Rene Thomas Folse, JD, Ph.D. is the host for this edition which reports on the following news stories: Court of Appeal Again Limits WCAB Jurisdiction on Reconsideration to 60 Days. Applicant Attorneys Battle Out Law Practice Sale Fee Split in En Banc Case. No Pay for Uninsured Contractor Even After Retroactive Reinstatement. After 9 Years, 3 Jury Trials, 2 Appeals – Attorney Fees are Far More Than Award. Special Shout-Out for Floyd Skeren Partner for Defense of $75M Civil Claim. Cal/OSHA Cites 9 Employers $168K For Silica Health and Safety Violations. VA Hospitals’ Quality Ratings Continue to Outperform Private Sector. American Academy of Physician Associates Calls Out AMA Turf War.
Congress passed the Ryan Haight Online Pharmacy Consumer Protection Act in 2008, which requires the DEA, in conjunction with HHS, to promulgate permanent rules to allow practitioners to prescribe certain controlled medications via telehealth through a special registration pathway.
As of today, the agency still had not done so. In the advent of the Public Health Emergency, the DEA allowed DEA-registered practitioners to issue prescriptions for certain controlled substances to patients via telemedicine without requiring an in-person medical evaluation. The DEA authorization was temporary and is set to expire at year-end.
The American Telemedicine Association reports that these flexibilities have been a lifeline for countless individuals across the country, ensuring uninterrupted access to essential mental health care, substance use treatment, end-of-life care, and many other crucial treatments during a time when in-person visits were impossible or unsafe.
The ongoing challenges in accessing mental health and substance use treatment services, particularly in rural and underserved areas, underscore the importance of maintaining these flexibilities. More than half of U.S. counties do not have a psychiatrist. The shortage is even more prominent in rural areas, with nearly three quarters of rural counties lacking a psychiatrist. Telemedicine has proven to be an effective tool in bridging the gap between patients and providers, reducing barriers to care, and supporting those most in need. At its pandemic peak, telehealth represented 40% of mental health and substance use outpatient visits, and still remains strong, representing 36% of outpatient visits currently.
Given the widespread provider shortage across medical professions and specialties, this flexibility has been essential in ensuring that patients receive timely and necessary care. Continuing these practices is vital to sustaining access to treatment and addressing the ongoing healthcare challenges in underserved areas.
For these reasons, this week, more than 330 stakeholder organizations asked Congress and the White House to intervene to ensure ongoing access to remote prescribing of controlled substances. The letters were co-led by the American Telemedicine Association (ATA) and ATA Action alongside other like-minded partners and organizations. Stakeholders anticipate, based on current reporting, that the Drug Enforcement Administration (DEA) will dramatically limit virtual prescribing, either through new regulations or by allowing the existing flexibilities to expire at year-end.
“This is a predictable and preventable crisis that is looming come January 1 and we are quickly running out of time to save countless patients from being abandoned, left without lifesaving clinically appropriate care,” said Kyle Zebley, the ATA’s senior vice president, public policy, and executive director, ATA Action. “With each day, we are losing precious time the DEA needs to properly develop a rule that appropriately permits and regulates the prescribing of controlled substances through telehealth without jeopardizing the health and safety of Americans, especially those in underserved communities.”
Specifically, the letters to House and Senate leaders urge Congress to include a two-year extension of pandemic-era remote prescribing flexibilities for controlled substances in an end-of-year legislative package.
The letter to the White House recommends that the Biden Administration work with the DEA and other relevant agencies to use existing authorities to extend these flexibilities for two years, providing the DEA with additional time to fulfill its congressional mandate to establish a special registration pathway that balances access to medically necessary care with appropriate enforcement.
“President Biden has already pledged to do all he can to protect all Americans, especially those who are vulnerable, from losing access to vital healthcare services, and we are grateful for the Administration’s longstanding commitment to establishing telehealth as a permanent part of care delivery,”
Zebley added. “It’s in the hands of our policy champions in the Administration and Congress to safeguard the American people, create predictability for our providers, and modernize our healthcare system to make sure patients receive timely and necessary care. We continue to stand ready to work with policymakers to make telehealth a permanent option in a modernized healthcare system.”
