home hardening and brush clearance guidelines ...

Researchers from the Centre of Preventive Neurology have developed a new method for predicting dementia with over 80% accuracy and up to nine years before a diagnosis. The new method provides a more accurate way to predict dementia than memory tests or measurements of brain shrinkage, two commonly used methods for diagnosing dementia. The team, led by Professor Charles Marshall and published in Nature Mental Health, developed the predictive test by analysing functional MRI (fMRI) scans to detect changes in the brain’s ‘default mode network’ (DMN). The DMN connects regions of the brain to perform specific cognitive functions and is the first neural network to be affected by Alzheimer’s disease. The researchers used fMRI scans from over 1,100 volunteers from UK Biobank, a large-scale biomedical database and research resource containing genetic and health information from half a million UK participants, to estimate the effective connectivity between ten regions of the brain that constitute the default mode network. The researchers assigned each patient with a probability of dementia value based on the extent to which their effective connectivity pattern conforms to a pattern that indicates dementia or a control-like pattern. They compared these predictions to the medical data of each patient, on record with the UK Biobank. The findings showed that the model had accurately predicted onset of dementia up to nine years before an official diagnosis was made, and with greater than 80% accuracy. In the cases where the volunteers had gone on to develop dementia, it was also found that the model could predict within a two-year margin of error exactly how long it would take that diagnosis to be made. The researchers also examined whether changes to the DMN might be caused by known risk factors for dementia. Their analysis showed that genetic risk for Alzheimer's disease was strongly associated with connectivity changes in the DMN, supporting the idea that these changes are specific to Alzheimer's disease. They also found that social isolation was likely to increase risk of dementia through its effect on connectivity in the DMN. Charles Marshall, Professor and Honorary Consultant Neurologist, led the research team within the Centre for Preventive Neurology at the Wolfson Institute of Population Health. He said: "Predicting who is going to get dementia in the future will be vital for developing treatments that can prevent the irreversible loss of brain cells that causes the symptoms of dementia. Although we are getting better at detecting the proteins in the brain that can cause Alzheimer’s disease, many people live for decades with these proteins in their brain without developing symptoms of dementia. We hope that the measure of brain function that we have developed will allow us to be much more precise about whether someone is actually going to develop dementia, and how soon, so that we can identify whether they might benefit from future treatments." Samuel Ereira, lead author and Academic Foundation Programme Doctor at the Centre for Preventive Neurology, Wolfson Institute of Population Health, said: "Using these analysis techniques with large datasets we can identify those at high dementia risk, and also learn which environmental risk factors pushed these people into a high-risk zone. Enormous potential exists to apply these methods to different brain networks and populations, to help us better understand the interplays between environment, neurobiology and illness, both in dementia and possibly other neurodegenerative diseases. fMRI is a non-invasive medical imaging tool, and it takes about 6 minutes to collect the necessary data on an MRI scanner, so it could be integrated into existing diagnostic pathways, particularly where MRI is already used." ...

Palomar Health, a California public health care district located in San Diego County, has paid $250,000 to resolve allegations of diversion of fentanyl from one of its facilities and failure to keep accurate records for fentanyl. Palomar Health is California’s largest health care district, with campuses in Escondido and Poway. This settlement arises from a self-disclosure Palomar Health made to the U.S. Drug Enforcement Administration (DEA) that one of its employees may have diverted controlled substances. The government investigated Palomar Health and concluded that vials of fentanyl were diverted from Pyxis machines - automated medication dispensing machines often used in hospital settings - located at Palomar Health’s Cardiac Catheterization Lab in Escondido. Specifically, the government concluded that over a five - month period, numerous vials of fentanyl were diverted from the Pyxis machines and unused fentanyl was not properly disposed of. In addition to paying $250,000 to resolve the government’s claims, Palomar Health entered into a Memorandum of Agreement with the DEA requiring Palomar Health to undertake additional measures to increase security, implement specialized training, and to handle controlled substances properly and safely. "We value our relationships with our registrant population and encourage all of them to be diligent in preventing and catching diversion," said Diversion Program Manager Rostant Farfan. "Keeping medications, like fentanyl, off of the street is the responsibility of all who work with controlled substances." This settlement was the result of a coordinated effort by the U.S. Attorney’s Office for the Southern District of California and the Drug Enforcement Administration. To report a tip directly to a DEA representative regarding medical personnel writing suspicious opioid prescriptions and pharmacies dispensing large amounts of opioids, call (571) 324-6499 or visit the DEA’s website (https://www.deadiversion.usdoj.gov/tips-online.html) and click on "Rx Abuse Online Reporting." This case was prosecuted by Assistant U.S. Attorney Dylan M. Aste. The claims resolved by the settlement are allegations only, and there has been no determination of liability ...

