The Justice Department announced the results of its 2025 National Health Care Fraud Takedown, which resulted in criminal charges against 324 defendants, including 96 doctors, nurse practitioners, pharmacists, and other licensed medical professionals, in 50 federal districts and 12 State Attorneys General’s Offices across the United States, for their alleged participation in various health care fraud schemes involving over $14.6 billion in intended loss. And reaching across the country, the U.S. Attorneys office for the Central District of California announced that an Orange County man, who's name might have a familiar ring to the worker's compensation community, has just been charged via federal criminal complaint with submitting nearly $270 million in fraudulent claims to Medi-Cal, over an 11-month span, for expensive prescription drugs containing generic ingredients that were not medically necessary and, in many instances, not provided to the purported recipients. 66 year old Paul Richard Randall is now charged with health care fraud, a felony that carries a statutory maximum penalty of 10 years in federal prison.Randall made his initial appearance in United States District Court in Los Angeles on Friday and was ordered jailed without bond. His arraignment is scheduled for July 17. Randall has a long criminal history as he reportedly began his career as a hospital marketer in the mid-1990s after serving a stint in federal prison for racketeering. He was convicted of the felony in 1993 for deals that involved buying wooden shipping pallets on credit and reselling them without paying the original vendors, and was sentenced to a 21-month term. After serving time in the Terminal Island federal correctional facility in Long Beach harbor, Mr. Randall went into business with Michael D. Drobot, the owner of Pacific Hospital of Long Beach. Drobot pleaded guilty to criminal charges related to paying more than $20 million in kickbacks and bribing California state Sen. Ron Calderon to preserve a loophole in state law that enabled him to charge insurers sky-high prices for spinal hardware used at the Pacific Hospital of Long Beach. The FBI has said the kickbacks-for-surgeries scam is believed to be the largest in California history. After a business dispute between the two men, Randall moved to Tri-City Regional Medical Center in Hawaiian Gardens in 2008, a hospital eight miles away that then focused on bariatric surgery. Tri-City, which is a nonprofit institution, paid Mr. Randall more than $3.2 million between 2008 and July 2011 as a business-development consultant. Mr. Randall recruited some of the same spine surgeons to Tri-City that he earlier introduced to Mr. Drobot at Pacific Hospital. By August 2011, Mr. Randall said, he was back to doing spine-surgery marketing work for Mr. Drobot at Pacific Hospital of Long Beach. Randall reportedly said he signed a $100,000-a-month marketing agreement with Mr. Drobot – technically between Mr. Drobot’s spinal-implant distributorship and a Randall marketing firm – under which Mr. Randall was to provide services such as “recruiting surgeons to the medical staff of hospitals that use” implants Mr. Drobot distributes. Drobot disputed signing such an agreement. Randall pleaded guilty on April 16, 2012 to conspiracy to commit mail fraud. Randall admitted recruiting chiropractors and doctors to refer patients to Tri-City in exchange for kickbacks. Randall’s guilty plea in 2012 and agreement to cooperate in “Operation Spinal Cap” suggest he provided information to federal investigators, potentially implicating others in the Pacific Hospital and Tri-City schemes. However, his 2017 arrest for violating pre-sentencing release terms in the Tri-City case and subsequent fraud allegations indicate continued criminal activity. A judge denied bail on October 23, 2017, ordering Randall to remain in custody at the Santa Ana city jail until sentencing. His sentencing was advanced to November 17, 2017, from December 22, 2017. Prosecutors sought a sentence of 37 to 46 months in prison, plus restitution. Randall incorporated a company, Pharma Pro Solutions, in 2016, which was implicated in a scheme to defraud the University of California’s Student Health Insurance Plan (UC SHIP). The scheme allegedly stole student health plan ID numbers to bill $12 million for compound drugs over six months starting in October 2016. The Regents of the University of California amended a civil complaint in July 2017, filed in Los Angeles County Superior Court, alleging Randall’s involvement. The scheme involved recruiting students to apply for positions selling topical creams, requiring them to provide UC SHIP numbers and fill out health history forms, or offering payments for participating in “clinical trials” of pain creams. Also, in what may be characterized as a federal lawsuit pieced together from evidence that exists across existing criminal and civil litigation, 14 AIG insurance related companies sought restitution from nearly 30 named defendants who it claims fraudulently or illegally made claims for payment for providing worker’s compensation treatment on cases where AIG entities provided coverage. The 22 page federal lawsuit filed on October 31, 2017 listed Paul Richard Randall as one of the named defendants. According to an affidavit filed with the newest complaint, Randall, Kyrollos Mekail, 37, of Moreno Valley, and Patricia Anderson, 57, of West Hills, took advantage of Medi-Cal’s suspension of its requirement that health care providers obtain prior authorization before providing certain health care services or medications as a condition of reimbursement. The suspension of the prior authorization requirements was part of an ongoing transition of Medi-Cal’s prescription drug program to a new payment system. Through a business called Monte Vista Pharmacy, Randall and his co-schemers allegedly exploited Medi-Cal’s prior authorization suspension by billing Medi-Cal tens of millions of dollars per month for dispensing high-reimbursement, non-contracted, generic drugs through Monte Vista Pharmacy. Some prescription medications purportedly were to treat pain and included Folite tablets, a vitamin available over the counter. Normally, these high-cost reimbursement medications would have required prior authorization under Medi-Cal’s old payment system. Medication involved in this scheme was medically unnecessary, frequently was not dispensed to patients, and procured by kickbacks. From May 2022 to April 2023, Monte Vista billed Medi-Cal more than $269 million and was paid more than $178 million for 19 expensive, non-contracted drugs containing low-cost, generic ingredients that were not medically necessary, not provided, or both. Randall and others then allegedly laundered their illicit proceeds by transferring the proceeds of the Medi-Cal fraud scheme to a third party to pay kickbacks to Anderson, to promote the fraud scheme and to conceal and disguise the transfers from detection by law enforcement. Relatedly, Anderson was charged in a two-count information charging her with health care fraud for her role in the scheme which was unsealed last week. Mekail pleaded guilty to criminal charges in August 2024 and awaits sentencing. As a result of the national takedown, the government seized more than $245 million in cash, luxury vehicles, cryptocurrency, and other assets as part of the coordinated enforcement efforts. As part of the whole-of-government approach to combating health care fraud announced today, the Centers for Medicare and Medicaid Services (CMS) also announced that it successfully prevented more than $4 billion from being paid in response to false and fraudulent claims and that it suspended or revoked the billing privileges of 205 providers in the months leading up to the Takedown ...