The American Hospital Association (AHA) released a new report finding that hospital and health system performance on key patient safety and quality measures was better in the first quarter of 2024 than it was before the COVID-19 pandemic, and that hospitals made these improvements while caring for patients with more significant health care needs.
For the report, Vizient provided a risk-adjusted analysis of data from a wide spectrum of 715 general acute care hospitals across 49 states and the District of Columbia with data from the fourth quarter of 2019 through the first quarter of 2024. The 2023 and 2024 data provide a timelier snapshot on hospitals’ performance on key measures compared to some other reports that often use older or outdated data.
Key findings from the report include:
– – Despite being sicker and having more complex conditions, hospitalized patients in the first quarter of 2024 were on average over 20% more likely to survive than expected given the severity of their illnesses compared to the fourth quarter of 2019.
– – Based on Vizient’s analysis, the AHA using national hospitalization data projects that while caring for sicker patients, hospitals’ efforts to improve safety led to 200,000 Americans hospitalized between April 2023 and March 2024 surviving episodes of care they wouldn’t have in 2019.
– – Hospitals cared for more patients overall in the first quarter of 2024 than in the last quarter of 2019, including providing care to a sicker, more complex patient population.
– – Hospitals’ central line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract (CAUTI) infections in the first quarter of 2024 were at rates lower than those recorded in 2019.
– – Not only did multiple key preventive health screenings rapidly rebound to pre-pandemic levels, but ongoing improvement has led to a 60%-to-80% increase in breast, colon and cervical cancer screenings compared to 2019.
“Hospitals and health systems are continuously working to advance patient safety and quality – which is always the hospital field’s top priority,” said AHA President and CEO Rick Pollack. “This report shows hospitals have made significant improvements on pre-pandemic performance in key patient safety outcomes. Hospitals’ commitment to improving patient outcomes and enhancing the patient experience continues to drive these efforts forward.”
“The data in this report underscore the resilience and unwavering commitment of hospitals and health systems – and the millions of hospital team members across the country – to delivering better care and outcomes to the patients and communities they serve,” said AHA Chief Physician Executive and Senior Vice President Chris DeRienzo, M.D. “While hospitals are proud of the progress they continue to make, they also recognize that there is still work to be done.”
“The recent findings from the American Hospital Association highlight the critical role of data in understanding hospital performance on essential patient safety and quality measures,” said Vizient Chief Medical Officer David Levine, M.D.
On March 8, 2018, Tatyana Litvinova filed a putative collective-action complaint against the City and County of San Francisco alleging that the City violated the Fair Labor Standards Act by not paying staff nurses time-and-a-half for overtime work, including per diem shifts. Litvinova v. City and County of San Francisco, No. 3:18-cv-1494-RS (N.D. Cal.). She moved to certify a collective action under 29 U.S.C. § 216(b), and the district court granted the motion.
On October 22, 2020, Kristen Silloway, Christa Duran, and Brigitta van Ewijk filed a similar complaint on behalf of themselves and “similarly situated dual-status registered nurses.” Silloway v. City and County of San Francisco, No. 3:20-cv-7400-RS (N.D. Cal.). Given the factual similarity between the two cases, the district court issued an order treating them as related. Between the two separate collective actions, a total of about 353 plaintiffs opted in.
On cross-motions for summary judgment, the district court granted summary judgment in favor of the City, concluding that the staff nurses were paid on a “salary basis” and therefore exempt from the FLSA overtime requirements. Litvinova v. City and County of San Francisco, 615 F. Supp. 3d 1061, 1069 (N.D. Cal. 2022). The district court treated the published salary ordinance, which referred to staff nurses as salaried employees, as “dispositive evidence” that the nurses were compensated on a salary basis. The district court found the nurses’ hourly pay rates to be a mere “accounting fiction” used for administrative purposes, and it rejected plaintiffs’ allegations of improper pay deductions by finding that the City’s expert report provided adequate explanations for those discrepancies.
Silloway timely appealed the district court’s decision. Litvinova filed a Motion for Reconsideration under Federal Rules of Civil Procedure 59 and 60 and then, after it was denied, timely appealed as well.