Jennifer Reveles filed an Application for Adjudication of her claim of injury while employed by the State of California Sierra Conservation Center. On May 8, 2023, defendant filed a petition seeking an order compelling applicant to complete, sign and return medical releases, and that should applicant fail to do so, that the Workers’ Compensation Appeals Board (WCAB) suspend applicant’s entitlement to benefits. On June 29, 2023, the parties proceeded to trial, framing for decision defendant’s May 8, 2023 Petition to Compel, and "whether defendant has to depose Applicant if further information is required [that is] not contained in the medical release." A Findings of Fact and Orders (F&O) issued by the Workers’ Compensation Administrative Law Judge on August 1, 2023, which ordered Reveles to list the medical treatment received during the last 10 years to the neck, bilateral upper extremities, and bilateral wrists. The WCJ further ordered that any additional information sought by defendant would need to be obtained by deposition. The WCJ’s Opinion on Decision notes that the order complies with section 4663(d), and that section 5708 allows depositions to be admitted into evidence as part of proceedings before the WCAB. Applicant filed a Petition for Removal which was granted, and the the decision of August 1, 2023 was rescinded in the panel decision of Reveles v State of California Sierra Conservation Center - ADJ16783231 (April 2025) In her Petition for Removal applicant contends that the order to disclose medical treatment is not authorized under Labor Code section 4663(d), and that the WCJ’s order is premised on defendant’s demand for information, which is functionally equivalent to written interrogatories. Applicant further asserts that scope of the compelled disclosure will require applicant to list medical treatment she has received during the last 10 years, including doctors, medical facilities, addresses, locations, parts of body treated, types of treatment, and the approximate date(s) of treatment. Applicant cites Lubin v. Berkley East Convalescent Hop. & Mission Ins. Co.3 (1976) 41 Cal.Comp.Cases 283 [1976 Cal. Wrk. Comp. LEXIS 2480], wherein a panel of the Appeals Board noted that "in most cases the specific provisions of the Labor Code and of our rules relating to discovery will provide adequate tools to the practitioner," and that only "in very rare instances, submission of written interrogatories to an opposing party may be the only practical and feasible way of obtaining adequate discovery." Applicant asserts that the record does not support the necessity of interrogatories in lieu of other discovery vehicles available to defendant. Hardesty v. McCord & Holdren, Inc. (1976) 41 Cal.Comp.Cases 111 Section 4663(d) requires that, "[a]n employee who claims an industrial injury shall, upon request, disclose all previous permanent disabilities or physical impairments." (Lab. Code, § 4663(d).) Thus, while the section contemplates disclosure of specified disability or impairment, it does not require the employee to disclose all prior medical treatment." The WCAB panel therefore agreed with applicant that the order that she disclose prior medical treatment to specified body parts does not comport with the disclosure required by section 4663(d). Defendant’s Petition to Compel "fails to explain how compelling applicant’s authorization to disclose an unlimited medical treatment history comports with the requirement for disclosure of disability or impairment pursuant to section 4663(d)." However, the WCAB Panel went on to say "Irrespective of the requirements of section 4663(d), however, the WCJ retains significant discretion in resolving discovery disputes arising under the provisions of the Labor Code and our rules regarding pre-trial discovery. In Hardesty v. McCord & Holdren, Inc. (1976) 41 Cal.Comp.Cases 111 [1976 Cal. Wrk. Comp. LEXIS 2406] "we explained that 'in most cases the specific provisions of the Labor Code and of our rules relating to discovery will provide adequate tools to the practitioner, and that he should not be encouraged to go beyond them in search of other remedies. In those cases where the Labor Code and our rules do not provide a sufficient remedy, 'the trial judge has, and should exercise[,] the authority conferred on him by § [10330] of our rules to issue such interlocutory orders relating to discovery as he determines are necessary to insure the full and fair adjudication of the matter before him, to expedite litigation and to safeguard against unfair surprise.' " "Thus, and insofar as the defendant seeks to compel discovery in the form of written disclosure of prior medical treatment, defendant must establish why the specific provisions of the Labor Code and our rules relating to discovery are otherwise inadequate. Here, defendant offers no argument for the need to resort to written discovery, nor does it aver previously unsuccessful discovery efforts. Because defendant does not assert that less burdensome vehicles for discovery are unavailable to defendant, and because the record reflects no such requests, we are persuaded that defendant’s requests for written disclosures are unduly burdensome." ...