United States Attorney for the Northern District of California announced criminal charges against five defendants in connection with allegations that they defrauded Medicare and other federal health care benefit programs and illegally diverted drugs. The charges filed in federal court are part of the Department of Justice’s 2025 National Health Care Fraud Takedown. The charges stem from various schemes, including a doctor who submitted unnecessary claims for medical equipment, individuals who ran or participated in fraud schemes to obtain money from federally funded health insurance programs through false claims, and a nurse who diverted pain medication for his own use. The California charges are part of a strategically coordinated, nationwide law enforcement action that resulted in criminal charges against 324 defendants for their alleged participation in health care fraud and illegal drug diversion schemes that involved the submission of over $14.6 billion in alleged false billings and over 15 million pills of illegally diverted controlled substances. The defendants allegedly defrauded programs entrusted for the care of the elderly and disabled to line their own pockets, and the Government, in connection with the Takedown, seized over $245 million in cash, luxury vehicles, and other assets. The following individuals were charged in the Northern District of California: - - Vincent Thayer, 41, of San Jose, California, was charged by indictment with wire fraud, health care fraud, and aggravated identity theft in connection with a $68 million medical office visit scheme. As alleged in the indictment, Thayer owned Patient Payment Agent, which did business as My Community Testing, and was a purported COVID-19 testing money. Through this company, Thayer caused the submission of approximately $68,205,233 in false and fraudulent claims to Medicare, Medicaid, and the HRSA COVID-19 Uninsured Program, of which approximately $11,751,819 was paid, for office visits purportedly performed by medical professionals but that never occurred. Thayer also misappropriated the identity of a doctor to enroll his company in Medicare and Medi-Cal (California’s Medicaid program). - - Sevendik Huseynov, 47, a national of Azerbaijan currently residing in Sunnyvale, California, and the owner and CEO of Vonyes, Inc. in Sunnyvale, California, was charged by criminal complaint and arrested on June 26, 2025. The complaint alleges that the defendant committed health care fraud through a scheme to submit fraudulent claims to Medicare Advantage Organizations (“MAOs”) on behalf of unsuspecting beneficiaries for durable medical equipment (“DME”). The complaint alleges that Huseynov, from January 15, 2025, through June 16, 2025, through his entity Vonyes, submitted more than 7,200 claims to at least eight separate MAOs offering Medicare Part C benefit plans, and that those claims sought reimbursement of more than $137 million for DME such as back braces, knee braces, and wrist braces. The complaint alleges that certain of the purported beneficiaries contacted by law enforcement were not aware of the DME prescriptions and did not need the prescribed DME. The complaint also alleges that a healthcare provider listed as a referring physician on many billing claims had never prescribed DME supplied by Vonyes and that the patients listed on those claims were not his patients. The complaint also alleges that a review of bank records for Vonyes and Huseynov did not show any purchases of actual DME. At least $761,037.63 was paid to Vonyes, into accounts controlled solely by Huseynov, from MAOs during the scheme. - - Clinton Johnson Christian, 38, of Fairfield, California, was charged by indictment with tampering with consumer products and intentionally obtaining controlled substances through deception and subterfuge in connection with diverting a controlled substance for his personal use. As alleged in the indictment, Christian accessed a machine that held hydromorphone by falsely stating a patient needed the controlled substance, removed a vial of hydromorphone, extracted the hydromorphone and re-filled the vial with saline before replacing the vial and cancelling the patient’s order.\ - - Dr. Yasmin Pirani, 46, of British Columbia, Canada, was charged by indictment with health care fraud and false statements related to health care matters in connection with a $35.2 million telemedicine fraud scheme. As alleged in the indictment, in exchange for payments from a telemedicine company, Dr. Pirani signed prescriptions for DME that was medically unnecessary, for Medicare beneficiaries with whom she lacked a pre-existing doctor-patient relationship, without a physical examination, and without any conversation with the beneficiary or based solely on a short telephonic conversation. Dr. Pirani falsely diagnosed Medicare beneficiaries with certain conditions to support the DME prescriptions and falsely attested that the information in medical records was accurate, concealing that she did not have any interaction with the Medicare beneficiaries or that the interaction was brief and telephonic. The telemedicine company solicited illegal kickbacks and bribes from DME suppliers in exchange for DME prescriptions signed by Dr. Pirani, and the DME suppliers billed Medicare approximately $32.5 million based on Dr. Pirani’s prescriptions. - - Patrick Omeife, 33, of Ghana, was charged by indictment with two counts of concealment money laundering in connection with a scheme to launder approximately $33,765 that was fraudulently disbursed from a federal COVID-19 relief program and intended for an optometrist whose identity had been stolen. As alleged in the indictment, Omeife, falsely purporting to be a covert agent of the U.S. government, began an online romantic relationship with a woman and requested that the woman use her bank account to receive his salary. This woman provided Omeife with her bank account information, and her account was used in a September 2020 fraudulent application for funds from the COVID-19 Provider Relief Fund (“PRF”). The PRF provided funds to health care providers that were financially impacted by COVID-19. Based on the fraudulent September 2020 application, the PRF disbursed approximately $33,765 intended for the optometrist into the woman’s bank account. At Omeife’s direction, the woman converted the funds to Bitcoin cryptocurrency and transferred the Bitcoin to Omeife’s cryptocurrency account. Omeife repeatedly provided identifying information to his cryptocurrency exchange, to include his Republic of Ghana driver’s license and “selfie” photographs of his face and bare upper body, depicting a distinctive tattoo on his chest of the Bitcoin currency symbol. Numerous additional fraudulent PRF applications connected to the application made in the optometrist’s name resulted in at least $1.6 million of fraudulent disbursement of funds related to COVID-19 relief programs. The Northern District of California, in particular, worked with the Department’s Criminal Division and Health Care Fraud Unit and the U.S. Department of Health and Human Services Office of Inspector General; the Federal Bureau of Investigation, and the FDA Office of Criminal Investigations ...

A Southern California healthcare clinic operator, Oscar B. Abrons III, has been sentenced for his involvement in a prescription medication diversion scheme that defrauded Medi-Cal, the state’s Medicaid program, of more than $20 million. Abrons was sentenced by the Orange County Superior Court to four years in jail and stipulated that the loss to the Medi-Cal program exceeded $20 million. A restitution hearing will be held to determine the loss amount owed by Abrons. Abron’s co-conspirators, Steven Derrick Fleming and Mohamed Waddah El-Nachef, were previously sentenced. Fleming was sentenced to five years in state prison, and El-Nachef was sentenced to a five-year local custody sentence and surrendered his medical license. As part of his sentence, El-Nachef also paid $2.3 million in restitution. At the time of his arrest in 2020 El-Nachef had stipulated to disciplinary charges filed in 2019 with the California Board of Medicine and had been placed on seven years probation. El-Nachef was also suspended from participating in the workers’ compensation system as a physician, practitioner, or provider on February 23, 2023 by an order of the Administrative Director of the DWC. El-Nachef was charged in March 2020 with a half-dozen felony counts, including executing a scheme to defraud Medi-Cal, making a fraudulent claim for a health benefit, filing a fraudulent insurance benefit claim, conspiring in the unauthorized practice of medicine and grand theft, with sentencing enhancement allegations for aggravated white- collar crime between $100,000 to $500,000 and aggravated white-collar crime exceeding $500,000. Fleming and Abrons jointly operated God’s Property, an unlicensed clinic where Medi-Cal beneficiaries were paid cash in exchange for obtaining medically unnecessary prescriptions for HIV medications, antipsychotics and controlled substances, which were then sold to buyers on the illicit market. Fleming and Abrons, alongside Mohamed Waddah El-Nachef, an Orange County medical doctor, carried out the diversion scheme from June 23, 2014, to October 1, 2016. During this time, El-Nachef became the top prescriber of HIV medications in the state. As a result of the scheme, Medi-Cal suffered an estimated loss of over $20 million. The prosecution of these individuals was carried out by the California Department of Justice’s Division of Medi-Cal Fraud and Elder Abuse (DMFEA). DMFEA works to protect Californians by investigating and prosecuting those responsible for abuse, neglect, and fraud committed against elderly and dependent adults in the state, and those who perpetrate fraud on the Medi-Cal program. The Division of Medi-Cal Fraud and Elder Abuse receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $69,244,976 for Federal fiscal year (FY) 2025. The remaining 25 percent is funded by the State of California. FY 2025 is from October 1, 2024, through September 30, 2025 ...

After declining steadily from 2018 through 2022, the number of Independent Medical Review (IMR) decision letters issued in response to California workers’ comp medical disputes is now trending up, increasing in 2023, 2024, and the first quarter of 2025 according to the California Workers’ Compensation Institute (CWCI), though the uphold rate for medical service modifications and denials remains close to 90%. CWCI’s latest review of IMR activity and outcomes examined 1.57 million IMR decision letters issued from 2015 through March of this year in response to applications submitted to the state after a Utilization Review (UR) physician modified or denied a workers’ comp medical service request. As in prior reviews, CWCI tracked the number of letters issued each quarter; determined the distribution and uphold rates for disputed treatment requests by type of medical service (and the distribution and outcomes of pharmaceutical IMRs by major drug group); measured IMR response times; and calculated the percentage of IMRs associated with high-volume physicians. IMR, introduced in 2013, was expected to reduce medical disputes by helping to ensure that workers’ comp treatment met evidence-based medicine standards, but it was not until 2019 that the number of IMR disputes began a steady decline, with the number of IMR decision letters falling by 31% from the peak level of 184,385 in 2018 to 127,215 in 2022. That decline coincided with a reduction in the number of job injury claims during the pandemic and a drop in the number of pharmaceutical disputes after the state added Pain Management and Opioid Guidelines to its Medical Treatment Utilization Schedule (MTUS) in late 2017 and adopted the MTUS Drug Formulary in January 2018. More recent data, however, show IMR letter volume rose 2.9% in 2023 and 8.2% in 2024, and initial results for this year show the trend accelerating, with 38,393 IMR decision letters in the first 3 months of 2025, 13% more than in the same period last year. Even with the increase in IMR volume, the median IMR response time (from receipt of the application to the date of the decision letter) was 32 days in 2024, the same as in 2022. Furthermore, 25% of the letters were issued within 28 days, and 75% were issued within 38 days, all within the time allotted to the state’s Independent Medical Review Organization to confirm the eligibility of the application; request, receive, and process medical records; assign the case to a physician reviewer; and issue a decision. Disputes over prescription drug requests represented 30.6% of all IMRs in the first quarter of this year – more than any other type of medical service, but down from 33.4% in 2024 and 50.7% in 2015. Much of that decline was due to the reduction in IMRs involving opioid requests, which dropped from 32% of all pharmaceutical IMRs in 2018 to 18.6% in the first quarter of this year. With prescription drugs representing a declining share of the IMR disputes, the percentage of IMRs involving disputes over other medical services has increased, with physical therapy disputes accounting for 13.6% of IMRs in the first quarter of 2025, injection disputes accounting for 12.9%, and disputes over durable medical equipment, prosthetics, orthotics and supplies accounting for 9.7%. A small number of physicians continue to drive much of the IMR activity, as the top 1% of requesting physicians (81 doctors) accounted for 42.2% of the disputed service requests that underwent IMR in the 12 months ending on March 30 of this year, and the top 10 individual physicians accounted for 10.9% of the disputed requests. CWCI found that 7 of the providers on the latest top 10 list were also on the top 10 list the prior year. IMR outcomes remain stable, as IMR physicians upheld 89.1% of UR doctors’ treatment modifications or denials in the first quarter of 2025 compared to 88.0% in 2024. As in the past, uphold rates varied by type of service, ranging from 77.4% for evaluation/management services to 92.9% for acupuncture. CWCI members and subscribers will find a more detailed summary of IMR experience through March 2025 in Bulletin 25-09 at www.cwci.org. Institute members can also access updated IMR slides under the Research tab ...