The United States Court of Appeals for the 9th Circuit consolidated the two appeals for argument and decision. It reversed the grant of the summary judgment motion in favor of the City in the published case of Kristen Silloway, et.al. v City and County of San Francisco 22-16079 (September 2024).
The City of San Francisco employs staff nurses in its hospitals, jails, and clinics. Many work more than 40 hours in a week. The Fair Labor Standards Act provides that employees should generally receive time-and-a-half pay for working overtime, but one of the Act’s exemptions from that requirement applies to employees working in a bona fide professional capacity. The City claims that staff nurses fall into that exemption. The plaintiffs disagree.
The 9th Circuit concluded that the district court erred in granting summary judgment to the City. The salary ordinance, which the district court found to be dispositive evidence that the staff nurses were paid on a salary basis, is neither the starting point nor the ending point for that inquiry. Rather, the salary basis test asks whether an employee actually receives a predetermined amount of compensation on a weekly or less frequent basis as a matter of practice. In this case, the parties dispute several factual issues that are material to answering that question.
The most significant is whether staff nurses are guaranteed the opportunity to work the hours corresponding to their full-time equivalency every week. According to an expert report submitted by the City itself, the City recorded staff nurses as working or being credited for fewer hours than their full-time equivalencies in at least 72 employee pay periods out of more than 2,200 reviewed.
Because staff nurses are paid according to the number of hours they are recorded as working or otherwise credited, it is uncertain whether staff nurses received their predetermined amounts of compensation during these irregular pay periods.
Additionally, the FLSA’s “actual practice” and “window of correction” provisions offer the City no refuge, at least on summary judgment. Assuming that the 72 abnormal pay periods represent improper deductions – as must be done in reviewing a grant of summary judgment against the plaintiffs – the City made improper deductions much more frequently than in cases where courts have found that no “actual practice” existed.
Questions about the propriety of these 72 deductions leave material factual issues in dispute as to whether the City maintained an “actual practice” of making improper deductions. As for the “window of correction” defense, the City has not provided evidence showing that the staff nurses were reimbursed for any of these possibly improper deductions, so summary judgment cannot be granted or affirmed on that ground, either.
The panel reversed the district court’s summary judgment for the City and County of San Francisco, and remanded, in both cases.
The emergence of medical innovations, new technologies and cutting-edge procedures spurred most of the annual changes presented in the release of the Current Procedural Terminology (CPT®) 2025, the nation’s uniform data-sharing code set for medical procedures and services published by the American Medical Association (AMA).
“The CPT code set is the foundation for the efficient and effective exchange of standardized information in a data-driven health system, facilitating the reporting, measuring, analyzing, researching, and benchmarking of medical services and procedures with the goal of delivering better patient care, improved outcomes and lower costs,” said AMA President Bruce A, Scott, M.D. “The latest updates to the CPT code set reflect advancements in contemporary clinical practice and ensures the code set fulfills its vital role as the trusted universal language of medicine.”
There are 420 overall updates in the CPT 2025 code set, including 270 new codes, 112 deletions, and 38 revisions. The CPT code set continues to expand in new areas of medicine with proprietary laboratory analyses assigned to the largest proportion of new codes (37%), mostly for novel genetic testing. Category III CPT codes for emerging medical services accounted for about a third of new codes (30%).
Updates to the CPT code set are considered through an open editorial process managed by the CPT Editorial Panel, an independent body convened by the AMA that collects broad input from the health care community and beyond to ensure CPT content reflects the demands of a modern health care system. This rigorous editorial process keeps the CPT code set current with contemporary medical science and technology so it can fulfill its vital role as the trusted language of medicine today and the code to its future.
Key updates in the CPT 2025 code set include:
– – Digital medicine – Remote therapeutic monitoring (RTM) services were editorially revised. Code 98975 was updated to include digital therapeutic intervention, while codes 98976-98978 were revised to include device supply for data access or data transmissions to support RTM of patients.