A new rapid test that checks for traumatic brain injuries (TBI) using a single drop of blood is expected to make its debut in the military in the coming months. The product marks one of the most significant steps forward for TBI patients’ care in the past 20 years, Lt. Col. Bradley Dengler, an Army neuroscientist who directs the Military Traumatic Brain Initiative at the Uniformed Services University in Bethesda, Maryland, said in a recent release announcing the product’s approval by the Food and Drug Administration. U.S. Army officials, in partnership with medical device manufacturer Abbott, jointly announced April 1, 2024, that the company's i-STAT® TBI whole blood cartridge had received FDA marketing clearance. Abbott developed the blood test in collaboration with USAMMDA. Previous tests to help diagnose concussion or more severe TBI were cleared by FDA in early 2021 only for use with blood plasma or serum. This required samples to be sent to a laboratory for processing and results. The new test, which takes only 15 minutes for results and is run on a portable device, also can be used to evaluate patients up to 24 hours after injury, a significant improvement from previously available tests. The device therefore could aid in decisions on priority evacuations from forward deployments in a future conflict where rapid evacuation (the "golden hour") is not possible. "Given the large numbers of expected casualties with all severities of traumatic brain injury in future large-scale combat operations, this test can help maintain combat power far forward by helping to eliminate unnecessary evacuations," Dengler said. "Additionally, and just as important, given the limited number of neurosurgeons available in-theater, ongoing research demonstrates that a future version of this test could be used to triage more severely injured patients, as the blood biomarker elevations correlate with the severity of their intracranial injuries," Dengler commented. "This can help get the most severely injured service members to neurosurgeons faster and ultimately save lives." The U.S. Army Medical Research and Development Command, headquartered at Fort Detrick in Frederick, Maryland, has been dedicated to developing a solution for detecting and evaluating TBIs for more than two decades. The new diagnostic method will prevent unnecessary medical evacuations and improve TBI case management in the field since not all patients will require head CT scans, said U.S. Army Col. Andy Nuce, commander of the U.S. Army Medical Materiel Development Activity part of USAMRDC. In July 2023, the technology was tested in simulated battle conditions during a soldier "touchpoint" as part of the Global Medic combat support training exercise at the U.S. Army’s Fort Hunter Liggett, California, which is known as the military's premier total force training center. "TBIs are a major concern for warfighter health, readiness, and resiliency," said U.S. Army Brig. Gen. (Dr.) Edward H. Bailey, commanding general of USAMRDC. "This milestone demonstrates how Army medical developers can partner with industry to deliver solutions for frontline medical personnel caring for our injured service members." ...

Djeneba Sidibe, Jerry Jankowski, Susan Hansen, David Herman, Optimum Graphics, Inc., and Johnson Pool & Spa ("Plaintiffs") represent a certified class of individuals and businesses in Northern California who paid health insurance premiums to certain health plans run by Aetna, Anthem Blue Cross, Blue Shield of California, Health Net, and United Healthcare. Plaintiffs are or were insured by health plans that contract with Sutter, a healthcare system that spans 24 hospitals, five medical foundations, and 40 ambulatory surgery centers. Plaintiffs allege that Sutter charged supracompetitive rates to these health plans, which the health plans in turn passed on to Plaintiffs by charging higher premiums. Plaintiffs are therefore "indirect purchasers" of Sutter’s services, and their "theory of antitrust impact depends on two separate overcharges": an overcharge by Sutter to the health plans, and an overcharge by the health plans to Plaintiffs. Aetna Health of California Inc., Aetna Live Insurance Company, Anthem Blue Cross, Blue Shield of California, United Healthcare Services Inc., and Kaiser Foundation Health Plan Inc., are Intervenors in this action. This litigation was filed in 2012 and has proceeded for over a decade. The lawsuit was certified as a class action in 2020, allowing it to proceed on behalf of millions of Californians with health plans from specific insurers. The district court initially set a damages period beginning on September 28, 2008. This was four years before Plaintiffs sued in September 2012, reflecting the statute of limitations for all three statutes. Second, the district court granted summary judgment to Sutter on Plaintiffs’ monopolization claims (section 2 of the Sherman Act) and for all claims between 2008 and 2010. Thus, the damages period began on January 1, 2011. Third, the district court granted several of Sutter’s motions in limine to exclude evidence.. The case proceeded to trial in February 2022 at a San Francisco Federal District Court on Plaintiffs’ claims under the Cartwright Act only. Following a four week trial a jury returned a verdict in favor of Sutter. Plaintiffs appealed the entry of final judgment in favor of Sutter. The 9th Circuit Court of Appeals reversed the district court’s entry of final judgment and remand for a new trial in the published case of Sidibe et. al. v Sutter Health -22-15634 (June 2024) On appeal Plaintiffs contended that the district court impermissibly excluded relevant evidence, failed to instruct the jury to consider Sutter’s anticompetitive purpose, failed to instruct the jury that the relevant purchasers are the health plans, and wrongly denied