Munir Uwaydah was an orthopedic surgeon well known as a treating physician in California workers’ compensation cases. He had been charged as the ringleader in one of California’s biggest health fraud schemes allegedly perpetrated by his company Frontline Medical Associates, which included unnecessary operations by an untrained assistant that scarred patients forever, according to indictments unsealed in Los Angeles County years ago. A total of 102 people testified during two separate Grand Jury proceedings. A new civil appellate case involving Frontline (as a plaintiff) decided in May 2025 depicts Uwaydah’s absence from the United States as beginning in 2010, allegedly to evade criminal investigations, with subsequent indictments in 2015 and 2019 solidifying his fugitive status in the civil case defendants’ view. Frontline’s conflicting representations - ranging from Uwaydah choosing not to return, to being under a strict travel ban, to potential extradition for perjury in the civil case - were deemed misleading by the court, contributing to the pattern of misconduct that led to the case’s dismissal by the trial court. This new case, Frontline Medical Associates v. Bird, Marella, Boxer, etc. (CA2/1, B336038) a May 2025 unpublished appellate case involves Frontline Medical Associates, Inc. appealing a trial court's decision to grant terminating sanctions, resulting in the dismissal of their case against the law firm of Bird, Marella, Boxer, Wolpert, Nessim, Drooks, Lincenberg & Rhow, P.C., and Benjamin Gluck (collectively, Bird Marella). The dismissal was based on the trial court's finding of Frontline's pervasive misconduct during litigation of this case. Frontline filed this lawsuit in July 2019, with an amended complaint in December 2021, alleging that Bird Marella, their former legal counsel, committed professional misconduct. Specifically, Frontline claimed that Bird Marella made misrepresentations to induce Frontline to pay $2,250,000 for legal services to represent Paul Turley, who operated Frontline before September 2015. Additionally, Frontline alleged that Bird Marella, which had also represented Frontline and Uwaydah, failed to adequately advise Frontline about potential conflicts of interest arising from their simultaneous representation of Turley. The complaint included causes of action for breach of fiduciary duty, fraud by intentional misrepresentation, fraud by fiduciary, conversion, common counts, and declaratory relief, seeking to address the alleged financial and ethical misconduct by Bird Marella. Paul Turley was a chiropractor and a key figure associated with Frontline Medical Associates. His involvement with Frontline and its owner, Munir Uwaydah, placed him at the center of significant legal and criminal proceedings related to an alleged massive insurance fraud scheme that allegedly generated $150 million in fraudulent workers’ compensation claims. In September 2015, Turley was arrested as part of a Los Angeles County District Attorney’s investigation. Over 18 months following the 2015 indictments, a judge dismissed most of the 132 counts in the initial indictments due to insufficient evidence, particularly the aggravated mayhem charges, which carried potential life sentences. In March 2017, at the prosecutors’ request, Los Angeles County Superior Court Judge Kathleen Kennedy dismissed the pending charges against 13 defendants, including Turley, except for two fugitives. Prosecutors immediately refiled new charges in three separate criminal complaints, listing 194 counts, including aggravated mayhem, money laundering, insurance fraud, and unlawful patient referrals. Benjamin Gluck, Turley’s attorney, criticized the refiling as an attempt to restart the case after prosecutorial missteps, stating, “They want to basically say, ‘We don’t like the way this game is going so we’re turning the board over.’” In December 2018, Paul Turley pleaded guilty to multiple charges, including conspiracy to commit insurance fraud, insurance fraud, unlawful referrals, and mayhem. As part of his plea, he confirmed in a factual statement that Frontline paid “cappers” to recruit injured workers to maximize billing, regardless of patient needs, and that services like prescriptions and surgeries were prioritized for profitability. Returning to the civil case appeal decided this month, Uwaydah’s role was pivotal in the Frontline case against Bird Marella due to his historical control over Frontline and his status as a key witness. The defendants alleged that Frontline was essentially a "fake company" operated by Uwaydah, who had fled to Lebanon in 2010 amid criminal investigations for healthcare fraud. Frontline claimed Uwaydah transferred his ownership interest in Frontline to Medconsult, S.A.L., a Lebanese company, in early 2022 to satisfy a debt, though this was contested as a misrepresentation. Uwaydah’s inability or unwillingness to travel to Los Angeles for trial or deposition, coupled with contradictory statements about his travel restrictions, was a significant issue. The court ordered a bench trial to determine if Uwaydah was Frontline’s alter ego, and his status as a fugitive and the ownership transfer claims were central to the defendants’ arguments for dismissal. The trial court ultimately dismissed Frontline’s case with prejudice on October 27, 2023, granting Bird Marella’s third motion for terminating sanctions due to Frontline’s deliberate, egregious misconduct that rendered a fair trial impossible. The court cited both its inherent authority and statutory authority under Code of Civil Procedure section 2023.030 for the dismissal. The specific conduct included misrepresentations about attorney Browne’s conflict of Interest. Frontline’s attorney, David Browne, declared on May 4, 2023, that he had to withdraw due to an unwaivable conflict of interest stemming from a contempt proceeding related to his representation of Medconsult, S.A.L., the purported owner of Frontline. On June 13, 2023, he reiterated this conflict was mandatory and unwaivable. However, evidence showed Browne continued to act as Frontline’s counsel, preparing key witnesses Paul Turley and Amber Woodley for depositions and trial in July 2023. The court found Browne’s claims about the conflict’s severity were exaggerated to delay proceedings, constituting a fraud on the court. The court dismissed Frontline’s expert testimony defending Browne’s actions as unpersuasive, noting Browne’s post-withdrawal work contradicted his stated ethical concerns. The court additionally found that Frontline repeatedly failed to comply with discovery obligations and court orders over several years. Itfailed to timely respond to multiple sets of interrogatories and requests for production of documents served between March 2021 and August 2022. Despite court orders to provide code-compliant responses, Frontline missed deadlines, ignored meet-and-confer efforts, and provided incomplete or evasive responses. The court imposed monetary sanctions ($3,000 and $7,500) for these failures, but Frontline’s noncompliance persisted. Frontline obstructed depositions of its Person Most Qualified (PMQ) and other witnesses. Frontline failed to appear for PMQ depositions noticed for March and September 2022. When it produced David Livingston as PMQ in November 2022, he was unprepared, answering “I don’t know” over 500 times. A subsequent PMQ, Amber Woodley, arrived late and left early, limiting testimony. The court found these actions willful and noncompliant with court orders. Depositions of Janek Hunt and Adib Kassir were disrupted by late arrivals, excessive breaks, refusals to answer, and early terminations. Frontline failed to produce Ali Mohsen and Mazen Helou for depositions despite court orders, further evidencing noncompliance. The court rejected Frontline’s excuses (e.g., documents seized in raids, witnesses overseas) as insufficient, finding a “pattern of willful noncompliance” that violated numerous court orders. Frontline initially represented that Uwaydah was its primary principal (until December 8, 2022). After the court ordered an alter ego trial, Frontline claimed in January 2023 that Uwaydah had transferred his ownership to Medconsult in early 2022 to satisfy a debt. Contradictory evidence, including a January 11, 2022 contract showing Medconsult paid $1 million for Frontline (despite its assets being worth millions and Medconsult already holding a 2005 security interest), and the lack of documentation for a $10 million arbitration award, led the court to find these representations “highly misleading, if not wholly false.” The court concluded Frontline misrepresented ownership to manipulate the use of Uwaydah’s testimony. Frontline provided conflicting statements about Uwaydah’s ability to travel to Los Angeles. Initially, it claimed Uwaydah chose not to return due to criminal charges (July 2022), with Browne guaranteeing in January 2023 that Uwaydah could travel if he agreed to extradition. Later, Frontline asserted Uwaydah was under a travel ban in Lebanon, unable to leave legally. A Lebanese decree and Uwaydah’s extradition waiver suggesting Frontline misrepresented his status to avoid in-person testimony while seeking to use his deposition, potentially evading perjury accountability. The court found that Frontline’s cumulative misconduct - misrepresentations, discovery abuses, and disregard for court orders - demonstrated a “mockery of the judicial process.” Previous monetary and evidentiary sanctions had failed to deter Frontline’s behavior, and the court concluded that lesser sanctions would not ensure future compliance. The pervasive, deliberate, and egregious nature of the misconduct, which prejudiced the defendants and undermined trial fairness, justified terminating sanctions. The appellate court affirmed the trial court's dismissal of the case, finding substantial evidence supported the trial court’s findings and no abuse of discretion in the dismissal ...