– – Augmented/Artificial Intelligence (AI) – The AI Taxonomy introduced in 2023 has been implemented in category III CPT codes to classify AI medical services and procedures as assistive, augmentative, or autonomous based on the work performed by the AI application on behalf of the physician or other qualified health care professional (QHP). Seven category III code have been established for AI augmentative data analysis involved in electrocardiogram measurements (0902T and 0932T), medical chest imagining (0877T-0880T), and image-guided prostate biopsy (0898T).
– – General surgery – Updates were made to CPT’s general surgery section to reflect novel approaches in skin grafts for wound care and recovery (15011-15018) and advancements in surgical techniques for the elimination of tumors within the abdomen (49186-49190).
The AMA invites the health care community to the world’s only medical coding event delivered by the authority on the CPT code set. Get guidance on the updates for the CPT 2025 code set by virtually attending the CPT & RBRVS 2025 Annual Symposium in November.
Coding books and products are available from the AMA Storefront on Amazon, including the CPT 2025 Professional Edition codebook. CPT data products, including the CPT 2025 Standard Data File, are available via the AMA Intelligent Platform.
Rene Thomas Folse, JD, Ph.D. is the host for this edition which reports on the following news stories: Supreme Ct. Increases Scope of Discovery Sanctions in $2.5M Example. Jury Finds Infamous Plaintiff Lawyer Tom Girardi Guilty of Defrauding Clients. Appellate Case Shows Web of Entities in Biggest Comp Fraud Schemes. SoCal Federal Whistleblower Pilot Program to Flesh Out High-Level Crimes. Man Sentenced to 7 Years for Defrauding Buyers of Medical-Grade Gloves. Fresno Acupuncturist Agrees to $850,000 Healthcare Fraud Settlement. 2,325 People Died From Heat Last Year, Mostly In The Desert Southwest. Cal/OSHA Bolsters Staff to Investigate the Most Egregious Violations.
Anna Nicole Smith was an American model, actress and television personality. On February 8, 2007, Smith was found dead at the Seminole Hard Rock Hotel and Casino in Hollywood, Florida. Broward County Medical Examiner and Forensic Pathologist Dr. Joshua Perper announced that Smith died of “combined drug intoxication” with the sleeping medication chloral hydrate as the “major component.”
Dr. Perper claimed that Dr. Khristine Elaine Eroshevich, an Encino psychiatrist had issued 11 prescriptions to Smith. Eroshevich was with Smith when she checked into the Florida hotel, where she later died. More than 600 pills – including about 450 muscle relaxants – were missing from prescriptions that were no more than five weeks old.
Eroshevich also is the teal party in interest and lien claimant who seeks payment for services rendered to workers’ compensation claimants in approximately 1,100 lien claims. Much of the history in this case appears in a 2020 Opinion and Decision After Reconsideration in her consolidated cases.
On September 23,2009, Dr. Eroshevich was charged with six felony counts. On October 28,2010, and after more than two months of trial, Dr. Eroshevich was found guilty by a jury of Count 7, conviction for prescription fraud.
On October 12, 2011, The Medical Board of California, Department of Consumer Affairs issued an accusation against Dr. Eroshevich seeking disciplinary action pursuant to Business and Professions Code section 2236, based on her conviction for “a crime substantially related to the qualifications, functions, or duties as a physician and surgeon.”
On January 19, 2012, the California Attorney General and Dr. Eroshevich entered into a Stipulated Settlement and Disciplinary Order (Medical Board Stipulation) based on the First and Sixth cause for discipline. The Stipulation contains the following reservation: “The admissions made by Respondent herein are only for the Pgrpgse.s of this proceeding, or any other proceedings in which the Medical Board of California or other professional licensing agency is involved, and shall not be admissible in any other criminal or civil proceeding.”
On May 6,2016, the Medical Board terminated probation and reinstated Dr. Eroshevich’s license based on good cause pursuant to Business and Professions Code section 2307 and California Code of Regulations, title 16, section 1360.2.
On February 16,2018, the Chief Judge of the Department of Workers’Compensation issued a Consolidation and Order Staying Liens.On March 14, 2018, lien claimant filed a response to the Consolidation Order requesting that her suspension from the workers’ compensation system be vacated.