Plaintiffs’ motion for sanctions against Sutter for the destruction of evidence. In the 98 page Opinion, the Court of Appeals first addressed Plaintiffs’ contention that the district court contravened California law when it omitted the word "purpose" from the jury instructions on Plaintiffs’ unreasonable course of conduct claim and that the legal error was not harmless. The panel held that the district court contravened California law by removing the word "purpose" from the Judicial Council of California Civil Jury Instructions and thus failing to instruct the jury to consider Sutter’s anticompetitive purpose as to the unreasonable course of conduct claim, and that the legal error was not harmless. Plaintiffs’ second contention is that the district court abused its discretion in excluding pre-2006 evidence and that the error was prejudicial. The panel held that the district court abused its discretion under Fed. R. Evid. 403 in excluding as minimally relevant all evidence of Sutter’s conduct before 2006, which was five years before the specific contracts that Plaintiffs alleged caused them harm were negotiated and took effect. The excluded evidence concerned the inception, Sutter’s stated purpose, and effects of the conduct challenged during the trial. The panel held that Sutter failed to rebut the presumption that the error prejudiced Plaintiffs because, among other things, the excluded evidence would have rebutted Sutter’s testimony and arguments at trial. For the foregoing reasons, the district court erred in failing to instruct the jury to consider Sutter’s anticompetitive purpose and in excluding highly relevant pre-2006 evidence. Accordingly, the Court of Appeals reversed the district court’s entry of final judgment and remand for a new trial. Dissenting, Judge Bumatay would affirm the jury verdict ...

Physicians for a Healthy California (PHC), formerly known as the CMA Foundation, started in 1963 as a charitable arm of the California Medical Association (CMA), disbursing over $1 million dollars in grants and loans to medical students to support future physicians. It is dedicated to improving community health, growing a diverse physician workforce and promoting health equity. A recent study, "A Prescription for Change," by the nonprofit reveals a growing number of minority female doctors are feeling burned out and leaving their field of work. Prior research has demonstrated that women physicians are more likely than their male counterparts to report feelings of "burnout." Our prior research funded by The Physicians Foundation found that "burnout" among women physicians of color was uniquely associated with workplace harassment and low perceived value at work. Burnout and disengagement were also higher in women physicians whose competency was questioned by peers. This follow-up study was undertaken to determine if there were changes in the rates of burnout among different races or the factors that contribute to career dissatisfaction since the beginning of the COVID-19 pandemic, and to collect data to inform health care organizations on effective strategies to improve the recruitment and retention of women physicians of color. Reported burnout of respondents increased by 4.8 percentage points with 45.8% reporting high levels of overall burnout in the current study. Women physicians of color, whether represented or underrepresented in medicine, reported slightly lower overall burnout. When probed in focus groups, women physicians of color reported several protective factors that interviewees credited with their resilience. Physician retention has been a growing problem for decades, exacerbated partly due to the COVID- 19 pandemic. California already suffers from severe physician shortages, creating vast underserved areas and under-resourced populations. Women physicians of color are more likely to serve these more vulnerable communities; therefore, to promote access to care and advance health equity, it is critical for health care organizations to implement effective strategies focused on the retention of this important group of clinicians. Both the qualitative and quantitative research undertaken in this current study have led PHC researcher to develop eight recommendations for health care organizations to help address the retention of women physicians of color. Summary of Recommendation to Improve Retention. - - Commit to understanding, acknowledging and addressing the ways in which health care organizations influence attrition among women physicians of color. - - Consider and accommodate for the effects of health care system changes on physicians, especially women physicians. Identify high-yield metrics to help determine success with diversity, equity and inclusion (DEI) programs and retention efforts. - - Develop trusted mechanisms for employees to provide anonymous feedback to leadership. - - Establish transparency into DEI measures and employee feedback, and develop an accountability framework that tracks plans to address inequities and outcomes. - - Evaluate compensation, benefits, opportunities, and resources to ensure equity among genders and races. - - Compensate for the diversity tax. - - Revitalize employees’ sense of meaning and community at work. This qualitative research also aligns with growing body of research that moral injury, rather than personal characteristics, is an important driver of physicians’ decisions to leave the workforce. In addition to the COVID-19 pandemic, interviewees reported several systemic issues leading them to feel stress and burnout including institutional racism, individual acts of discrimination committed by patients and colleagues, increased focus on revenue generation, decreased boundaries between work and personal life due to technology, and pressures to take on uncompensated diversity and equity work ...