Eric Benjamin “Ben” Halem, 37, of Porter Ranch, a former full-time Los Angeles Police Department officer and current LAPD reserve officer, and his brother, Jacob Halem, 32, of Tarzana, were arraigned on felony insurance fraud charges following an investigation by the California Department of Insurance. The investigation found the brothers allegedly filed a fraudulent auto insurance claim in an attempt to obtain benefits they were not entitled to receive. The Department of Insurance began its investigation after receiving a fraud referral alleging Eric Halem falsely reported a crash involving his 2020 Bentley Continental GT, stating his brother Jacob Halem had borrowed the vehicle and was involved in a solo-collision on January 5, 2023. However, the investigation revealed that the luxury vehicle had actually been rented out through Eric Halem’s exotic car rental company, Drive LA, and crashed by the renter three days earlier. Los Angeles Sheriff’s Department (LASD) deputies responded to the accident scene, documenting the vehicle’s damage with body-worn camera footage before it was impounded. Shortly after, Eric Halem contacted his insurance company twice to obtain proof of insurance, which he then used to release the Bentley from impound. Meanwhile, the renter filed a claim with their insurance company, but it was denied due to lack of first-party collision coverage. Upon learning that the rental driver’s claim had been denied, Eric Halem allegedly filed a fraudulent claim with his insurance company on his personal policy, misrepresenting the accident details. He claimed that his brother, Jacob Halem, had been driving the vehicle at the time of the crash. To support their false claim, Eric and Jacob Halem submitted staged photographs of the damaged Bentley on a tow truck near the alleged accident location. These photos were intended to mislead adjusters, but the investigation discovered that the damage in the photos was identical to the damage captured in LASD’s body-worn camera footage from January 2, 2023, showing the damage was created before when the brothers claimed. Further investigation revealed that Jacob Halem also provided a false statement to the insurance company investigator in an effort to corroborate his brother’s fraudulent claim. The total potential loss from the fraudulent claim was $229,283. Insurance fraud impacts all Californians by driving up costs for consumers and businesses. If you suspect insurance fraud, report it to the California Department of Insurance at 800-927-4357 or visit www.insurance.ca.gov. The National Insurance Crime Bureau assisted with the investigation and the Los Angeles County District Attorney’s Office is prosecuting this case ...

As policymakers nationwide focus on the rising costs of health care, a new study from the Workers Compensation Research Institute (WCRI) reveals that hospital outpatient payments for workers’ compensation grew faster in states with fee schedules based on a percentage of hospital charges and in states without fee schedules. “This study provides meaningful state comparisons at a time when many are considering or revising hospital fee regulations,” said Sebastian Negrusa, vice president of research at WCRI. “It offers a clear, evidence-based perspective on how different regulatory approaches influence cost growth and payment levels.” The report, Hospital Outpatient Payment Index: Interstate Variations and Policy Analysis, 14th Edition, analyzes payments for common outpatient surgeries across 36 states, representing 88 percent of the nation’s workers’ compensation benefits. Covering data from 2005 to 2023, the study also compares workers’ compensation hospital payments to Medicare rates. The following are among the major findings: - - Faster growth in states with charge-based fee regulations and in non-fee schedule states: From 2011 to 2023, growth in outpatient payments for common surgeries reached 61–81 percent among states with charge-based fee schedules, and 55–88 percent in non-fee schedule states, substantially higher than 24 percent in the median fixed-amount fee schedule state. - - Higher payments in states without fee schedules: Outpatient payments were 63 to 154 percent higher than the median of states with fixed-amount fee schedules. In these states, workers’ compensation paid $7,550 to $22,002 more per surgical episode than Medicare. - - Percent-of-charge states cost more: States like Alabama and Louisiana, using percent-of-charge-based fee schedules, paid 83 to 233 percent more than states with fixed-amount fee schedules. - - Wide variation vs. Medicare: Average workers’ compensation payments for a common group of outpatient surgeries ranged from 40 percent below Medicare in Nevada to 480 percent above in Alabama. The report also tracks the impact of recent policy reforms. In May 2023, Florida expanded its fixed-amount fee schedule by eliminating charge-based reimbursement for unlisted procedures. This policy change led to a 6 percent decrease in hospital outpatient payments per surgical episode within the same year ...

The founder and former CEO of the now-defunct Sovereign Health Group addiction treatment provider was arrested on an eight-count federal grand jury indictment alleging he submitted more than $149 million in fraudulent claims to health insurers – including for fraudulent urinalysis claims – and, in addition, paid more than $21 million in illegal kickbacks for patient referrals. Tonmoy Sharma, 61, of Tustin, was arrested at Los Angeles International Airport and is expected to make his initial appearance and be arraigned in United States District Court in downtown Los Angeles. Sharma is charged with four counts of wire fraud, one count of conspiracy, and three counts of illegal remunerations for referrals to clinical treatment facilities. Also arrested was co-defendant Paul Jin Sen Khor, 45, of Irvine, who worked as Sovereign’s cash management and accounts payable supervisor. Khor is charged with one count of conspiracy and one count of illegal remunerations for referrals to clinical treatment facilities. Khor was arraigned in United States District Court in Santa Ana. He pleaded not guilty and a July 29 trial date was scheduled. A federal magistrate judge ordered him released on $20,000 bond. According to the indictment, the San Clemente-based Sovereign once was a prominent addiction treatment provider throughout Southern California and several other states. From 2014 to 2020, Sovereign billed private insurance companies for drug addicted and mentally ill patients often at high, out-of-network rates. At Sharma’s direction, Sovereign employees aggressively pursued patients through various forms of marketing, directing the patients to contact the company at its toll-free phone number. Once patients called in to Sovereign’s call center, employees used various tactics to enroll patients into the company’s treatment facilities, including misrepresentations. One such misrepresentation was that a patient’s treatment would be paid for by a foundation funded by donations from former Sovereign patients. In fact, the foundation was a sham organization and a ruse for Sovereign employees – at Sharma’s direction – to obtain patients’ names, dates of birth, and Social Security numbers for use in surreptitiously obtaining health insurance coverage on their behalf. In order to obtain these private health insurance plans, Sovereign employees, at Sharma’s direction, made false representations on insurance applications, claiming qualifying life events that had not happened in order to obtain new insurance outside the enrollment period and inflating or underreporting their income so the patients would qualify for Affordable Care Act government-subsidized private insurance instead of Medicaid, whose reimbursement rates were significantly lower than private insurers. Patients generally did not know that Sovereign would enroll them into these policies or authorize Sovereign to do so. Sovereign employees at times even pretended to be the patients when calling into those insurance companies. Those insurance companies would not have covered any services under plans obtained by these fraudulent means. Sovereign also fraudulently billed insurers more than $29 million for urinalysis tests not authorized by the purported ordering health providers. At Sharma’s direction, Sovereign submitted fraudulent claims for comprehensive urinalysis screening, including through its laboratory, Vedanta Laboratories Inc. Sovereign patients were frequently drug tested through both cup testing and comprehensive panel testing. The cup testing returned results within minutes, while the panel testing was much more comprehensive, with results taking several days to return. The comprehensive panel testing screened for dozens of different substances and, accordingly, was billed at a significantly higher rate than cup testing. Sharma directed Sovereign employees to frequently administer cup testing and comprehensive panel testing on patients, including comprehensive panel testing up to three times a week. Sovereign submitted thousands of claims to insurance companies, including for comprehensive panel tests that purportedly were authorized by physicians when, in reality, the physicians did not authorize the tests. Sovereign also submitted numerous claims to the insurance companies, including urinalysis tests, after physicians were no longer working at Sovereign. Finally, in addition to the patients obtained through the call center above, Sharma and Khor also procured patients for Sovereign by paying illegal kickbacks to patient brokers. To conceal the nature of these transactions, Sharma and Khor caused Sovereign to enter sham contracts that referred to the brokers’ services as “marketing hours,” a term the brokers used when sending invoices to Sovereign for payment. Sovereign paid more than $21 million in illegal kickbacks for patient referrals. A 2017 investigative series, “Rehab Riviera,” by the Southern California News Group highlighted widespread fraud and lack of oversight in the industry, with Sovereign Health as a key example. Families and advocates have also criticized Sharma’s facilities for negligence, linking poorly run centers to patient deaths, including overdoses. In 2022, a Los Angeles jury ordered Sharma and Sovereign Health to pay nearly $45 million to Health Net for fraudulent claims, finding that they acted with “malice, oppression, or fraud” and violated the Racketeering Influence and Corrupt Organizations Act (RICO). Additionally, in 2008, the British General Medical Council revoked Sharma’s medical license in the UK for lying about his academic qualifications and conducting unethical drug studies. Despite this, he became CEO of Sovereign Health in 2009 ...