Plaintiff Joanne Allison, a former registered nurse (RN), brought the underlying class action against her former employer, Dignity Health, alleging claims for unpaid work, meal period and rest break violations, as well as derivative claims. Allison filed a motion for class certification on behalf of RNs who worked at three Dignity’s hospitals - St. John’s Regional Medical Center in Oxnard, CA, St. John’s Pleasant Valley Hospital in Camarillo, CA and Mercy General Hospital in Sacramento - since June 1, 2014. She also sought certification of subclasses for certain claims, including meal period violations and rest break violations. Allison asserted that a “facial review of RN timecards” showed most RNs experienced meal periods that failed to comply with law. Her expert identified all work shifts eligible for one or more meal periods and then “identified each instance where the time records reflected a Sample Class Member’s meal period was either missed, late, or short/interrupted.” After “accounting for premiums paid” based on Dignity’s payroll data, the expert opined that over 70 percent of relevant shifts had a non-compliant meal period with an unpaid premium. Allison averred that this evidence established a rebuttable presumption of class-wide liability under the Supreme Court case of Donohue v. AMN Services, LLC (2021) 11 Cal.5th 58 (Donohue). Moreover, because Dignity admitted it did not record the reason for any given non-compliant meal period - instead it required class members to self-report and to apply for a premium payment - Allison contended the lawfulness of placing the burden on employees to keep meal break records was a common question. Allison based her noncompliant rest break claim (and, to some extent, her meal period claim) on purported interruptions from work-issued communication devices - i.e., Vocera devices and Spectralink devices. She asserted “Dignity’s policy required RNs to wear these devices at all times . . . even during breaks,” giving rise to a common question whether this resulted in unlawful off-the-clock interruptions. As common proof to establish Dignity’s class-wide liability under this theory, Allison’s expert opined that a “comparison of Vocera log ins with RN timecards show[ed] nearly 70% of employees in the Vocera sample were using the device while clocked-out in [Dignity’s] timekeeping program.” In opposing certification, Dignity argued individual inquiries predominated the meal period claim despite Allison’s use of Dignity’s time- clock records as class-wide proof. The trial court granted in part and denied in part Allison’s motion for class certification during a class period of June 1, 2014 to January 13, 2022. The court explained that Dignity’s showing that RNs “sometimes were able to take uninterrupted breaks” was insufficient to defeat the predominance of common issues. Nineteen months after the initial certification order, Dignity moved to decertify the class on grounds that post-certification discovery refuted the trial court’s prior predominance findings. In opposition to the motion, plaintiffs argued Dignity failed to satisfy its threshold burden to show “new law or new evidence showing changed circumstances” since the certification order. Plaintiffs also countered that the post-certification evidence further demonstrated the propriety of class treatment. Following a hearing, the trial court granted the decertification motion. As a threshold matter, the trial court ruled the “large number of new declarations” as well as “plaintiffs’ efforts at a statistical analysis” constituted new evidence. And, in light of such new evidence, it determined “there [was] no good reason to ignore other evidence,” and therefore it considered the entire record. The court determined that “ ‘commonality’ ” was not the central issue; rather, “[t]he problem is the ‘predominance’ issue, as individual issues swamp the common issues.” The trial court also expressed concern that plaintiffs’ trial plan betrayed fatal flaws to continued class status. The Court of Appeal affirmed in the published case of Allison v. Dignity Health CA1/4 - A169225 (June 2025) Class actions are permitted “when the question is one of a common or general interest, of many persons, . . . and it is impracticable to bring them all before the court . . . .” (Code Civ. Proc., § 382.) Our Supreme Court has articulated that to proceed as a class action there must be “the existence of an ascertainable and sufficiently numerous class, a well-defined community of interest, and substantial benefits from certification that render proceeding as a class superior to the alternatives.” (Brinker Restaurant Corp. v. Superior Court (2012) 53 Cal.4th 1004,1021.) “ ‘In turn, the “community of interest requirement embodies three factors: (1) predominant common questions of law or fact; (2) class representatives with claims or defenses typical of the class; and (3) class representatives who can adequately represent the class.” ’ ” (Ibid.) A class “can be decertified at any time, even during trial, should it later appear individual issues dominate the case,” (Macmanus v. A. E. Realty Partners (1987) 195 Cal.App.3d 1106, 1117), decertification is appropriate “ ‘only where it is clear there exist changed circumstances making continued class action treatment improper.’ ” (Green v. Obledo (1981) 29 Cal.3d 126, 148.) Our Supreme Court’s decisions “clearly contemplate the possibility of successive motions concerning certification” based on evidence uncovered in post-certification discovery. (Occidental Land, Inc. v. Superior Court (1976) 18 Cal.3d 355, 360 (Occidental).) "Here, the trial court expressly found there was new evidence, referencing 'a large number of new declarations,' plus 'plaintiffs’ efforts at a statistical analysis.' Indeed, following certification, Dignity deposed 44 class members from the three hospitals at issue." ...

A new study from the Workers Compensation Research Institute (WCRI) examines how stakeholders view the promises and challenges of artificial intelligence (AI) in the workers’ compensation system. “In recent years, interest in the role of artificial intelligence in workers’ compensation has grown rapidly,” said Sebastian Negrusa, vice president of research at WCRI. “This study is an important step toward understanding how stakeholders are approaching the opportunities and risks associated with these emerging technologies.” To develop the study, WCRI researchers conducted semi-structured interviews with 34 leaders across 20 organizations - including employers, insurers, medical providers, worker advocates, and regulators - supplemented by informal discussions. They also reviewed literature and regulations on AI developments and applications. The key questions asked in the interviews included: - - How do you define AI and its role in the economy and the workers’ compensation system? - - Where do you see the value of AI tools for your job, your organization, and the system? - - What challenges and risks do you foresee with broader AI adoption, and how can these be mitigated? By outlining current and emerging uses of AI in workers’ compensation and identifying risks and potential guardrails, the study, Artificial Intelligence in Workers’ Compensation: An Overview of Promises and Challenges, aims to provide a common language for stakeholders and inform policy discussions to promote responsible AI use that improves injured workers’ recovery and experience. The authors of the study are Bogdan Savych and Vennela Thumula ...