The industrial claim of Ayana Spencer stems from a 2019 incident at an Oakland Unified School District elementary school, when the mother of a third-grader (and, also, a former student) confronted her over her treatment of those children. This parent was reportedly "known to be using drugs (crack and marijuana and alcohol)" and was familiar to Ms. Spencer from the time the older child began at the school in 2005. Spencer called the police, who came and escorted the mother from the school. Ms. Spencer left work early, called Kaiser’s mental health facility and, thereafter, her own therapist, who took her off work. Defendant paid temporary disability benefits beginning May 4, 2019, through January 6, 2020, when Spencer returned to a modified position with the school district. She had an earlier 2008 incident in which a custodian, disguised with wig and sunglasses and reportedly armed with a semi-automatic weapon, attacked her from behind and pistol-whipped her, causing lacerations and lasting psychological trauma diagnosed as post-traumatic stress disorder or PTSD. Spencer missed relatively little time from work from this earlier incident, however, though she did continue in therapy and took prescription medications for a time. The parties engaged an agreed medical evaluator (AME), Dr. Richard Lieberman, who reported on November 10, 2009, that applicant’s injury had stabilized, with a GAF3 score of 60 or 15% permanent impairment, of which he apportioned 10% to non-industrial causes. The first workers’ compensation case resolved by a stipulated award of 27% permanent disability with a need for further medical treatment. Dr. Lieberman reëxamined Ms. Spencer in 2016, concluding in his report of June 16, 2016, that she no longer showed signs of PTSD. The AME at this point did find a GAF score of 64 and recommended limiting further treatment. In the current 2019 case, the parties have engaged a qualified medical evaluator (QME), Dr. Robbins. March 4, 2020, the QME found her maximally improved, with a GAF score of 65, plus additional impairment for sleep difficulties, amounting to 11% whole-person impairment, of which 75% stems from the 2019 injury and the rest from that in 2008. The WCJ found that the impairment found by this QME did overlap the impairment in the 2008 injury, and thus did not affect different abilities to compete and earn. (Sanchez v. County of Los Angeles (2005) 70 Cal.Comp.Cases 1440 (appeals board en banc). The result was a finding of injury and need for treatment, but no permanent disability as the entirety of permanent disability was apportioned under Labor Code section 4664.. The apportionment was affirmed in the panel decision of Spencer v Oakland Unified School District --ADJ13057141 (May 2024). The essence of applicant’s argument on reconsideration is that applicant’s disability to the psyche in 2008 does not overlap with the current disability to psyche in 2019, and thus defendant failed to prove apportionment. The injury to psyche in both cases was post-traumatic stress disorder. Applicant’s disability was rated the exact same way, using the Global Assessment of Functioning (GAF). The diminished future earnings capacity modifier for both cases was 1.4. It is the same body part, same diagnosis, and same rating method in both cases. On these facts the two disabilities clearly overlap. (See, Kopping v. Workers' Comp. Appeals Bd., (2006), 142 Cal. App. 4th 1099.) "The WCJ was correct to apply apportionment under section 4664. ... There may be cases where separate and independent disabilities occur to the same body part and the analysis of overlap is more intricate. The record here does not support such a finding." ...