Felony charges have been filed against Ghada Kalsho Kassab M.D, a 57 year old San Diego dermatologist, for a $1.3 million Medi-Cal fraud scheme. The investigation uncovered that the dermatologist charged Medi-Cal $1,386,995 for services that were never rendered. According to the Medical Board of California, Kassab currently holds a Physician and Surgeon license (A 114457). The physician is reportedly a 1999 graduate of the University of Baghdad College of Medicine. Kassab practices dermatology at GK Dermatology of San Diego, located at 3737 Moraga Ave, Ste A206, San Diego, CA 92117. A complaint was filed in San Diego County Superior Court charging the dermatologist with 22 counts of healthcare insurance fraud, one count of Medi-Cal fraud, the white-collar crime enhancement, and the excessive takings enhancement. Prosecutors alleged that the dermatologist was invoicing for as many as 233 patients on a daily basis, averaging between 60 to 70 patients per day for identical or comparable services. Furthermore, it was found that all patients were undergoing light therapy, with the majority using non-medical lamps. It was further alleged that the crimes committed by defendant Ghada Kassab involved a pattern of related felony conduct, and the pattern of related felony conduct involving the taking of, and resulted in the loss of more than five hundred thousand dollars ($500,000), within the meaning of Penal Code §186.11 (a)(2). This enhancement is known as the aggravated white collar crime enhancement Pursuant to Penal Code §1170(h), prison custody time is to be served in state prison if the enhancement pursuant to Penal Code §186.11(a)(2) is imposed as part of a sentence for the offenses ...

The Madera County Sheriff’s Office arrested 57-year-old Martha Gutierrez DeRomero. She is facing a felony insurance fraud charge after claiming two men stole her van with thousands of dollars’ worth of items inside – but, according to Sheriff Tyson Pogue, that was a lie. On May 23, 2025, DeRomero reported a carjacking at knifepoint near Avenue 21 and Road 26. She claimed an unknown assailant stole her white Chevrolet panel van, which contained $60,000 worth of merchandise. The Madera County Sheriff’s Office, led by Sheriff Tyson Pogue, investigated the incident and discovered it was a staged event orchestrated by DeRomero and her boyfriend, Alfredo Delezma, to commit insurance fraud. The investigation revealed that the van, reported stolen, was later found by the Merced County Sheriff’s Office in a storage facility in Merced, along with the supposedly stolen merchandise. This discovery unraveled the scheme, confirming that no carjacking had occurred. On May 28, 2025, DeRomero was arrested and booked into Madera County Jail on charges of felony insurance fraud, conspiracy, and filing a false police report. Authorities indicated that Alfredo Delezma may also face charges for his role in the conspiracy, although no further details on his status were provided in the reports. The case was reported by multiple news outlets, including ABC30 Fresno, ABC7 Los Angeles, ABC7 Chicago, and KMPH, all citing the Madera County Sheriff’s Office. Sheriff Pogue commended the deputies for their thorough investigation, which prevented an fraudulent insurance claim. For further information, contact the Madera County Sheriff’s Office at (559) 675-7770 or visit www.maderacounty.com/sheriff ...

Edgar Osuna worked for Spectrum Security Services, Inc., from October 2011 to February 2022. During his tenure Spectrum allegedly committed Labor Code violations against Osuna and other employees. The violations against other employees purportedly continued after Osuna’s employment terminated. In August 2023, Osuna notified the Labor and Workforce Development Agency (LWDA) of Spectrum’s alleged failure to comply with the Labor Code. After the LWDA failed to respond within the statutory period Osuna filed a representative PAGA claim based on the underlying violations identified in Osuna’s LWDA notice, and individual and class claims based on the same allegedly unlawful conduct. Spectrum demurred to the PAGA claim. It argued the applicable one-year statute of limitations bars the claim because Osuna did not provide the LWDA with notice of the alleged Labor Code violations until 18 months after his employment ended. Spectrum also argued Osuna lacks standing to bring his PAGA claim because he was not employed during the time he sought to represent other aggrieved employees. (Citing Robinson v. Southern Counties Oil Co. (2020) 53 Cal.App.5th 476 (Robinson).) It urged the trial court to sustain the demurrer without granting leave to amend. The trial court agreed with Spectrum's argument and dismissed Osuna’s class claims, sent his individual claims to arbitration, and sustained Spectrum’s demurrer to his representative PAGA claim without granting leave to amend. It concluded that Osuna lacked standing to bring the PAGA claim because he did not suffer a Labor Code violation during the one-year statute of limitations period for recovering civil penalties. The Court of Appeal reversed the portion of the order sustaining Spectrum’s demurrer to Osuna’s representative PAGA claim in the published case of Osuna v. Spectrum Security Services, Inc. CA2/6 - B338047 - (May 2025). Before turning to the issue of representative PAGA standing, the Court of Appeal resolve the threshold issue of appealability. Spectrum contended that it should dismiss Osuna’s appeal because “an order sustaining a demurrer to [fewer] than all of the [claims in a complaint is not immediately appealable.” It also contends the “death knell” doctrine - an exception to this general rule - is inapplicable here because Osuna has not shown that the trial court’s order was “a de facto final judgment for absent plaintiffs.” The Court of Appeal concluded "the Miranda rule applies here." (citing Miranda v. Anderson Enterprises, Inc. (2015) 241 Cal.App.4th 196) The order dismissing the representative PAGA claim without leave to amend operates as “a de facto final judgment for absent plaintiffs” (In re Baycol Cases I & II (2011) 51 Cal.4th 751, 759) and is appealable" Due to the systemic underenforcement of the Labor Code, the Labor Code Private Attorneys General Act of 2004 (Labor Code,1 § 2698 et seq.; PAGA) deputizes employees to stand in the shoes of the state to pursue civil penalties on behalf of themselves and other “aggrieved employees.” (Arias v. Superior Court (2009) 46 Cal.4th 969, 980 (Arias).) So long as they were employed by the alleged violator and personally suffered at least one Labor Code violation, aggrieved employees have standing to bring representative PAGA actions. The Legislature recently adopted Assembly Bill No. 2288 (2023-2024 Reg. Sess.), which amended portions of Labor Code § 2699. Among other changes, Assembly Bill No. 2288 “requir[es] an aggrieved employee to have personally suffered the alleged violations within [PAGA’s] one-year statute of limitations.” (Sen. Com. on Judiciary, Rep. on Assem. Bill No. 2288 (2023-2024 Reg. Sess.) as amended June 21, 2024, pp. 15-16.) Because those amendments apply only to lawsuits filed on or after June 19, 2024, they are inapplicable here. (See Stats. 2024, ch. 44, § 1.) If after notification the LWDA does not investigate, does not issue a citation, or fails to respond to the notice within 65 days, the employee may sue. But not every private citizen can maintain such a suit. Only an "aggrieved employee" has PAGA standing.The Labor Code defines such an employee as "any person who was employed by the alleged violator and against whom one or more of the alleged violations was committed." The issue here is whether Osuna meets that definition. The Court of Appeal concluded that he did. "The words of section 2699, former subdivision (c) are clear and unambiguous: To have standing to bring a PAGA action, “[t]he plaintiff must be an aggrieved employee, that is, someone ‘who was employed by the alleged violator’ and ‘against whom one or more of the alleged violations was committed." ...