This is a personal injury case. Jerry Cradduck sued defendant Hilton Domestic Operating Company, Inc. (Hilton) for negligence arising out of his use of a spa at an Embassy Suites property in Palm Desert in 2019. Liberty Mutual Insurance Company (Liberty) intervened in the case as a defendant because of its potential liability as an insurer. Plaintiff Cradduck was represented in this case. The hotel was independently owned by defendant EHT ESPD, LLC (EHT) under a franchise agreement with a Hilton subsidiary. His attorney in this case was attorney Todd Samuels. On his website Samuels states that he is "a seasoned litigator practicing in state and federal courts throughout California. He has successfully tried, arbitrated, and mediated hundreds of cases." And that he "represents individuals in personal injury lawsuits that have been injured by the careless and negligent conduct of others." The Samuels Law Group has an office in San Diego. The Cradduck trial began in 2023 with jury selection on May 16 and 17. The matter proceeded with opening statements, during which the attorney representing EHT conceded the duty and breach elements of negligence. The only issues left, counsel stated, were causation and damages. Plaintiff’s first witness testified in the afternoon, concluding shortly after 3:00 p.m. The court asked for the plaintiff’s next witness, but despite previous discussions between the court and counsel regarding witness availability, Samuels informed the court no other witnesses were available that day. The court asked if Cradduck could begin his testimony, since he was in the courtroom. Samuels was visibly upset. Cradduck testified for approximately 15 minutes before the jurors were excused and asked to return on Monday, May 22. On Saturday, May 20, Cradduck filed a motion for mistrial based on comments by counsel in EHT’s opening statement. Cradduck argued that although counsel had admitted negligence during its opening statement, two days later, it filed a motion to preclude him from presenting certain evidence, stating it had conceded negligence “‘in its use and maintenance of the subject hotel’” but the jury still had to decide causation and damages. He claimed he had been “severely prejudiced in his ability to receive a fair trial by the misleading and untrue statement to the jury.” The record does not reflect that Samuels made any objections during EHT’s opening statement. On Monday, May 22, defendants appeared for trial. Neither Cradduck nor Samuels appeared. The court advised defense counsel that it had “received word this morning that Mr. Samuels had a medical emergency so that he could not be here.” On May 23, Samuels filed a declaration. The declaration stated that on Sunday, May 21, around 6:00 p.m., he “suddenly began to feel extremely unwell and was taken to the emergency room” via ambulance. He remained in the emergency room for approximately 24 hours. A long course of events followed, including a mistrial. The court ultimately decided to dismiss the complaint due to Cradduck’s and Samuels’ failure to appear as ordered. The court’s decision was based primarily on Samuels’ failure to provide evidence of his medical condition justifying his failure to appear. He did not offer such evidence until much later, during post-judgment motions. Additionally, the evidence showed Samuels had continued to work on other cases just days after specially appearing counsel represented that he was disabled to the extent that he could not speak. The court found Samuels’ conduct sufficiently egregious that it ordered a reference to the State Bar of California. The Court of Appeal affirmed the dismissal of the plaintiff's case in the published decision of Cradduck v. Hilton Domestic Operating Co. CA4/3 - G064325 (June 2025). It carefully reviewed the record such as the examples below. At the hearing on May 24, Samuels did not appear, nor did Cradduck. Narine Mkrtchyan specially appeared for Cradduck. Mkrtchyan stated Samuels had been unable to appear at the hearing, and he had “a medical situation that is significant and is disabling to him at this point . . . it’s significant enough that he cannot proceed to trial.” She reiterated Samuels’ request for a mistrial. When asked, Mkrtchyan provided no specific information as to whether Samuels could not return the following Tuesday to resume the trial. Mkrtchyan’s reaction to the court’s statements was strongly negative, accusing the court of a “lack of compassion” that was “astonishing.” She stated she would “file a further declaration with further proof of his disability under ADA which the court is obligated to accommodate.” She did not file a further declaration on these topics at any point. On Friday, May 26, Samuels filed a notice of lodging medical records under seal. The Court of Appeal noted that "During the proceedings, attorney Narine Mkrtchyan specially appeared twice on Samuels’s behalf. During these appearances, she made numerous uncivil and disrespectful attacks on the court, including accusing the court of misrepresenting and ignoring evidence, and demonstrating bias. She ordered the court, at one point, to 'stop making any rulings right now,' and also interrupted the court and demanded the court 'let me finish.' Such conduct is reprehensible and untenable, and accordingly, we are referring Mkrtchyan to the State Bar of California for potential disciplinary action." On May 30, defendants appeared at trial, as did the jury. Cradduck did not appear, nor did Samuels. The court noted it had received and reviewed the lodged medical records, but to protect Samuels’ privacy, it did not discuss the contents in any detail. The court stated that having reviewed the records, it took the proper action the previous week by excusing the jury until the following Tuesday. The court did not “find any good cause for an additional continuance.” Defendants ultimately made an oral motion to dismiss. As the defendants and the court were discussing various matters, Mkrtchyan appeared remotely (rather than in person, as the court had ordered) and several minutes late. The court informed her of its tentative. She asserted that Samuels “is in the hospital under specialized care and requires significant medical treatment.” She again requested a continuance for another “week or until Mr. Samuels recovers from hospital” or a mistrial. The court again noted that "Mkrtchyan’s representations were in conflict with Samuels’ prior declaration and the documents filed under seal." The court continued the matter to 10:00 a.m. the next morning as an “OSC as to why the matter should not be dismissed.” On May 31, both Samuels and Mkrtchyan appeared remotely. Defense counsel appeared in person. The focus of the Defense argument was CCP section 581, subdivision (l), which allows a court to dismiss a case when a party fails to appear at trial. the court stayed further action and continued the hearing to June 7. Defendants attached documents undercutting representations on Samuels’ behalf that he was disabled, unable to speak, and in a life-threatening emergency during the relevant time period. Those documents discussed several other litigation matters in which Samuels had been active during this time period. One set of documents demonstrated that on June 1, Samuels exchanged e-mails with opposing counsel in another Riverside County matter, stating that he was “still engaged in trial.” They discussed a trial continuance based on the trial in which he was purportedly engaged as well as one opposing counsel had coming up. After review of the record, the Court of Appeal said "In this appeal, Cradduck argues multiple errors. He contends the trial court abused its discretion in denying no less than six motions and by ultimately granting the defense’s motion to dismiss. In doing so, he fails to adequately develop most of his legal arguments." 'Based on the information the court had before it at the hearing where it dismissed the case, we find no abuse of discretion. Samuels had weeks prior to the dismissal hearing to submit evidence of his medical condition and his unavailability. He failed to do so, forcing the court to rely on a scant evidentiary record that often conflicted with counsel’s oral representations. While he finally submitted evidence with postjudgment motions, those motions failed to adequately meet the legal standard required to justify relief. Accordingly, we find no abuse of discretion and affirm the judgment." ...

The California Attorney General filed a lawsuit against Sweetwater Care, a San Diego-based operator of skilled nursing facilities (SNFs). The lawsuit, which pertains to Sweetwater’s 19 California skilled nursing facilities, alleges that Sweetwater violated California law, specifically the Unfair Competition Law, due to their failure to meet statutory minimum staffing levels and to protect California residents under its care. The Attorney General said that this failure led to delayed care and critical oversights, resulting in severe harm to patients who depended on timely medical attention. The lawsuit also highlights that while Sweetwater received significant payments from Medi-Cal, the chain engaged in a pattern of violations of California law and regulations related to minimum skilled nursing facility staffing. The California Department of Justice (DOJ)’s Division of Medi-Cal Fraud and Elder Abuse (DMFEA)’s investigation found that Sweetwater was engaging in a pattern of unlawful conduct leading to associated patient harm, preventable neglect, abuse, and injuries. From 2020 through 2024, Sweetwater SNFs were staffed below California minimum staffing levels in over 14,126 instances. This unlawful level of understaffing led to patients at Sweetwater’s SNFs being exposed to preventable neglect, abuse, and injuries including fractured bones that went days without assessment or medical care, patients with head trauma leaving the facility unbeknownst to staff, unwitnessed falls, pressure injuries so severe that a patient’s hip bone was visible, medical emergencies that were not timely assessed or responded to, and patients being left for hours and overnight in soiled diapers because staff were too few or unwilling to provide care. The investigation also revealed that Sweetwater extracted over $31 million as “profit” or “management fees” instead of using those dollars to provide the legally required staffing to meet minimum nursing staff levels. The California Department of Justice is alleging Sweetwater violated California’s Unfair Competition Law in its lawsuit. The DOJ is also seeking remedies including civil monetary penalties, injunctive relief to prevent violations of California laws and regulations, the installation of a receiver or compliance monitor, and costs of suit. Pursuant to California’s Unfair Competition Law, Defendants are potentially liable for a civil penalty of up to $2,500 for each violation. That penalty may be doubled for each violation perpetrated against a senior citizen or disabled person. DMFEA works to protect Californians by investigating and prosecuting those responsible for abuse, neglect, and fraud committed against elderly and dependent adults in the state, and those who perpetrate fraud on the Medi-Cal program. The Division of Medi-Cal Fraud and Elder Abuse receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $69,244,976 for Federal fiscal year (FY) 2025. The remaining 25 percent is funded by the State of California. FY 2025 is from October 1, 2024, through September 30, 2025 ...

As part of an ongoing investigation of a 2024 Butte County arson, arrest and search warrants were issued and served in Butte, Sutter, and Sacramento Counties alleging multiple counts of arson and insurance fraud. Of those who were arrested, two men were public figures in their communities. Aaron Pamma who is the Live Oak Vice Mayor was arrested with Simren Pamma, who is a Live Oak Unified School District board member. In total three men were arrested on individual $1,000,000 warrants issued out of Butte County Superior Court. They were identified as: - - Aaron Pamma, 30, of Live Oak, was arrested on a warrant alleging Arson, Supporting a False Insurance - - -Claim, Perjury, Fraud, and Conspiracy to Destroy Insured Property for Fraud. - - Simren Pamma, 28, of Sacramento, was arrested on a warrant alleging Arson and Conspiracy to Destroy Insured Property for Fraud. - - Gurtej Singh, 28, of Yuba City, was arrested on a warrant alleging Arson, Destroying Insured Property for Fraud, Presenting a False Insurance Claim, Perjury, Fraud, and Wire Fraud. Butte County District Attorney Mike Ramsey said the arrest and search warrants were the result of a lengthy joint investigation involving the CalFire Law Enforcement Division, the Butte County District Attorney, and the Federal Bureau of Investigation. The investigation arose out of a February 17, 2024 arson fire that severely damaged a farmhouse on Ord Ferry Road in Butte County. During the investigation, CalFire investigators determined the house and surrounding orchards had been purchased in April of 2023 by Singh using a U.S. Department of Agriculture mortgage program. Approximately one month after purchasing the property Singh transferred fifty percent ownership of the property to Aaron Pamma and Simren Pamma. CalFire investigators determined Singh had purchased an insurance policy on the house approximately three months before the fire. Working with the insurance company, investigators determined Singh had made numerous false and/or misleading representations in the application for the insurance policy and that Singh and Aaron Pamma had made numerous false and/or misleading representations to the insurance company after the fire. Investigators alleged that shortly after the fire, Singh, Aaron Pamma, and Simren Pamma sold the Ord Ferry property and then collected payment from the insurance company resulting in an estimated gross profit of over $200,000. As part of the alleged conspiracy, investigators also determined that after buying the property in 2023, Singh, Aaron Pamma, and Simren Pamma hired Big Dog Handyman of Corning to renovate and improve the farmhouse. As part of the renovations and improvements, Big Dog Handyman purchased thousands of dollars’ worth of goods and materials from multiple Chico area businesses, using checks on a non-existent bank account. The owner of Big Dog Handyman, Javier Molina-Bravo, 37, of Corning, was charged in Butte County Superior Court with multiple felony counts of check fraud last March. Molina-Bravo failed to appear for a scheduled hearing in Butte County Superior Court and is currently a wanted fugitive from justice ...