The Creek Fire ignited on December 5, 2017 in Los Angeles County, and damaged multiple properties before being extinguished. On December 11 and 12, 2017, counsel for several of the plaintiffs insurance companies sent evidence preservation letters to Southern California Edison asserting that they believed SCE’s equipment likely contributed to the ignition and spread of the fire. Plaintiffs 21st Century Insurance Company et.al, filed their initial subrogation complaint against SCE on May 14, 2021. A master subrogation complaint filed on April 18, 2022, which plaintiffs joined, alleged that an electrical arc on SCE’s Lopez Circuit "ignite[d] nearby trees, brush, and vegetation giving rise to the Creek Fire." During discovery in the subrogation case, SCE withheld certain documents that it asserted were generated during an attorney initiated and directed internal investigation into the cause of the Creek Fire. Plaintiffs moved to compel, arguing the attorney-client privilege and attorney work product doctrine did not exempt these documents from production. Among other things, plaintiffs argued that SCE could not assert privilege and withhold documents because the primary reason SCE conducted the investigation was to comply with state law requiring it to publicly report any involvement it had in causing the fire. The trial court agreed the dominant purpose of the investigation was to comply with public reporting requirements, and held the documents thus were not privileged, and compelled production. SCE petitioned the Court of Appeal for a preemptory writ against the order compelling production of these documents. In the published case of Southern California Edison v Superior Court --B333798.PDF (May 2024), the Court of Appeal concluded that the trial court’s order improperly invaded the protection afforded by the attorney work product doctrine. A preemptory writ of mandate issue directing the trial court to vacate the November 17, 2023 order directing SCE to produce records in Los Angeles Superior Court case. California law shields the "work product" of an attorney from disclosure in litigation. The legislative policy for affording this protection is to "[p]reserve the rights of attorneys to prepare cases for trial with that degree of privacy necessary to encourage them to prepare their cases thoroughly and to investigate not only the favorable but the unfavorable aspects of those cases" (Code Civ. Proc., § 2018.020, subd. (a)) and "[p]revent attorneys from taking undue advantage of their adversary’s industry and efforts" (id., subd. (b)). To that end, subdivision (a) of section 2018.030 describes what is known as "absolute" work product protection, while subdivision (b) describes "qualified" protection. "A writing that reflects an attorney’s impressions, conclusions, opinions, or legal research or theories is not discoverable under any circumstances." (Id., subd. (a).) Any attorney work product that does not reflect counsel’s impressions, conclusions, opinions, or legal research or theories "is not discoverable unless the court determines that denial of discovery will unfairly prejudice the party seeking discovery in preparing that party’s claim or defense or will result in an injustice." (Id., subd. (b).) "[T]he Legislature in enacting section 2018.030 did not define ‘work product’ and instead left the term open to judicial interpretation." (Coito v. Superior Court (2012) 54 Cal.4th 480, 494 (Coito).) Courts have defined attorney work product as "the product of the attorney's effort, research, and thought in the preparation of his client’s case. It includes the results of his own work, and the work of those employed by him or for him by his client, in investigating both the favorable and unfavorable aspects of the case, the information thus assembled, and the legal theories and plan of strategy developed by the attorney-all as reflected in interviews, statements, memoranda, correspondence, briefs, and any other writings reflecting the attorney’s ‘impressions, conclusions, opinions, or legal research or theories’ and in countless other tangible and intangible ways. "The documents at issue, which SCE provided substantial evidence were prepared as part of an attorney led internal investigation, are the type of materials typically entitled to work product protection. Our Supreme Court’s decision in Coito is instructive." ...