Chula Vista resident and businessowner Fernando Valenzuela Ayub pleaded guilty in federal court, admitting that he conspired with others to launder millions of dollars of health care fraud proceeds and paid unlawful kickbacks. According to his plea agreement, Valenzuela and co-conspirators owned and operated multiple durable medical equipment (DME) companies, which sold orthotics – including back, wrist, and knee braces – to Medicare beneficiaries. Valenzuela admitted that in operating the DME companies, he and co-conspirators paid unlawful kickback payments to sham marketing companies who provided bogus prescriptions for DME. In total, Valenzuela paid $3.7 million in kickbacks. Valenzuela admitted that he used his DME companies to submit fraudulent claims to Medicare. Once Valenzuela’s DME companies were suspended from billing Medicare, Valenzuela conspired to put DME companies in the names of nominee owners while he maintained control of the companies and the monies received from Medicare. In total, Valenzuela billed Medicare approximately $51 million and was paid approximately $20 million, and ultimately laundered at least $14 million dollars of Medicare proceeds. As part of his guilty plea, Valenzuela agreed to forfeit $7,101,320. Valenzuela’s sentencing is scheduled for August 15, 2025. The case is being prosecuted by Assistant U.S. Attorney Blanca Quintero of the Southern District of California ...

Beckers Hospital Review just reported that in May 2025, a federal jury in the U.S. District Court for the Central District of California awarded $147 million in damages to Scottsdale, Arizona–based Innovative Health, a medical device reprocessor, in a lawsuit filed in 2019 against Johnson & Johnson’s subsidiary, Biosense Webster. The jury found that Biosense Webster violated federal antitrust laws (Sherman Antitrust Act, Sections 1 and 2 and California Cartwright Act) by engaging in anticompetitive practices, specifically by withholding clinical support from hospitals that used reprocessed catheters instead of purchasing new ones from Biosense. The lawsuit centered on Biosense Webster’s policy of tying access to clinical support for its CARTO 3 cardiac mapping system to the exclusive purchase of its high-density mapping and ultrasound catheters. Innovative Health alleged that this policy, implemented after they received FDA clearance in 2016 to reprocess Biosense’s catheters, pressured hospitals to buy new devices, stifling competition and maintaining Biosense’s monopoly in the cardiac mapping catheter market. Internal emails presented during the trial showed hospitals expressing interest in Innovative’s cost-effective reprocessed catheters but facing warnings from Biosense about discontinued support. Biosense defended the policy, arguing it was necessary to ensure service quality and prevent competitors from “free-riding” on their clinical support infrastructure. However, the jury sided with Innovative Health, determining that the tying arrangement and monopolistic practices were illegal. The case was initially dismissed in 2022 but revived by the Ninth Circuit Court of Appeals in 2023, leading to the trial that began in April 2025. Association of Medical Device Reprocessors issued the following statement: "Friday’s unanimous verdict by a federal jury in Santa Ana, California for Innovative Health against Johnson & Johnson (NYSE: JNJ) is a victory for America’s hospitals, providers, patients, and the environment. The jury found that Biosense Webster violated federal and state antitrust laws by withholding clinical support to hospitals using Innovative Health’s FDA regulated, reprocessed catheters." “For too long, Johnson & Johnson has used tying arrangements and other tactics to interfere with fair competition from lower-cost, FDA-regulated, reprocessed ‘single-use’ devices (SUDs),” the association’s CEO Daniel J. Vukelich said in a news release. “We hope this jury’s message will be heard loud and clear: Hospitals want to reduce costs and greenhouse gas emissions by using more reprocessed SUDs without fear of retribution by their original equipment manufacturers (OEMs).” The verdict is seen as a significant win for reprocessors and hospitals seeking cost-effective, FDA-regulated reprocessed devices to reduce costs and environmental impact ...

The U.S. Department of Labor's Occupational Safety and Health Administration announced it has updated the inspection program that directs agency enforcement resources to establishments with the highest rates of injuries and illnesses based on injury and illness data submitted in accordance with OSHA's recordkeeping requirements. The Site-Specific Targeting program is OSHA's primary planned inspection program for non-construction establishments with 20 or more employees. Using OSHA Form 300A data from calendar years 2021-2023, establishments may be selected for inspection based on: - - High injury and illness rates from 2023 data. - - Upwardly trending injury and illness rates based on 2021-2023 data at or above twice the 2022 private sector average. - - Injury and illness rates markedly below industry averages. - - Failure to submit an OSHA Form 300A in 2023. The new directive replaces the previous SST program directive issued on February 7, 2023. OSHA also uses national and local emphasis programs to target high-risk industries and hazards. Learn more about these emphasis programs. OSHA's On-Site Consultation Program provides free, confidential occupational safety and health services to help small- and medium-sized businesses identify workplace hazards, comply with OSHA standards, and establish and improve safety and health programs. On-Site Consultation services are separate from enforcement and do not result in penalties or citations ...

Deborah Hemsted’s workers' compensation claim is based on an injury she sustained on September 24, 2014, when she was a Medical Assistant III for United Indian Health Service at Arcata, California. The history of the United Indian Health Services began in 1968. It was a time when Native activism coincided with the nation-wide Civil Rights Movement and the Office of Economic Opportunity programs. Together these factors helped create a new era of self-determination for Indian peoples. Hemsted first received benefits and treatment for her injury through United Indian’s tribal workers’ compensation system. After a dispute arose, Hemsted filed a claim with the state workers’ compensation system. United Indian took the position that, in light of its tribal immunity, California’s workers’ compensation system lacked jurisdiction to adjudicate the claim. In a March 2024 decision, the workers’ compensation administrative law judge (ALJ) rejected United Indian’s claim of sovereign immunity after applying the California Supreme Court Miami Nation’s five-factor arm-of-the-tribe test. (People v. Miami Nation Enterprises (2016) 2 Cal.5th 222.) With respect to United Indian’s method of creation, the ALJ found that it was a California non-profit created through the Indian Health Board and authorized by several tribes, including federally recognized tribes, to provide health services to their members. The ALJ observed that eight or nine tribes have sanctioned United Indian as their health provider. The ALJ noted that most of the tribal resolutions did not specifically designate United Indian as a tribal organization. Based on these circumstances, the ALJ concluded that United Indian’s method of creation weighed against sovereign immunity. As to the question of intent, the ALJ found no evidence that the tribes intended to share their sovereign immunity with United Indian. The ALJ held that United Indian’s purpose - to serve the health needs of Indians in Humboldt and Del Norte Counties - weighed in favor of sovereign immunity. As for control, the ALJ concluded that “[c]ontrol weighs against sovereign immunity because the Board [of Directors of United Indian] consisted of tribal members and others who may or may not be tribal members.” With respect to the financial relationship between United Indian and the tribes, the ALJ found United Indian was not funded by the tribes, but instead by grants obtained by the Indian Health Board and distributed to United Indian. The ALJ reasoned that, because United Indian is incorporated separately from the tribes, “any action against [United Indian] would not threaten the tribes’ resources, nor the resources of the members of the board.” The judge therefore concluded that this factor weighed against immunity. In her report on reconsideration, the ALJ recommended that the Board deny United Indian’s request for reconsideration. The ALJ appeared to change her view on the funding factor, stating: “Defendant's argument on Reconsideration with regard to funding is well made. The[ir] point [that] any monies lost through suit would not be available to [United Indian] to provide medical treatment to the tribes weighs in favor of sovereign immunity.” However, the ALJ’s overall assessment remained that United Indian had failed to establish its entitlement to sovereign immunity. Denying United Indian’s reconsideration request, the Board adopted and incorporated the ALJ’s report on reconsideration. The Board found no abuse of discretion in the ALJ’s rejection of United Indian’s claim of sovereign immunity. The Court of Appeal granted a petition for writ of review, and reversed the Boards decision in the unpublished case of United Indian Health etc. v. Workers' Comp. Appeals Bd. - A170950 - (May 2025). "No one Miami Nation factor of the five-factor test is dispositive." Whether sovereign immunity applies to an entity is a question of law reviewed de novo. (Miami Nation, supra, 2 Cal.5th at p. 250.) the Court of Appeal also applid the de novo standard when interpreting written instruments, except to the extent that the interpretation turns on conflicting extrinsic evidence. Considering both the law and the circumstances under which United Indian was formed (Miami Nation, supra, 2 Cal.5th at pp. 245-246), the method of creation factor weighs somewhat in favor of sovereign immunity. The ALJ concluded the tribes had no intent to share their sovereign immunity with United Indian. The record contained no tribal documents stating the tribes’ intent to extend sovereign immunity to United Indian. "However, that even absent express statements of a tribe’s intent, tribal intent may be inferred from the tribe’s actions or other circumstances." And as United Indian asserts, it may be possible to infer the intent to share tribal immunity based on the fact that the tribes established and sanctioned United Indian to provide healthcare services to tribe members under a federal system intended to further tribal self-governance. The Court of Appeal agreed with the ALJ that United Indian’s provision of health care serves a purpose central to tribal self-sufficiency and self-governance, weighing in favor of sovereign immunity The control factor also weighs in favor of sovereign immunity. The tribes participate in the management and control of United Indian in at least three respects. Finally, the financial relationship factor likewise weighs in favor of immunity. Miami Nation makes clear that where a judgment against the tribal entity would significantly reduce tribal resources, sovereign immunity is appropriate, even if the tribe’s treasury is not directly affected. "In sum, although there is no express evidence that United Indian’s participating tribes intended to share their immunity, the remaining factors reflect that United Indian is an arm of the tribes that it serves." ...