The former CEO and chairman of the board of directors of Ontrak Inc., a Miami, Florida-based publicly traded health care company, was sentenced to 42 months in federal prison for engaging in an insider trading scheme – using Rule 10b5-1 stock trading plans – to avoid losses of more than $12.5 million. Terren Scott Peizer, 65, a resident of Puerto Rico and Santa Monica, was sentenced by United States District Judge Dale S. Fischer, who also ordered him to pay a $5.2 million fine and $12.7 million in restitution. At the conclusion of a 10-day trial in June 2024, a jury found Peizer guilty of one count of securities fraud and two counts of insider trading. The case is part of a data-driven initiative led by the Justice Department’s Criminal Division’s Fraud Section to identify executive abuses of 10b5-1 trading plans. Rule 10b5-1 trading plans can offer an executive a defense to insider trading charges. However, the defense is unavailable if the executive is in possession of material, non-public information at the time he or she enters into the 10b5-1 trading plan. Additionally, a plan does not protect an executive if the trading plan was not entered into in good faith or was entered into as part of an effort or scheme to evade the prohibitions of Rule 10b5-1. Peizer avoided losses of approximately $12.5 million by entering into two Rule 10b5-1 trading plans while in possession of material, non-public information concerning the serious risk that Ontrak’s then-largest customer would terminate its contract. In May 2021, Peizer entered into his first 10b5-1 trading plan shortly after learning that the relationship between Ontrak and the customer was deteriorating, and that the customer had expressed serious reservations about continuing its contract with Ontrak. Peizer later learned that the customer informed Ontrak of its intent to terminate the contract. Then, in August 2021, Peizer entered into his second 10b5-1 trading plan approximately one hour after Ontrak’s chief negotiator for the contract confirmed to Peizer that the contract likely would be terminated. In establishing his 10b5-1 plans, Peizer refused to engage in any “cooling-off” period – the time between when he entered into the plan and when he sold stock – despite warnings from two brokers, a senior Ontrak executive, and attorneys. Instead, Peizer began selling shares of Ontrak on the next trading day after establishing each plan. On August 19, 2021, just six days after Peizer adopted his August 10b5-1 plan, Ontrak announced that the customer had terminated its contract and Ontrak’s stock price declined by more than 44%. The FBI investigated the case, with substantial assistance from the Financial Industry Regulatory Authority’s (FINRA) Criminal Prosecution Assistance Group. The U.S. Attorneys Office and Matthew Reilly of the Justice Department’s Criminal Division’s Fraud Section prosecuted this case. Assistant United States Attorney Jonathan S. Galatzan of the Asset Forfeiture and Recovery Section handled the forfeiture proceedings ...

Karyn Stanley worked as a firefighter for the City of Sanford, Florida, starting in 1999. At first, she planned to serve for 25 years. Part of the reason for that had to do with health insurance. When Ms. Stanley was hired, the City offered health insurance until age 65 for two categories of retirees: those with 25 years of service and those who retired earlier due to disability. In 2003, the City changed its policy to provide health insurance up to age 65 only for retirees with 25 years of service, while those who retired earlier due to disability would receive just 24 months of coverage. Ms. Stanley later developed Parkinson’s disease, a disability that forced her to retire in 2018, entitling her to only 24 months of health insurance under the revised policy. Ms. Stanley sued, claiming the City violated the Americans with Disabilities Act by providing different health-insurance benefits to those who retire with 25 years of service and those who retire due to disability. The City responded by filing a motion to dismiss Ms. Stanley’s complaint for failure to state a claim. The district court denied that motion in part, allowing some of Ms. Stanley’s claims to proceed. But with respect to her ADA claim, The district court dismissed her ADA claim, reasoning that the alleged discrimination occurred after she retired, when she was not a “qualified individual” under Title I of the ADA, 42 U. S. C. §12112(a), because she no longer held or sought a job with the defendant. The Eleventh Circuit Court of Appeals affirmed the trial court. The Supreme Court of the United States affirmed the the Eleventh Circuit in the case of Stanley v City of Sanford, Florida -No. 23–997 (June 2025). Title I of the Americans with Disabilities Act bars employers from “discriminat[ing] against a qualified individual on the basis of disability in regard to . . . compensation” and other matters. 42 U. S. C. §12112(a). The statute defines a “qualified individual” as “an individual who, with or without reasonable accommodation, can perform the essential functions of the employment position that such individual holds or desires.” §12111(8). The question before the United States Supreme Court in this case concerns whether a retired employee who does not hold or seek a job is a “qualified individual.” The Eleventh Circuit concluded that §12112(a) does not reach allegations of discrimination against a retiree “who does not hold or desire to hold an employment position” that she is capable of performing with reasonable accommodation. 83 F. 4th 1333, 1337 (2023). But, the court acknowledged, not every court of appeals would agree. Like the Eleventh Circuit, the Sixth, Seventh, and Ninth Circuits (Weyer v. Twentieth Century Fox Film Corp., 198 F.3d 1104, 1112 (9th Cir. 2000) ) have said that Title I’s anti-discrimination provision “does not protect people who neither held nor desired a job with the defendant at the time of discrimination.” Id., at 1341. But the Second and Third Circuits take a different view. As those courts see it, the ADA’s definition of “qualified individual” is “ambiguous,” and they have resolved that ambiguity “in favor of ” extending the statute to reach retirees like Ms. Stanley. Ibid. SCOTUS resolved the circuit court conflict, and agreed with the Eleventh Circuit in this case, (and with California and the 9th Circuit which previously came to the same conclusion.) To prevail under the ADA §12112(a), a plaintiff must plead and prove that she held or desired a job, and could perform its essential functions with or without reasonable accommodation, at the time of an employer’s alleged act of disability-based discrimination ...

The National Safety Council (NSC) is America’s leading nonprofit safety advocate – and has been for over 110 years. As a mission-based organization, we work to eliminate the leading causes of preventable death and injury, focusing our efforts on the workplace and roadways. We create a culture of safety to not only keep people safer at work, but also beyond the workplace so they can live their fullest lives. The NSC just released findings from 2023-2024 MSD Solutions Lab Research to Solutions (R2S) and MSD Solutions Pilot Grant programs. Results showed practical applications and measurable progress toward reducing musculoskeletal disorders (MSDs), the most common workplace injury. Launched by the MSD Solutions Lab, a groundbreaking NSC initiative established in 2021 with funding from Amazon (NASDAQ: AMZN), the grant programs empower researchers and employers to explore and pilot new solutions that can help prevent MSDs. Now in its third grant cycle, nearly $850,000 has been awarded by NSC, including $275,000 to nine pioneering organizations during the inaugural 2023-2024 cycle. “The 2023-2024 grantees have made remarkable progress in turning innovative concepts into actionable solutions,” said Katherine Mendoza, senior director of workplace safety programs at NSC. “By investing in both academic research and employer-led pilot projects, we’re advancing scalable strategies that can help protect workers across any industry.” Highlights from the 2023-2024 R2S program include: - - Rutgers University developed an AI-based image captioning tool that helps employers identify ergonomic risks in real time - - Iowa State University created a predictive model to evaluate shoulder MSD hazards in high-risk jobs - - Virginia Tech implemented low-cost, camera-based sensors with machine learning to assess workplace MSD exposures - - University of Waterloo produced guidance for integrating computer vision into workplace ergonomics programs The 2023-2024 MSD Solutions Pilot Grant program supported Amerisure Insurance, Burlington Hydro, General Electric Aerospace and Guarantee Electrical Company in applying emerging technologies to manual materials handling – a major driver of MSDs. Trials were conducted with HeroWear, an exosuit developer, and TuMeke Ergonomics, which uses computer vision to detect risky postures and movements. Notable takeaways from participants included positive employee feedback regarding use of the technologies and improvements in risk identification and injury prevention strategies. "When we partnered with NSC to launch the MSD Solutions Lab in 2021, we recognized that addressing MSDs effectively requires strategic investment, innovative thinking, and collaboration across industries," said Sarah Rhoads, vice president of Global Workplace Health and Safety at Amazon. "We’re pleased to see the Lab explore a wide range of technologies and programs that may lead to the next great advancement in workplace safety practices, benefitting workers across industries." From reducing ergonomic risks to providing data-backed insights on emerging safety technology, the R2S and MSD Solutions Pilot grants are among several initiatives led by the MSD Solutions Lab to prevent MSDs. To learn more about these efforts, visit nsc.org/msd ...