The U.S. Department of Labor has published the final rule, "Federal Register - Improving Protections for Workers in Temporary Agricultural Employment in the United States" effective on June 28, 2024. The final rule strengthens protections for temporary agricultural workers by making several changes to H-2A program regulations to bolster the Department’s efforts to prevent adverse effect on workers in the U.S. and ensure that H-2A workers are employed only when there are not sufficient able, willing, and qualified U.S. workers available to perform the work. These changes include empowering workers to advocate on behalf of themselves and their coworkers regarding working conditions; improving accountability for employers using the H-2A program; improving transparency and accountability in the foreign labor recruitment process; requiring seat belts in most vehicles used to transport workers; enhancing existing enforcement provisions; improving transparency into the nature of the job opportunity by collecting additional information about owners, operators, managers, and supervisors to better enforce program requirements; clarifying when a termination is "for cause" to protect essential worker rights; and revising provisions and codifying protections that are outdated, unclear, or subject to misinterpretation in the current regulations. The final rule also strengthens protections for temporary agricultural workers when employers fail to properly notify workers that the start date of work is delayed, and clarifies and streamlines procedures to prevent noncompliant employers from using the Employment Service. The Department of Labor will host a public webinar on Thursday, June 6, 2024, to educate employers, agricultural associations, farm labor contractors, farmworkers, advocates, and other interested members of the public on the changes to the H-2A and Wagner-Peyser Employment Service programs made by the 2024 Farmworker Protection Final Rule. Participants of this webinar will learn from the Office of Foreign Labor Certification, the Office of Workforce Investment, and the Wage and Hour Division about the key aspects of this rule. The Final Rule will become effective June 28, 2024, and OFLC will begin accepting applications subject to the provisions of this rule on August 29, 2024. Additional Information - - Final Rule: Improving Protections for Workers in Temporary Agricultural Employment in the United States - - Frequently Asked Questions - - H-2A Employer’s Guide to the Final Rule "Improving Protections for Workers in Temporary Agricultural Employment in the United States" - - Flyer: Protections for Workers Employed Under the H-2A Program (English and Spanish) - - Flyer: Protections for U.S. Workers Under the H-2A Program (English and Spanish) - - Proposed rule ...

The Department of Labor just announced strategic changes to the structure of its Occupational Safety and Health Administration’s regional operations designed to direct its resources effectively and make the agency more resilient. The changes include the creation of a new OSHA regional office in Birmingham, Alabama, overseeing agency operations in the state, and those in Arkansas, Kentucky, Louisiana, Mississippi and Tennessee as well as the Florida Panhandle. The Birmingham Region will address the area’s growing worker population and the hazardous work done by people employed in food processing, construction, heavy manufacturing and chemical processing. OSHA is also planning to merge Regions 9 and 10 (view the new regional map) into a new San Francisco Region to improve operations and reduce operating costs. As part of the changes, the agency will also rename its regions to associate them by geography, rather than its current practice of assigning numbers to regions. As such, the area OSHA calls Region 4 will be renamed the Atlanta Region with jurisdiction over Florida, excluding the Panhandle; Georgia, North Carolina and South Carolina. The current Region 6 will be renamed the Dallas Region and have jurisdiction over workplace safety issues in New Mexico, Oklahoma and Texas. The composition of OSHA’s other regions will remain the same. "The changes reflect the nation’s demographic and industrial changes since the passage of the OSH Act and will allow our professionals to better respond to the needs of all workers, including those historically underserved," explained Assistant Secretary for Occupational Safety and Health Doug Parker. "With a stronger enforcement presence in the South and more consolidated state oversight and whistleblower presence in the West - an area dominated by states that operate their OSHA programs - we can direct our resources where they’re needed most." OSHA plans to fully transition to its new regional structure later in fiscal year 2024. Once implemented, the agency’s regional maps and contact information online will be updated publicly ...

Arasely Soto was injured during a routine medical procedure and had to retire from her job as a public school teacher. She sued her medical providers for medical malpractice and also sought disability retirement benefits from the California State Teachers’ Retirement System (CalSTRS). The Sotos attended a CalSTRS benefits planning session in January 2018. CalSTRS gave them information and documents about applying for disability benefits. The documents explained CalSTRS’s "[r]ight of subrogation" as follows: "[I]f you pursue a claim against a third party for the same impairment that entitles you to a disability benefit from CalSTRS, you must notify us. This is true even if the claim has not yet resulted in a court action. [¶] CalSTRS has the right to participate in the claim by filing our own action against the responsible party, intervening in your claim, or filing a lien against any judgment you may recover. [¶] If you don’t notify CalSTRS and you recover - or have already recovered - a