The owner of a San Jose-based security company, Raul Chavez, 40, was sentenced after a California Department of Insurance investigation uncovered a six year-long scheme to underreport payroll and avoid paying workers’ compensation insurance premiums. Chavez pleaded guilty to felony premium fraud, sentenced to 180 days in county jail, two years of formal probation, and ordered to pay $225,168 in restitution to the State Compensation Insurance Fund (State Fund). Chavez has paid his restitution and served his jail time on electric monitoring. “Premium fraud puts workers at risk and shifts the financial burden to honest employers who follow the law,” said Insurance Commissioner Ricardo Lara. “This case is a clear example of our commitment to protecting workers and holding those accountable who try to game the system. Thank you to the Santa Clara County District Attorney’s Office for their partnership and dedication in bringing this case to justice. ” Chavez owned and operated Tactical Operations Protective Services, a limited liability company providing security guard, staffing, and patrol services in Santa Clara County. The Department received a suspected fraud referral in September 2023 from State Fund alleging Chavez failed to report an employee injury that occurred in June 2022. The referral further alleged Chavez had significantly underreported payroll for multiple security guards over a six-year period. Although Chavez transported the injured worker to an emergency room on the date of the injury, he failed to notify State Fund or report the incident as required. The Department’s investigation revealed that from 2017 to 2022, Chavez had falsely claimed to State Fund that he had no employees or payroll. For the 2022 to 2023 policy year, he reported only $40,000 in payroll related to the injured employee. However, the Department’s audit uncovered that Chavez concealed $3,431,903 in payroll from 2017 through 2023. This underreporting resulted in an estimated $205,565 in unpaid workers’ compensation premiums owed to State Fund. The case was prosecuted by the Santa Clara County District Attorney’s Office ...

Abel Vazquez was employed as a seasonal agricultural worker by Inocensio Renteria on March 17, 2017, when he sustained an industrial injury to his left ankle and left calf, and claims to have sustained injury to his left lower extremity, psyche, and in the form of hypertension, diabetes, and hyperlipidemia. Ira Fishman, M.D., was selected as a QME to evaluate the compensability of applicant’s internal complaints, and issued two reports. Dr. Fishman initially evaluated applicant on May 21, 2021. On May 31, 2022, he issued a supplemental report following his review of additional records. On July 29, 2024, applicant requested a re-evaluation with Dr. Fishman.The next available evaluation date was for December 2, 2024, which was 127 days later. On August 5, 2024, defendant requested a replacement panel pursuant to AD Rules 31.3(e) and 31.5(a)(2), because the re-evaluation appointment with Dr. Fishman was scheduled more than 120 days from the date of applicant’s request. On August 15, 2024, applicant objected to the request for a replacement panel, arguing that the time limits only applied to initial evaluations and not to subsequent evaluations. Defendant responded to applicant’s letter by citing AD Rule 31.3(f) and arguing that the timeframes for QME appointments apply to both initial and subsequent evaluations. The Division of Workers’ Compensation (DWC) Medical Unit issued a replacement panel on September 12, 2024. Applicant objected, and the issue of whether a replacement panel was appropriate was set for trial. The WCJ found that defendant was entitled to a replacement panel due to the QME’s inability to set an appointment within 120 days. The WCAB sitting en banc (Lab. Code, § 115.) granted applicant's petition for reconsideration in the case of Vazquez v Inocensio Renteria -ADJ11017003 90 Cal.Comp.Case ___ (May, 2025). It rescinded the March 11, 2025 F&O and return the matter to the trial level for further proceedings. In doing so it held that: 1. Only the Appeals Board has jurisdiction to determine whether a replacement panel is valid or otherwise appropriate. 2. In a represented case, where a QME does not timely establish availability to set an appointment pursuant to AD Rule 31.3, a WCJ or the Appeals Board has discretion to order a replacement QME for good cause. The WCJ or the Appeals Board may consider the following: a. The length of delay caused by the QME’s unavailability. b. The amount of prejudice caused by the delay in availability versus the amount of prejudice caused by restarting the QME process. c. What efforts, if any, have been made to remedy the QME’s availability. d. Case specific factual reasons that justify replacing or keeping the current QME, including whether a party may have waived its objection. e. The Appeals Board’s constitutional mandate to “accomplish substantial justice in all cases expeditiously, inexpensively, and without incumbrance of any character.” (Cal. Const., art. XIV, § 4.) As explained in the decision, "when sections 4062.5 and 139.2(j)(1) are read together, a party’s statutory right to seek replacement of a QME in represented cases arises when the QME fails to timely issue a report following a medical evaluation. In represented cases, the determination of whether a QME should be replaced due to unavailability to set an evaluation is within the discretionary power of the Appeals Board, and a QME may be replaced where a party demonstrates good cause for the replacement." Application of this decision is prospective only ...

A former Westminster police officer has been charged with 15 felonies for allegedly stealing more than $600,000 in fraudulent workers’ compensation payments after she was caught dancing and drinking at the Stagecoach country music festival, skiing, running 5k races, and going to Disneyland all while claiming to be completely disabled due to a head injury she said she suffered while handcuffing a suspect. The former officer’s stepfather, a licensed attorney who practices workers’ compensation defense on behalf of insurance companies, has also been charged with two felonies for allegedly conspiring with his stepdaughter to orchestrate the fraudulent workers’ compensation scheme. Nicole Brown, 39, of Riverside, has been charged with nine felony counts of making a fraudulent statement to obtain compensation, six felony counts of making a fraudulent insurance benefit claim, and one felony enhancement of committing an aggravated while collar crime over $100,000. She faces a maximum sentence of 22 years in state prison if convicted on all counts. Brown’s stepfather, Peter Gregory Schuman, 57, of Buena Park, has been charged with one felony count of making a fraudulent insurance benefit claim and one felony count of assisting, abetting, conspiring with and soliciting a person in unlawful act. He faces a maximum sentence of eight years in state prison if convicted on all counts. As an attorney licensed by the State of California, he may also suffer discipline by the State Bar of California. On March 21, 2022, Brown was employed as a police officer with the Westminster Police Department when she suffered a minor abrasion to her forehead while attempting to arrest and handcuff an uncooperative suspect. She complained to her watch commander that she had a headache and was feeling dizzy, but an emergency room doctor who examined her that same day released her back to work without restrictions. After calling out sick for several days, on March 30, 2022, Brown was diagnosed with severe concussion syndrome and was taken off work by the doctor and placed on Total Temporary Disability (TTD). When police officers are injured on the job and unable to work, they may be entitled to Total Temporary Disability benefits under the workers’ compensation system. When an officer is temporarily disabled due to a work-related injury, the officer will receive their full salary, not just a percentage, for up to one year. The full salary of the officer for the first year is paid by the city, county, or state agency that employs the officer. If the officer is still temporarily disabled after the one-year period, they then transition to regular workers’ compensation TTD benefits and are paid at two-thirds of their average weekly wage, subject to a statewide maximum. These benefits can last up to 104 weeks within a five-year period. While out on Total Temporary Disability, Brown cost the city of Westminster more than $600,000, which included Brown’s full salary – tax-free – and her medical expenses. During her time on TTD Brown’s ongoing complaints were headaches, dizziness, sensitivity to light and noise, problems processing thoughts and words, and an inability to work on the computer or do any screentime. Despite her representations to doctors and the City of Westminster regarding her inability to work as a police officer due to her injury, on April 29, 2023, Brown was seen by several people who knew she was off work on total disability as she was dancing and drinking at the Stagecoach Music Festival, with more than 75,000 people in attendance with loud music and bright lights everywhere and temperatures in excess of 100 degrees. Her behavior was reported to the Westminster Police Department, which brought the case to the Orange County District Attorney’s Office, which launched an investigation into potential workers’ compensation fraud. Three days after the festival, Brown attended an interactive process zoom meeting to discuss what duties she could perform as a police officer. Brown’s stepfather, Peter Schuman, attended the meeting and advocated for Brown. During the meeting Brown claimed she was unable to look at the screen. Brown was sitting in a dark room. Schuman did all of the talking for Brown with respect to what she could or could not do , and stated she was unable to do paperwork, and was uncertain that she could do phone calls due to her inability to process words or thoughts. Schuman spoke for Brown during this meeting. After the meeting with Schuman, Brown was admitted to an in-patient center for individuals who have a traumatic brain injury. The investigation found that three days after the injury, when she called out sick, Brown allegedly went to an AYSO soccer conference, in San Diego, where she attended multiple sessions where PowerPoint presentations were utilized. While out on disability, Brown also ran in two 5K races, went snowboarding and/or skiing in Big Bear and Mammoth, went to three AYSO soccer conferences, attended baseball games, played golf, went to Disneyland, and took online courses with a local university. If convicted of a felony, Brown will forfeit any pension credits she accrued back to the date the felony was committed. Deputy District Attorney Katie Lubinski of the Insurance Fraud Unit is prosecuting this case ...