Shawn Pollard sustained admitted injury on October 20, 2016 while employed as an Equipment Operator by Lemstra Cattle Company. This applicant selected Michael Azevedo, M.D., as his PTP. The parties have further selected M. Nathan Oehlschlaeger, D.C., as the QME in chiropractic medicine. The Defendant obtained surveillance video of applicant on multiple occasions between December 1, 2022 and February 22, 2023. On March 6, 2023, the parties completed the deposition of the QME. Following the QME deposition, On April 14, 2023, defendant sent a letter to applicant’s counsel attaching surveillance videos and proposing their submission to the QME, barring objection received in twenty days. On April 18, 2023, applicant’s counsel timely objected to the submission of surveillance video to the QME. On May 23, 2023, PTP Michael Azevedo, M.D., issued a PR-2 interim report in response to a request that he review sub rosa video of applicant. The PTP’s report discussed the films and the physician’s opinions regarding applicant’s work restrictions. On September 27, 2023, the parties proceeded to trial and framed for decision the issue of whether defendant was precluded from sending surveillance video to the QME. The parties also framed the issue of the admissibility of the May 23, 2023 report of the PTP. The WCJ heard testimony from the claims examiner and ordered the matter submitted for decision. On December 7, 2023, the WCJ issued the F&O, determining in relevant part that “Defendant is precluded from sending the surveillance videos in question to the QME, Dr. Oehlschlaeger.” The WCJ further ordered the May 23, 2023, report of PTP Dr. Azevedo excluded from evidence. The Defendants' Petition for Removal filed with the WCAB over this Order was granted in the panel decision of Pollard v Lemstra Cattle Company - ADJ10675931 (June 2025). Defendant’s Petition for Removal acknowledges that it obtained multiple dates of surveillance videos and that “[t]he video obtained in 2017 and 2021 was not previously disclosed to any party, partly because the deposition of the applicant had been scheduled, re-scheduled, continued several times, but never actually took place.” Defendant contends the WCJ’s order disallowing submission of the surveillance videos to the QME is prejudicial because defendant has complied with the applicable statutes regarding submission of information to the QME. Defendant acknowledges that “[t]here is no real dispute here that the surveillance videos in question would have constituted information and had to be sent to the applicant’s attorney 20 days prior to being sent to Dr. Oehlschlaeger … [w]hen applicant’s attorney timely objected, the only way the videos could be sent to the PQME would be by order of the court.” Defendant thus contends it has complied with the provisions of Labor Code section 4062.3 and Administrative Direct (AD) Rule 35 (Cal. Code Regs., tit. 8, § 35) and should be allowed to send the subject videos to Dr. Oehlschlaeger for his review. Generally, when a party makes a demand pursuant to Hardesty v. Mccord & Holdren (1976) 41 Cal.Comp.Cases 111, 114 [1976 Cal. Wrk. Comp. LEXIS 2406] for service of existing evidence, including sub rosa video, the employer is obligated to promptly serve the requested materials. A failure of timely service of sub rosa video or other demanded evidence may result in the imposition of various monetary or evidentiary sanctions, including the exclusion of evidence from the record. (Lab. Code, §§ 5502(d)(3). The WCAB noted that "Here, however, it does not appear that applicant’s deposition has been accomplished, nor has the defendant sought to introduce the sub rosa video into evidence at mandatory settlement conference on the case in chief. Rather, defendant has provided applicant with a copy of the sub rosa video and proposed to submit the video to the QME for review unless applicant objected within twenty days pursuant to section 4062.3(b)." The WCAB panel concluded by saying "On this record, we discern no violation of our Rules or other statutory prohibition that would preclude the QME’s review of sub rosa video. Accordingly, we will grant defendant’s petition, rescind the F&O, and substitute a new finding of fact that defendant may submit the surveillance video dated December 1, 2022, December 9, 2022, December 14, 2022, February 16, 2023, February 21, 2023, and February 22, 2023, to QME Dr. Oehlschlaeger." And "having concluded that defendant followed the procedure for submission of sub rosa video to the QME under section 4062.3(b), and that the sub rosa video may be submitted to6 the QME as a result, we discern no basis upon which to exclude the PTP’s reporting following review of the same evidence." ...

The Kaiser Permanente Bernard J. Tyson School of Medicine reported that is devoted to offering an outstanding, forward-thinking medical education. Its curriculum is built on the three pillars of Biomedical Science, Clinical Science, and Health Systems Science. Students think broadly about the ways care can be more effective for everyone and learn how to advocate for better health in homes, schools, workplaces, neighborhoods, and society. The school says that it incorporates many of the most innovative and effective educational practices available today. In addition, the school’s future physicians learn the knowledge and skills essential to the highest quality patient care and the transformation of the nation’s healthcare so that all people thrive. Learn more at medschool.kp.org. Pepperdine Graziadio Business School just announced a groundbreaking partnership with Kaiser Permanente Bernard J. Tyson School of Medicine to launch a new MD/MBA program to equip future physicians with critical business and leadership skills. The integrated MD/MBA program will provide medical students with the tools to navigate today’s complex healthcare landscape, manage financial resources effectively, and lead systemic change within healthcare organizations. This innovative collaboration reflects a growing demand for physicians who are not only clinically skilled but also capable of making strategic decisions grounded in business principles. “This innovative partnership between Kaiser Permanente School of Medicine and Pepperdine Graziadio Business School represents a forward-thinking approach to medical education,” said Dr. Clemens Kownatzki, Associate Dean of Academic Programs and Associate Professor of Finance at Pepperdine Graziadio. “Over the years, many physicians in our Executive MBA programs have shared their desire to better understand business and organizational management. A common reflection we hear is, ‘I wish I had done my MBA much earlier in my career.’ This dual-degree program allows medical students to gain that critical business knowledge at the outset of their careers,” Kownatzki added. “This new program aligns perfectly with our mission to prepare physician leaders who can drive meaningful change in health care,” said Dr. Paul J. Chung, Chair of Health Systems Science and Professor at Kaiser Permanente Bernard J. Tyson School of Medicine. “By providing opportunities for interested students to combine medical training with business education, we’re equipping them to lead not only in clinical teams but also in boardrooms, health systems, and policy arenas. Our collaboration with Pepperdine Graziadio reflects a shared commitment to shaping the future of healthcare leadership.” Karen Jackson, Head of Partnership Development at the Pepperdine Graziadio Business School, added, “The MD/MBA program offers a unique opportunity for medical students to jumpstart their professional growth. Unlike traditional paths where clinicians return to business school later in life, this program allows students to integrate business knowledge with their medical education from the start. We’re honored to collaborate with Kaiser Permanente Bernard J. Tyson School of Medicine on this impactful initiative.” ...

The Santa Clara County District Attorney’s Office has charged a San Jose fraud prevention expert with submitting more than 150 fraudulent healthcare claims for over $100,000 against her tech company’s health plan. Faranak Firozan, 47, faces numerous felony charges, including altering medical records with fraudulent intent and preparing false statements in connection with insurance claims. She also faces an Aggravated White-Collar Crime Enhancement. Firozan will be arraigned on July 15, 2025, in Department 23, at 1:30 p.m., at the Hall of Justice in San Jose. If convicted, she could face years in prison and would be ordered to pay any outstanding restitution. Firozan was a senior manager of privacy and security at NVIDIA and regularly spoke as an expert on fraud prevention. She is accused of submitting 167 fraudulent claims, many of which were entirely made-up, between November 2020 and January 2024 to NVIDIA’s self-insured health plan, which is administered by Cigna. “It’s crucial for everyone, especially those who are experts in fraud prevention, to uphold the same standards they promote,” District Attorney Jeff Rosen said. “We are grateful for our partners in this investigation that brought this serious matter to light.” Firozan’s scheme was unraveled through subpoenas, provider interviews, and bank records in a joint investigation by the DA’s Bureau of Investigations (BOI) and the California Department of Insurance (CDI). In August 2024, CDI received a suspected fraudulent claim referral from Cigna. Firozan had been flagged previously in Cigna’s system in October 2023 after she submitted a large amount of reimbursement claims in one month. Many of the claims featured handwritten codes. “Insurance fraud drives up costs for everyone and erodes trust in the system,” said Insurance Commissioner Ricardo Lara. “When someone entrusted with preventing fraud is accused of committing it, that betrayal must be met with accountability. I commend our investigators and the Santa Clara County DA’s Office for their strong partnership in this case.” Firozan is accused of altering bills by changing service dates and often fabricating entire documents. Providers verified that services listed in her claims were either not performed at all or were duplicated claims. On her LinkedIn page, Firozan described herself as an expert in abuse prevention systems and fraud investigations for financial institutions. In 2020, she provided training on cyber laundering for the Information Systems Security Association Silicon Valley Chapter. The DA’s Office and CDI urge anyone with further information on this case or any similar fraud matters to contact BOI Investigator Kathleen Rak at krak1@dao.sccgov.org. The DA’s Office emphasizes the importance of maintaining the integrity of insurance systems and its dedication to prosecuting fraudulent activities to the fullest extent of the law ...