monetary sum from the third party, you may be required to reimburse CalSTRS for part of the costs of your disability benefit." One day after the Sotos’ benefits planning session with CalSTRS, they released their claims against Dr. Borna in exchange for a six-figure settlement. Ten days later, Arasely filled out an application for disability benefits. Her application stated that her injuries were caused by employees of the hospital, including Dr. Borna.CalSTRS acknowledged receipt of Arasely’s application for disability benefits in February 2018. That same day, the court in the malpractice action granted the Sotos’ request to dismiss Dr. Borna from the lawsuit. In May 2018, the Sotos released their claims against the hospital in exchange for a seven-figure settlement. Eight days later, the Sotos dismissed the malpractice action with prejudice. CalSTRS brought suit against the Sotos, seeking to enforce its right to subrogation or reimbursement. The complaint alleges that CalSTRS is entitled to be reimbursed for Arasely’s disability benefits from her settlement with the malpractice defendants. CalSTRS moved for summary adjudication on its declaratory relief cause of action, and the Sotos moved for summary judgment. In connection with both motions, the Sotos argued that Civil Code section 3333.1 bars any subrogation claim that CalSTRS would have asserted against the malpractice defendants. Subdivision (a) of section 3333.1 authorizes a defendant in a medical malpractice action to introduce evidence of a variety of 'collateral source' benefits - including health insurance, disability insurance or worker’s compensation benefits." Subdivision (b) of the statute provides, in turn, that ‘[n]o source of collateral benefits introduced pursuant to subdivision (a) shall recover any amount against the plaintiff nor shall it be subrogated to the rights of a plaintiff against a defendant." In opposition, CalSTRS argues that (1) CalSTRS was not a source of collateral benefits for purposes of section 3333.1; (2) Arasely’s disability retirement benefits were never introduced as evidence in the malpractice action; and (3) the statutes governing CalSTRS’s right of subrogation were enacted after section 3333.1, and the later-enacted statutes prevailed. The trial court ruled in favor of Cal/STERS. The Court of Appeal affirmed the trial court in the published case of Soto v. Super. Ct. -E081902 (May 2024). It expressed no opinion on the parties' legal arguments concerning the applicability of section 3333.1 in general. The Legislature enacted section 3333.1 in 1975 as part of the Medical Injury Compensation Reform Act (MICRA), a wide-ranging statutory scheme designed to reduce the cost of medical malpractice insurance ‘by limiting the amount and timing of recovery in cases of professional negligence. MICRA addressed the problem in numerous ways, including by revising certain legal rules applicable to medical malpractice litigation. ( Education Code section 24500 grants CalSTRS "a right of subrogation" for the amounts CalSTRS "paid and became obligated to pay as disability retirement allowances, disability allowances, family allowances, or survivor benefit allowances." (Ed. Code, § 24500; see Ed. Code, § 22174.) The Legislature enacted the statutes giving CalSTRS a right of subrogation in 1988. (Ed. Code, former §§ 23300-23305, added by Stats. 1988, ch. 380, § 1, pp. 1699-1700, repealed and reenacted as Ed. Code, §§ 24500-24505 by Stats. 1993, ch. 893, §§ 1-2, pp. 4867, 4973-4974.) According to the legislative history, the CalSTRS subrogation provisions were "patterned" on the subrogation provisions governing the California Public Employees’ Retirement System (CalPERS). "The CalPERS provisions also incorporate the workers’ compensation statutes, and the pertinent language of the CalSTRS and CalPERS subrogation provisions is nearly identical." The workers’ compensation subrogation provisions bar double recovery by an employee who claims workers’ compensation benefits "and also seek[s] damages for the employee’s injury or death from negligent third parties." Section 3333.1, subdivision (a), does not specify how jurors should use the collateral source evidence, but “the Legislature apparently assumed that in most cases the jury would set plaintiff’s damages at a lower level because of its awareness of plaintiff’s ‘net’ collateral source benefits. But the employer’s consent is not required if the settlement includes only the employee’s claim for damages that will not be paid by workers’ compensation benefits. (Lab. Code, § 3859, subd. (b); Marrujo, at p. 978.) That is, the employee may segregate their claim from that of the employer and settle it without the employer’s consent. (Board of Administration v. Glover (1983) 34 Cal.3d 906, 913 (Glover); Marrujo, at p. 978.) If the employee segregates and settles their claim in that manner, then the settlement is not subject to the employer’s claim for reimbursement of workers’ compensation benefits, while the employer retains its subrogation right "against the alleged tortfeasor to recover payments it had made to its employee." (Glover, at p. 914; Marrujo, at p. 978; Lab. Code, § 3860, subd. (b).) But if the employee settles an unsegregated claim (i.e., a claim that includes both the employer’s claim for reimbursement of benefits and the employee’s claim for damages not compensated by benefits), then the employer may seek reimbursement out of the settlement proceeds. The Sotos did not offer any evidence that the malpractice defendants sought to introduce evidence of Arasely’s disability retirement benefits in the underlying action, so section 3333.1 was never triggered. In addition, if the Sotos had offered such evidence, then section 3333.1 would be irrelevant. The same evidence would tend to show that CalSTRS has no reimbursement claim against the Sotos for reasons independent of section 3333.1 ...