Alonzo McClanahan claimed workers’ compensation benefits for an alleged industrial injury to his right shoulder that occurred on July 25, 2017, while working at Employer DPR Construction (DPR). At the time its workers’ compensation carrier was National Union Fire Insurance Company. DPR's claims administrator denied the claim a few months later. The following year, McClanahan sought board adjudication of his claim. (§ 5500; Cal. Code Regs., tit. 8, § 10455.) Dr. Hanley was originally designated as the qualified medical evaluator and prepared two reports in that capacity in 2018 (the Hanley reports). He was later replaced as the qualified medical evaluator by Dr. Foglar and then by Dr. McGahan. After engaging in discovery, the parties participated in a mandatory settlement conference (§ 5502, subd. (d)), which was unsuccessful, so the matter was set for trial. The pretrial conference statement stipulated to Dr. McGahan as the qualified medical evaluator (§ 4062.2) and provided a list of exhibits, including reports by Dr. McGahan, but the Hanley reports were not included. At trial, McClanahan testified that his right shoulder was injured on the morning of July 25, 2017, while working for DPR (the 2017 injury). Specifically, he was “moving like 200 2-by-4s, 20-foot long, from one place to another” for four or five hours when the area between his shoulder and neck started to get stiff. He told his foreman that he couldn’t lift anymore with his shoulder hurting, and when he got off a few hours later, he told his superintendent that his “shoulder up in [his] neck” was sore. The superintendent asked him if he wanted to make a report, but McClanahan declined because he didn’t think it was that bad. But when McClanahan woke up the next day, his arm and shoulder were stiff. He went to a doctor that night who advised taking a few days off work because his shoulder may be overworked. McClanahan reported this to DPR, but he did not see a workers’ compensation doctor until August 10, 2017. In his view, DPR caused the delay. Three DPR employees disagreed with McClanahan’s account. Both the foreman and the superintendent stated that McClanahan did not report an injury to them on July 25, 2017. And the DPR safety manager who prepared the incident report testified that to his knowledge, McClanahan did not report an injury to anyone on July 25, 2017. DPR’s evidence included the employee sign out sheet for July 25, 2017, that indicated McClanahan signed out at 3:00 p.m. and checked the box indicating he was not injured.1 The safety manager also testified he made several attempts to take McClanahan to the workers’ compensation clinic between July 27, 2017, and August 7, 2017, in accordance with DPR policy, but McClanahan never showed up. In a deposition, McClanahan testified DPR was the first place he ever had right shoulder pain, but at trial he admitted he suffered an industrial injury below his right elbow in 2013, a few years before working for DPR (the 2013 injury), and felt pain in his right shoulder as a result. He also testified he never went to a doctor for right shoulder pain before July 2017, but medical records showed that he sought or obtained care for shoulder pain or strain several times between 2013 and 2015, had an MRI of his right shoulder in 2014, and was diagnosed with a right shoulder condition in 2015. The records also indicated that he sought treatment for impingement in the right shoulder after a tree branch fell on it in 2015, but McClanahan could not remember a tree ever falling on his shoulder. According to Dr. McGahan’s evaluation, McClanahan sustained “an industrial injury to his right shoulder arising out of and caused by the industrial exposure of July 25, 2017.” Dr. McGahan found it clear that McClanahan had preexisting right shoulder pathology but concluded it was “medically probable that [McClanahan’s] work duties on July 25, 2017, contributed to a worsening of his right shoulder pain.” In a supplemental report, Dr. McGahan stated that if “McClanahan is not a credible witness, then this certainly would call into question the credibility of his claim. Under this circumstance, the incident of July 25, 2017, may simply represent an exacerbation of his prior industrial injury rather than aggravation. Over DPR’s objection, the workers’ compensation judge (WCJ) admitted the Hanley reports because DPR had received them before the mandatory settlement conference. In the first report, Dr. Hanley noted that some of McClanahan’s providers were suspicious about the validity of his complaints. In a supplemental report, Dr. Hanley concluded the “red flags” in McClanahan’s history were no longer of concern. Based on McClanahan’s “credible testimony, the treatment records, and the findings by QME Dr. McGahan,” the WCJ concluded that McClanahan sustained an injury to his right shoulder arising out of and in the course of employment on July 25, 2017. After reconsideration, the WCAB affirmed the WCJ’s determination on August 22, 2024 in a two-to-one decision. The affirming board members found that McClanahan erred by omitting the Hanley reports from the pretrial conference statement but concluded the error was harmless for two reasons: (1) the WCJ did not rely on the Hanley reports to find the industrial injury; and (2) the WCJ retains the discretion to determine if evidence should be admitted into the record as a matter of due process. The Court of Appeal agreed to hear the case, and after it's review annulled the board’s decision and remanded for further proceedings in the unpublished case of DPR Construction v. Workers' Compensation Appeals Board CA3 - C100254- (May 2025). On appeal, Petitioners contend the board exceeded its powers in two ways: (1) by failing to state the reasons for finding McClanahan credible and (2) by admitting two medical reports that were not listed in the pretrial conference statement. The Court of Appeal disagreed with petitioners as to the first contention but agreed as to the second. In workers’ compensation proceedings, discovery closes on the date of the mandatory settlement conference. ( at p. 1164; § 5502, subd. (d)(3).) If the claim is not resolved at the conference, the parties must file a pretrial conference statement noting the specific issues in dispute, listing the exhibits, and disclosing witnesses. (§ 5502, subd. (d)(3); Cal. Code Regs., tit. 8, § 10759, subd. (b).) Evidence not disclosed or obtained thereafter is not admissible unless the proponent can demonstrate it was not available or could not have been discovered by the exercise of due diligence before the settlement conference. (§ 5502, subd. (d)(3).) The purpose of this requirement is two-fold: (1) to “eliminate the element of surprise in workers’ compensation proceedings” and (2) “ ‘ “ ‘to guarantee a productive dialogue leading, if not to expeditious resolution of the whole dispute, to thorough and accurate framing of the stipulations and issues for hearing.’ ” ’ ” (Telles Transport, Inc. v. Workers’ Comp. Appeals Bd. (2001) 92 Cal.App.4th 1159, at pp. 1164, 1167.) The board abuses its discretion when it relieves a party from the sanctions of section 5502 without that party showing good cause. (San Bernardino Community Hospital v. Workers’ Comp. Appeals Bd. (1999) 74 Cal.App.4th 928, 938. Section 5502 establishes the “bounds of discretion in the [WCJ] for keeping discovery open after the mandatory settlement conference.” (County of Sacramento v. Workers’ Comp. Appeals Bd. (1999) 68 Cal.App.4th 1429, 1433.) “[D]isregard for the statutory procedural mechanisms for resolving workers’ compensation cases is inappropriate.” (Ibid.) Such disregard is not subject to harmless error analysis. (San Bernardino, supra, 74 Cal.App.4th at p. 938.) ...