A California physician was sentenced in Los Angeles to 54 months in prison for health care fraud arising from her false home health certifications and related fraudulent billings to Medicare. She is a fugitive and was sentenced in absentia. According to court documents, Lilit Gagikovna Baltaian, 61, of Porter Ranch, was a physician licensed to practice in California and an enrolled Medicare provider. From approximately January 2012 to July 2018, she falsely certified patients to receive home health care from at least four Los Angeles area home health agencies. These certifications were used by the home health agencies to fraudulently bill Medicare. In some instances, Baltaian pre-signed blank, undated physician certification forms knowing that the home health agencies would falsify the forms to make appear that she had seen the Medicare beneficiaries and made clinical findings to support the need for home health care, when she had done neither. Baltaian received cash payments related to these referrals and also separately billed Medicare for signing the fraudulent certifications. Between January 2012 and July 2018, four home health agencies used Baltaian’s false certifications to submit fraudulent claims to Medicare, resulting in loss to the government estimated at $1,497,159.64. Baltaian pleaded guilty to one count of health care fraud on Nov. 21, 2024. At sentencing, she was also ordered to pay $1,497,159.64 in restitution. Matthew R. Galeotti, Head of the Justice Department’s Criminal Division, U.S. Attorney Bilal A. Essayli for the Central District of California, Assistant Director in Charge Akil Davis of the FBI Los Angeles Field Office and Deputy Inspector General for Investigations Christian J. Schrank of the Department of Health and Human Services Office of Inspector General (HHS-OIG) made the announcement. The FBI and HHS-OIG are investigating the case.Trial Attorney Matthew Belz of the Criminal Division’s Fraud Section is prosecuting the case. The Fraud Section leads the Criminal Division’s efforts to combat health care fraud through the Health Care Fraud Strike Force Program. Since March 2007, this program, currently comprised of nine strike forces operating in 27 federal districts, has charged more than 5,800 defendants who collectively have billed federal health care programs and private insurers more than $30 billion. In addition, the Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to hold providers accountable for their involvement in health care fraud schemes ...

Victoria Flores worked as a packer for Parter Medical. In February 2018, she submitted a claim for workers’ compensation related to an injury to her right hand and wrist, and was placed on medical leave. Flores hired The Dominguez Firm, LLP to handle her claim. Jace H. Kim, Carlos Andres Perez and Javier Ramirez were associate attorneys of the Dominguez Firm. Flores received medical treatment and physical therapy and, in early 2019, underwent surgery on her right hand and wrist from Dr. Liz Stark. In June 2019, Dr. Stephen Nichols, the panel qualified medical examiner appointed to Flores’s case, issued his report. Dr. Nichols said Flores suffered from “severe osteoarthritis” and would continue to need occupational therapy. In his opinion, Flores should be precluded from “lifting, carrying, pushing and pulling objects in excess of 20 pounds on a frequent basis.” On September 4, 2019, Attorney Robert Choi, representing Republic Indemnity Company of California (Republic Indemnity), sent a letter to attorney Juan Dominguez of the Dominguez Firm, proposing settlement options for Flores’s claim in light of Dr. Nichols’s report. Choi said, “Your client has the option of clarifying further with [Dr. Nichols], to move forward with the interactive process with the employer to address Dr. Stark’s permanent work restrictions, and then to finalize her case by way of a Stipulated Award with future care. [¶] However, I have been authorized to offer your client a Compromise and Release settlement” if Flores agreed to submit a voluntary resignation from her employment with Parter Medical in return for the lump sum settlement. Thereafter, Choi and Attorney Allan Carvalho of the Dominguez Firm discussed settlement options via e-mail. The Dominguez Firm initially proposed that Flores sign a release acknowledging her “separation” from Parter Medical. Choi said that separation language would not be acceptable and that Flores would need to resign from her employment with Parter Medical. The Dominguez Firm acquiesced and forwarded to Choi a resignation signed by Flores. The document was titled “Voluntary Resignation From Employment” and stated that Flores was resigning “voluntarily and of [her] own free will without undue influence or coercion of any kind.” Flores received a payment of $60,000 in settlement of her claim. The settlement was approved by the Workers’ Compensation Appeals Board. After settling her workers’ compensation claim, Flores, still represented by the Dominguez Firm, filed a civil complaint against Parter Medical alleging six causes of action: (1) discrimination in violation of FEHA; (2) retaliation in violation of FEHA; (3) failure to prevent discrimination and retaliation in violation of FEHA; (4) failure to accommodate in violation of FEHA; (5) failure to engage in good faith interactive process in violation of FEHA; and (6) wrongful termination in violation of public policy. At her deposition, Flores admitted she signed the resignation at the Dominguez Firm in connection with settling her workers’ compensation claim. But she also testified that before signing it, she had called about getting her job back and was told “there wasn’t any more work for me there. And they told me that I was not to show up there, I was not to call there, and they hung up on me.” Flores said she spoke with “Lina at human resources” and she said there was no more work for her because she had hired an attorney. On September 22, 2021, Parter Medical sent a letter to the Dominguez Firm asserting that based on Flores’s admissions that she had voluntarily resigned, it was clear she had not been terminated and the Dominguez Firm had “engaged in malicious prosecution” in filing the action. Parter Medical requested a dismissal of the action. Flores did not dismiss the action, and Parter Medical subsequently moved for summary judgment. In August 2022, summary judgment was granted in favor of Parter Medical in the underlying action. Parter Medical then filed this action for malicious prosecution against the Dominguez Firm and individual defendants Kim, Perez and Ramirez. Parter Medical alleged the Dominguez Firm initiated each of the six causes of action in the underlying action without probable cause and with malice. Defendants in the malicious prosecution action filed their anti-SLAPP motion in October 2023, arguing they brought and maintained the underlying action with a good faith belief the action was tenable. Defendants requested the trial court to strike the entire complaint as to all defendants, as to each cause of action individually, or alternatively as to all allegations of malicious prosecution that occurred before September 22, 2021 (the date Parter Medical sent the letter to defendants about Flores’s deposition admissions). The trial court denied their motion, and the defendants appealed. The Court of Appeal affirmed the trial court in the unpublished case of Parter Medical Products v. The Dominguez Firm CA2/8 - B335336 (June 2025) To defeat defendants’ motion, Parter Medical was required to demonstrate its malicious prosecution action was “ ‘both legally sufficient and supported by a sufficient prima facie showing of facts to sustain’ ” a judgment in its favor if its evidence was credited. (Wilson v. Parker, Covert & Chidester (2002) 28 Cal.4th 811, 821 (Wilson).) The Court of Appeal concluded that "There is no dispute the grant of summary judgment in favor of Parter Medical was a favorable termination of the underlying action. Defendants’ anti-SLAPP motion contested only the existence of the elements of probable cause and malice. We conclude Parter Medical met its burden of showing the requisite minimal merit to proceed with its malicious prosecution action." "Defendants argue that just because the underlying action did not survive summary judgment does not mean the action was legally untenable. This is unquestionably true, but it does not answer the question of whether a reasonable attorney, knowing what the Dominguez Firm knew from its representation of Flores in the workers’ compensation proceeding, would have thought the claims against Parter Medical were legally tenable." "The showing by Parter Medical adequately establishes, for purposes of defeating the motion, that the Dominguez Firm and its attorneys knew, from its representation of Flores in the workers’ compensation proceeding, that she had resigned and had not been terminated and that she had physical limitations that impacted her ability to continue to do her job as a packer. The reasonable inference from that evidence is that the claims against Parter Medical were knowingly pursued for the improper purpose of attempting to obtain additional monies from Parter Medical without regard to the merit of the wrongful termination and FEHA claims." ...