Stephen D. Meis, M.D., 73, formerly of Visalia, pleaded guilty to one count of introduction of misbranded drugs into interstate commerce. According to court documents, Meis was the Medical Director of Golden Sunrise Pharmaceutical Inc. and Golden Sunrise Nutraceutical Inc. that manufactured, marketed, and sold products claiming to effectively treat a variety of medical conditions. Beginning on March 30, 2020, Meis and Golden Sunrise’s Chief Executive Officer Huu Tieu, 62, of Porterville, began selling a set of herbal mixtures they called the “Emergency D-Virus Plan of Care” as a COVID-19 treatment. The treatment consisted of a box containing various vials of Golden Sunrise drug products, including one called “Imunstem,” together with an “Emergency D-Virus Plan of Care” information sheet. Meis and Tieu mailed the products to various practitioners, public officials, and other individuals both inside and outside of California. The labeling for the drugs, including the information sheet that accompanied the drugs, was false and misleading and stated that ImunStem and other Golden Sunrise products were “uniquely qualified to treat and modify the course of the virus epidemic in China and other countries.” Golden Sunrise falsely claimed the products had been the first dietary supplement in the United States to be approved as a prescription medicine by the U.S. Food and Drug Administration (FDA) to treat the COVID-19 virus. In fact, the drugs were not FDA approved, and no Golden Sunrise product had ever been approved by the FDA for any purpose. On June 12, 2024, Tieu was sentenced to 18 months in prison for introduction of misbranded drugs into interstate commerce. Meis is scheduled to be sentenced by U.S. District Judge Jennifer L. Thurston on July 14, 2025. Meis faces a maximum statutory penalty of 12 months in prison and a $100,000 fine. The actual sentence, however, will be determined at the discretion of the court after consideration of any applicable statutory factors and the Federal Sentencing Guidelines, which take into account a number of variables. This case is the product of an investigation by the FDA Office of Criminal Investigations, the U.S. Department of Health and Human Services Office of Inspector General, and the Federal Bureau of Investigation with assistance from the Tulare County District Attorney’s Office. Assistant U.S. Attorneys Jeffrey A. Spivak and Emilia P.E. Morris are prosecuting the case ...

In March 2017, Kelly Rose, a former employee of Hobby Lobby Stores, Inc., notified the California Labor and Workforce Development Agency (LWDA) and Hobby Lobby that she intended to seek civil penalties under PAGA on behalf of herself, the State of California, and other hourly-paid individuals who were employed by Hobby Lobby in California as cashiers or who were assigned cashier duties. Rose’s claims were based on allegations that Hobby Lobby violated the so-called “suitable seating” provisions of Industrial Welfare Commission Wage Order No. 7-2001 by not providing seats for cashiers. (Cal. Code Regs., tit. 8, § 11070, subds. 1, 14.) After the statutory deadline for the LWDA to respond to the notice had passed, Rose filed a civil action against Hobby Lobby alleging two causes of action based on the facts and theories alleged in her PAGA notice. The litigation proceeded for several years, and eventually a bench trial was held that resulted in a judgment for Hobby Lobby on both causes of action. In a separate appeal, the Court of Appeal affirmed the judgment. (Rose v. Hobby Lobby Stores, Inc. (March 25, 2025, A168301) [nonpub. opn.].) After judgment was entered, Hobby Lobby filed a memorandum of costs totaling $474,707.80. The trial court issued an order inviting the LWDA, which had not participated in the litigation, to file an amicus brief addressing its liability for an award of costs to a prevailing defendant in a PAGA action. At the trial court’s direction, Hobby Lobby served the order on the LWDA, at which point the LWDA first learned of Hobby Lobby’s attempt to recover its costs. The LWDA then filed a motion to intervene, which the trial court granted. The trial court concluded that the LWDA is responsible for costs incurred by defendants who prevail on PAGA claims, but struck certain cost items that Rose had challenged, resulting in an award of costs against the LWDA in the amount of $124,585.24. The LWDA timely appealed from the costs order. The trial court did not award Hobby Lobby any costs against Rose, and Rose is not a party to this appeal. The LWDA appealed, raising an issue of first impression: Is the LWDA liable for the litigation costs incurred by a prevailing defendant in an action filed under PAGA? The Court of Appeal concluded that costs are not recoverable against the LWDA where it did not participate in the litigation. Accordingly, it reversed the trial court costs order in the published case of Rose v. Hobby Lobby Stores CA1/2 - A169640 (May 2025). In seeking costs from the LWDA, Hobby Lobby relied on Code of Civil Procedure §1032(b), the general cost-recovery statute, which provides that a prevailing party is entitled to recover its costs “[e]xcept as otherwise expressly provided by statute,” and Code of Civil Procedure section 1028, which provides that when the State is a party to an action costs are “awarded against it on the same basis as against any other party.” PAGA provides that “[a]ny employee who prevails in any action shall be entitled to an award of reasonable attorney’s fees and costs” (Lab. Code, § 2699, subd. (k)(1)), but says nothing about prevailing employers. Hobby Lobby argues that in view of the guidance provided by our Supreme Court in Murillo v. Fleetwood Enterprises, Inc. (1998) 17 Cal.4th 985, 989 for interpreting so-called “one-way” fee and cost shifting statutes like the one in PAGA, the Court of Appeal should conclude that PAGA does not contain an express exception to section 1032(b) and therefore as a prevailing defendant Hobby Lobby is entitled to recover its costs. In Murillo, the Supreme Court construed a fee and cost shifting provision in the Song-Beverly Act (Civ. Code, § 1790 et seq), California’s automobile “lemon law,” which expressly permits a prevailing plaintiff-buyer to recover costs and attorney fees but is silent with respect to a prevailing defendant-seller. Murillo held that silence does not create an express exception to section 1032(b); therefore, a prevailing defendant-seller in a case brought under the Song-Beverly Act is entitled to recover its costs under section 1032(b). (Id. at p. 991.) The LWDA argues that legislative history shows that Labor Code section 2699, subdivision (k)(1) was intended to displace the general cost recovery rule of section 1032(b), and that Murillo, which concerns a consumer protection statute rather than a provision of the Labor Code, is inapposite. Hobby Lobby argued unpersuasively that the LWDA was nevertheless a party to Rose’s action from its commencement because Rose filed her PAGA suit as the LWDA’s agent, and that under Civil Code section 2330 the LWDA, as principal, is responsible for the acts and liabilities of its agent. "The LWDA did not sue Hobby Lobby. The LWDA was not a party to Rose’s lawsuit, nor did it take any action in the lawsuit until it moved to intervene, which it did only after it got word that Hobby Lobby sought to impose its costs on the LWDA. Accordingly, Hobby Lobby cannot recover its costs from the LWDA." "Because we conclude that the LWDA was not a party to Rose’s PAGA action, Code of Civil Procedure section 1028, which provides that when the State is a party costs are to be awarded against it on the same basis as against any other party, has no application here." "Hobby Lobby also argues that even if the LWDA was not a party to Rose’s PAGA action, it is liable for costs as the real party in interest. This argument is unpersuasive because Hobby Lobby cites no case in which litigation costs were imposed against a real party in interest that did not participate in the litigation." ...

The California Trucking Association (CTA) filed a lawsuit in November 2019 in the U.S. District Court for the Southern District of California challenged the application of California’s Assembly Bill 5 (AB 5) to the trucking industry, specifically arguing that it violates the Dormant Commerce Clause of the U.S. Constitution, among other claims. AB 5, enacted in 2019 and effective January 1, 2020, codified the "ABC test" to determine whether workers are classified as employees or independent contractors. The "B" prong of the test, which requires that a worker perform work outside the usual course of the hiring entity’s business to be considered an independent contractor, effectively prohibits the traditional leased owner-operator model in trucking, as owner-operators’ work (hauling freight) is central to a motor carrier’s business. Plaintiffs argued that AB 5 was preempted by the Federal Aviation Administration Authorization Act of 1994 (FAAAA), which prohibits states from enacting laws affecting a motor carrier’s prices, routes, or services. The Dormant Commerce Clause and Equal Protection Clause were also cited as grounds for challenge. On December 31, 2019, District Judge Roger Benitez granted a preliminary injunction, halting AB 5’s enforcement against the trucking industry, finding that the law likely violated FAAAA preemption by restricting motor carriers’ ability to use independent contractors, a core component of interstate trucking. The Ninth Circuit Court of Appeals reversed this injunction in its April 2021 published opinion, ruling that AB 5 was a generally applicable labor law that did not sufficiently impact prices, routes, or services to be preempted by the FAAAA. The injunction remained in place pending further appeals. The U.S. Supreme Court declined to review the case in June 2022, returning it to the Southern District of California and dissolving the injunction. The Owner-Operator Independent Drivers Association (“OOIDA”) is the international trade association representing the interests of independent owner-operators and professional drivers on all issues that affect truckers. More than 150,000 members of OOIDA are men and women in all 50 states and Canada who collectively own and/or operate more than 240,000 individual heavy-duty trucks and small truck fleets. Its national headquarters is located on the outskirts of Kansas City, in Grain Valley, MO. OOIDA joined the litigation in 2022 as an intervenor, focusing on the interests of small-business truckers, particularly those operating interstate. After the Supreme Court’s denial, CTA and OOIDA filed renewed motions for a preliminary injunction, combining arguments on FAAAA preemption, the Dormant Commerce Clause, and Equal Protection. They contended that AB 5’s ABC test, by effectively banning leased owner-operators, imposed an undue burden on interstate commerce, violating the Dormant Commerce Clause. This clause, inferred from Article I, Section 8 of the U.S. Constitution, prohibits states from enacting laws that discriminate against or excessively burden interstate commerce. On March 15, 2024, Judge Benitez rejected the renewed motions for a preliminary injunction, ruling against CTA and OOIDA on all claims. He concluded that AB 5 did not violate the Dormant Commerce Clause, as it lacked discriminatory intent or effect favoring California truckers over out-of-state truckers. Without such discrimination, the court declined to engage in Pike balancing, noting that only a “small number of cases” have found nondiscriminatory burdens substantial enough to violate the clause. In August 2024, the CTA announced it would not pursue further appeals, ending its four-and-a-half-year legal battle. OOIDA continued the fight, filing an appeal with the Ninth Circuit in August 2024. Their brief focused on the Dormant Commerce Clause, arguing that AB 5’s ABC test “effectively prohibits an entire sector of small business truckers” from operating as independent contractors in California, creating a significant burden on interstate commerce. They also reiterated the Equal Protection claim, citing the B2B exemption’s incompatibility with federal regulations. California’s Attorney General responded in November 2024, asserting that AB 5 does not prohibit owner-operators outright and that its regulatory costs do not trigger Pike balancing. The state argued that the law’s intent was to protect workers, not to discriminate against interstate commerce. On May 16, 2025 the Court of Appeals for the 9th Circuit issued an unpublished Memorandum Opinion in the case of Owner-Operator Independent Drivers Association, Inc. v. Bonta - Case # 3:18-cv-02458-BEN-DEB. It concluded - among other findings - that "AB 5 does not violate the dormant Commerce Clause. “The dormant Commerce Clause is not a roving license for federal courts to decide what activities are appropriate for state and local government to undertake, and what activities must be the province of private market competition.” United Haulers Ass’n, Inc. v. Oneida-Herkimer Solid Waste Mgmt. Auth., 550 U.S. 330, 343 (2007). " ...

Community Health System and its affiliate Physician Network Advantage Inc. have agreed to pay $31.5 million to the United States to resolve allegations that they violated the False Claims Act based on financial benefits provided to referring physicians. Community Health System operates in Fresno County and includes hospitals Community Regional Medical Center and Clovis Community Medical Center. The civil settlement resolves allegations that Community Health System and Physician Network Advantage Inc. (PNA) provided several types of extravagant benefits to induce physicians in the Fresno area to refer their patients to Community facilities for medical services, in violation of the False Claims Act. PNA is a health care technology business formed and funded by Community to support Fresno-area physicians’ adoption of the electronic health records platform used by Community. The United States contends that PNA also played a key role in securing business for Community by unlawful means. In a custom-built lounge located on premises at PNA’s offices, known as HQ2, PNA provided expensive wine, liquor, cigars, and meals to referring physicians, with the knowledge and funding of Community. The settlement also resolves allegations that Community and PNA provided financial subsidies for electronic health records technology and equipment used by certain physicians in their private offices in return for the referral of governmental health care program patients to Community. Further, the settlement resolves allegations that Community paid bonuses to certain physicians ostensibly for participation in clinical integration activities, when the real purpose of the bonuses was to reward referrals. The United States contends that these financial benefits violated the federal Anti-Kickback Statute, resulting in false claims for the medical services referred by physicians receiving the benefits, that were submitted to governmental health care programs. The United States also contends that the conduct described above created financial relationships with referring physicians under the Physician Self-Referral Law (known as the “Stark Law”). The Stark Law seeks to safeguard the integrity of the Medicare program by prohibiting a hospital from billing for certain services referred by physicians with whom the hospital has a financial relationship, unless that relationship satisfies one of the law’s statutory or regulatory exceptions, which the United States contends were not met. In connection with the settlement, Community entered into a five-year Corporate Integrity Agreement with HHS-OIG that requires, among other conditions, the implementation of a risk assessment and internal review process designed to identify and address evolving compliance risks. The Corporate Integrity Agreement also requires an independent review organization to annually assess the policies and systems to track arrangements with some referral sources. The settlement includes the resolution of claims brought under the qui tam or whistleblower provisions of the False Claims Act by relator Michael Terpening. Under those provisions, a private party can file an action on behalf of the United States and receive a portion of any recovery from that action. The qui tam case is captioned United States ex rel. Terpening v. Fresno Community Hospital and Medical Center, et al., 1:19-CV-01699 (E.D. Cal.). As part of the settlement announced today, Mr. Terpening will receive approximately $5 million. The resolution obtained in this matter was the result of a coordinated effort between the U.S. Attorney’s Office for the Eastern District of California and HHS-OIG with assistance from the Federal Bureau of Investigation and the U.S. Postal Service Office of Inspector General. Assistant U.S. Attorney David Thiess handled the case for the U.S. Attorney’s Office. The claims resolved by this settlement are allegations only, and there has been no determination of liability ...

The Ventura County District Attorney Erik Nasarenko announced that Nitun “Nate” Dayalghai Ahir (DOB 06/17/81), of Thousand Oaks, was arraigned for practicing medicine without a license, in violation of Business and Professions Code section 2052. Ahir was out on bail in case number 2024030574, in which he is alleged to have practiced medicine without a license and represented himself as a doctor at Regen Spine & Nerve, in Ventura, when the District Attorney’s Office received complaints that Ahir was continuing to practice medicine without a license. In his new case, Ahir is alleged to have unlawfully provided medical services to victims only days after being arraigned in case 2024030574. He is further charged with using the term “Doctor” and the prefix “Dr.” to imply he is a licensed medical professional when he is not. Judge David Hirsch explicitly made a condition of Ahir’s bail that he may not practice medicine, solicit medical business, attempt to treat patients, or receive compensation for any form of medical work, or he faces remand into custody. According to the California Department of Consumer Affairs, Ahir is not licensed in any capacity – as a doctor, surgeon, nurse, nurse practitioner, chiropractor, or otherwise – in the State of California, nor is he a licensed physician in any other state. The District Attorney requests that any member of the public who Ahir has attempted to treat contact Investigator Eric Jensen at Eric.Jensen@ventura.org or by calling 805-662-1739. The public is urged to review the licensure status of any medical professionals they are considering seeing by visiting the Department of Consumer Affairs' professional This case was investigated by the Department of Consumer Affairs, Health Quality Investigations Unit. Both of Ahir’s cases are set for early disposition conference on June 25, 2025, at 1:30 p.m. in Courtroom 12 of the Ventura County Superior Court. He remains out of custody on $50,000 bail ...