Matthew Langford Perry was an American and Canadian actor, comedian, director and screenwriter. He gained international fame for starring as Chandler Bing on the NBC television sitcom Friends (1994–2004). Perry also appeared on Ally McBeal (2002) and received Primetime Emmy Award nominations for his performances in The West Wing (2003) and The Ron Clark Story (2006). He played a leading role in the NBC series Studio 60 on the Sunset Strip (2006–2007), and also became known for his leading film roles in Fools Rush In (1997), Almost Heroes (1998), Three to Tango (1999), The Whole Nine Yards (2000), Serving Sara (2002), The Whole Ten Yards (2004), and 17 Again (2009). In his memoirs, Perry wrote that by age 14, he had become an alcoholic. He became addicted to Vicodin after a jet ski accident in 1997. In February 2001, Perry paused productions of Friends and Serving Sara for two months so that he could enter in-patient rehabilitation for his addictions to Vicodin, methadone, amphetamines, and alcohol. He said later that, due to his substance use disorder, he had no memory of three years of his work on Friends. Perry faked pain to get a prescription for 1,800 milligrams of hydrocodone per day and was having daily ketamine infusions. In 2022, he estimated that he had spent $9 million on his addiction, including 14 stomach surgeries, 15 stays in rehab and therapy twice a week for 30 years and had attended approximately 6,000 Alcoholics Anonymous meetings. On October 28, 2023, Perry was found unresponsive in a hot tub at his home in Pacific Palisades. On December 15, 2023, Perry's death was revealed to have occurred due to acute effects of ketamine. On August 15, 2024, indictments and charges were filed against five people: Perry's personal assistant, two doctors, and two drug dealers (including TV director Erik Fleming), alleging involvement in the distribution of ketamine that caused the death of Perry and one other person. Three of the accused agreed to plead guilty,with two, Fleming and Perry's former assistant Kenneth Iwamasa, having their guilty pleas entered into court soon after being charged. Iwamasa pleaded guilty on August 7, 2024, as did Fleming the following day. During a court hearing on August 30, 2024, it was agreed that former doctor Mark Chavez, who had signed a plea agreement but had not yet officially entered it into court, would have his guilty plea accepted. He now awaits sentencing in September 2025. The second doctor, Salvador Plasencia, just agreed to plead guilty on June 17, 2025. Plasencia admitted to illegally supplying Perry with approximately 20 vials of ketamine, ketamine lozenges, and syringes between September 30 and October 12, 2023, for about $55,000. He distributed the drug outside the scope of legitimate medical practice, including teaching Perry’s live-in assistant, Kenneth Iwamasa, how to inject ketamine, administering injections himself (including in a Long Beach parking lot), and leaving vials for self-administration without proper monitoring. On October 12, 2023, Plasencia witnessed Perry experience a severe reaction (high blood pressure and "freezing up") but still left additional vials with Iwamasa. Plasencia operated and was the owner of an urgent care clinic, Malibu Canyon Urgent Care LLC, located in Malibu, California, and worked with Dr. Mark Chavez, who supplied ketamine from his former clinic and obtained additional amounts through fraudulent means. Text messages revealed Plasencia’s intent to exploit Perry, referring to him as a “moron” and discussing how much he would pay. On September 30, 2023, Plasencia was introduced to Matthew Perry by one of Plasencia's own patients who stated that Perry was a “high profile person” who was seeking ketamine and was willing to pay “cash and lots of thousands” for ketamine treatment. Plasencia subsequently contacted Perry and requested a telehealth visit. The same day Plasencia contacted Mark Chavez, a medical doctor who had previously owned a ketamine clinic in Costa Mesa, to discuss Perry’s request for ketamine. After Chavez confirmed he had ketamine vials and lozenges that he could immediately sell to Plasencia, he informed Perry that he could provide him with 9, “maybe 18,” doses of ketamine. Perry agreed that Plasencia would deliver the ketamine to Perry's residence. In mid-October, Iwamasa had also allegedly begun buying ketamine from Jasveen Sangha, a.k.a. “The Ketamine Queen,” and one of her associates, Erik Fleming. The ketamine that ended up killing Perry had been obtained from them. Fleming also has pleaded guilty. Sangha is scheduled to go on trial in August 2025 ...

Cross Country Staffing, Inc. is a “comprehensive health care staffing company” that “recruits and places healthcare professionals in virtually every specialty and area of experience in hospitals globally.” Plaintiffs Isabel Silva, Alejandro Garcia, and Janai Velasco are all former or current employees of Cross Country Staffing. At the time plaintiffs started their employment with Cross Country Staffing, each signed the same two contracts - namely, (1) an “Arbitration Agreement” and (2) an “Employment Agreement.” In August 2023 plaintiffs filed a lawsuit alleging putative class and representative claims for (1) failure to pay wages (in violation of Labor Code sections 204, 510, 1182.12, 1194, 1194.2, 1197, 1197.1, and 1198), (2) failure to provide meal periods (in violation of Labor Code sections 512 and 226.7), (3) failure to provide rest periods (in violation of Labor Code section 226.7), (4) failure to reimburse business expenses (in violation of Labor Code section 2802), (5) failure to provide accurate itemized wage statements (in violation of Labor Code section 226), (6) waiting time penalties (under Labor Code sections 201 through 203), (7) unfair competition (under Business and Professions Code section 17200), and (8) violations of PAGA (under Labor Code section 2698 et seq.). Cross Country Staffing filed a motion to compel arbitration. In its moving papers, Cross Country Staffing included only the Arbitration Agreement; it did not include, or make any mention of, the Employment Agreement. Plaintiffs opposed the motion, arguing that the Arbitration Agreement must be read together with the Employment Agreement, and that the Arbitration Agreement when read with the Employment Agreement was unconscionable and hence unenforceable in its entirety. The trial court issued a 10-page order denying Cross Country Staffing’s motion to compel arbitration. First, the court ruled that it would read the Arbitration Agreement in light of the Employment Agreement because “both [were] executed on a single day as part of the employee’s hiring, and [because] both . . . govern dispute resolution as part of the overall employment relationship. Because the unconscionability rendered the entire Arbitration Agreement unenforceable, the court denied Cross Country Staffing’s motion to compel arbitration. The Court of Appeal affirmed the trial court's order in the published case of Silva et al. v. Cross Country Healthcare, Inc. et al. -B337435 CA2/5 (June, 2025). Cross Country Staffing challenges the trial court’s order denying its motion to compel arbitration. The review on appeal entails three questions: (1) Did the trial court correctly construe the Arbitration Agreement together with the Employment Agreement; if so, (2) did the trial court correctly conclude that the Arbitration Agreement is unconscionable; and if so, (3) did the trial court abuse its discretion in declining to sever the unconscionable terms and, instead, in declaring the Arbitration Agreement unenforceable? Civil Code section 1642 provides that “[s]everal contracts relating to the same matters, between the same parties, and made as parts of substantially one transaction, are to be taken together.” "The recent decision in Alberto v. Cambrian Homecare (2023) 91 Cal.App.5th 482, is directly on point. In that case, the plaintiff signed two contracts as part of the hiring process namely, (1) an arbitration agreement, and (2) a confidentiality agreement." "Invoking section 1642, the appellate court in Alberto had “no difficulty concluding” that the two agreements “should be read together” because “both [were] separate aspects of a single primary transaction—[the employee’s] hiring” and “both governed, ultimately, the same issue—how to resolve disputes arising between [the employee] and [the employer] arising from . . . employment.” (Id. at pp. 490- 491.) “Failing to read them together,” the court in Alberto continued, “artificially segments the parties’ contractual relationship” and “fails to account for the overall dispute resolution process the parties agreed upon.” (Id. at p. 491.) "Substantial evidence supports the trial court’s finding that section 1642 applies such that the Arbitration Agreement must be read together with the Employment Agreement." "We agree with Alberto, and publish to reject the further defenses raised by the employer in this case to what we view as an indefensible end-run around precedent. We accordingly affirm the trial court’s order finding the employer’s arbitration agreement unenforceable and denying the employer’s motion to compel arbitration." ...

The California Insurance Commissioner announced a formal investigation into State Farm’s handling of thousands of insurance claims from wildfire survivors affected by the Palisades and Eaton wildfires. The California Department of Insurance has initiated a Market Conduct Examination of State Farm General Insurance Company, expanding its ongoing investigation into consumer complaints against the insurer. A Market Conduct Examination is one of the Department's most effective tools, involving a thorough, fact-based review that typically takes several months. The Department is currently at a different stage in the claims process for these wildfires, which allows for a more comprehensive regulatory review for an examination of this magnitude and importance. Insurers are now making payment decisions, enabling the Department to evaluate adjuster practices and thoroughly assess State Farm’s methods across a wide range of claims handling. While the Department has received general allegations from wildfire survivor groups regarding State Farm’s processing of claims, a formal complaint is needed for the Department to take action and advocate for consumers. Complaints can be submitted at insurance.ca.gov or by calling 800-927-HELP. "Some troubling patterns that my staff will investigate include the frequent reassignment of multiple adjusters with little continuity in communication, inconsistent management of similar claims, and inadequate record-keeping or information-sharing among claims teams. These issues create unnecessary stress, prolong recovery, and erode trust," said Commissioner Lara. "The strongest evidence we can present is the voice of consumers themselves. I urge any wildfire survivor facing delayed payments, claim disputes, multiple adjusters, smoke damage issues, or any other problems to file a formal complaint with my Department." Since January, the Department has already recovered more than $40 million for survivors of the Eaton and Palisades fires through its intervention on formal consumer complaints. As of May 12, 2025, insurance companies have paid out nearly $17 billion to residential and commercial insurance policyholders impacted by the Eaton and Palisades Fires. One area of growing concern relates to how some insurers, including State Farm, are handling smoke damage claims. The unprecedented urban impact of these wildfires has created new challenges and a lack of consistency as to how insurance companies are handling these claims — leading to confusion and delays for homeowners. In response to concerns over how smoke claims are being handled, The Insurance Commissioner announced the creation of a Smoke Claims & Remediation Task Force last month, bringing together public health experts, remediation specialists, and consumer advocates to develop fair, science-based, and consistent standards for smoke remediation. The Insurance Commissioner's action is part of a multi-pronged effort to expand insurance options for consumers and require more accountability for all companies in the insurance market. A strong, accountable insurance market supports recovery from wildfire and other climate-driven risks ...