This matter went to trial on September 10, 2019. The WCJ admitted into evidence the parties exhibits and found as follows: Dr. Eroshevich was convicted of four felony counts that were reduced to one misdemeanor; Dr. Eroshevich stipulated to a determination by the Medical Board of California based on certain acts in workers’ compensation claims such that her medical license was suspended after a stay of revocation; Dr. Eroshevich was suspended from participating in the Workers’ Compensation system pursuant to an order issued on November 29,2017; and that Dr. Eroshevich filed liens in each of the cases involved in this consolidated matter.
The WCJ further found that lien claimant failed to meet the burden of proof required to rebut the presumption of Labor Code3 section 139.21(9). Erosevich’s Petition for Reconsideration was granted, and the WCAB rescinded the F&O, and returned this matter to the trial level for further proceedings consistent with this decision.in Tang (1) v Solar Link International, Dr. Khristine Eroshevich Real Party In Interest -SAU6852145 (April 2020).
Following remand, another Findings of Fact & Order after Remand by the Workers’ Compensation Appeals Board (F&O), issued on September 22, 2020 by a workers’ compensation administrative law judge (WCJ). The WCJ found in pertinent part that lien claimant was convicted of a misdemeanor for fraudulently prescribing a controlled substance in violation of Health and Safety Code section 11173, subdivision (a) (11173(a)); that this conviction was the only basis for the WCJ’s determination; and, that lien claimant failed to meet the burden of proof required to rebut the presumption set forth in Labor Code2 section 139.21, subdivision (g) (section 139.21(g)); and, therefore, all liens and underlying bills for service and claims for compensation from lien claimant arise from the conduct set forth in the Order of Suspension of lien claimant pursuant to section 139.21, subdivision (a)(1)(A)(iv) (section 139.21(a)(1)(A)(iv)). And that lien claimant’s liens be dismissed with prejudice and that lien claimant shall have no right to payment on all underlying bills for service and claims for compensation within the jurisdiction of the workers’ compensation system.
Sometime after the September 22, 2020 Finding of Fact & Order, the WCAB again granted the Petition for Reconsideration filed by lien claimant Kristine Eroshevich, M.D., Ph.D. “in order to study further the legal and factual issues raised therein.” . It was arguably what is referred to as a Grant-and-Study Order.
Then the Court of Appeal issued three different published opinions indicating that Grant-and-Study orders are not compliant with the Labor Code, and that the WCAB lacks jurisdiction to grant reconsideration if its fully reasoned grant of reconsideration did not occur within 60 days. See Earley v. Workers’ Comp. Appeals Bd. (2023) 94 Cal.App.5th 1 – Zurich American Ins. Co. v. Workers’ Comp. Appeals Bd. (2023) 97 Cal.App.5th 1213 – And recently Mayor v. Workers’ Compensation Appeals Bd A169465 (August 2024).
Nearly 4 years after the September 22, 2020 Findings of Fact & Order after Remand the WCAB issued its “Opinion and Decision after Reconsideration” on August 30, 2024 in the case of Tang (2) v Solar Link International, Dr. Khristine Eroshevich Real Party In Interest -SAU6852145 (August 2024), and affirmed the F&O in part, but amended the Findings of Fact and the Orders to find that lien claimant did rebut the section 139.21(g) presumption; that lien claimant’s lien claims are not dismissed with prejudice; and, that adjudication of the merits of lien claimant’s lien claims are deferred pending decision by the workers’ compensation administrative law judge pursuant to section 139.21, subdivision (i), whether to adjudicate the liens or to transfer the liens back to the district offices having venue over the cases in which the liens were filed.
The U.S. Drug Enforcement Administration has seen an increase in burglaries at independent pharmacies across the country. Nearly 900 burglaries involving the theft of controlled substances were reported to DEA in 2023. Stolen prescription medications adversely impact these small businesses while also putting patients and the community at risk.
The Eastern District of Arkansas, representatives from DEA joined the U.S. Attorney’s Office to announce the results of a 21-month investigation into a Houston-based drug trafficking organization (DTO) responsible for hundreds of pharmacy burglaries across the country.
The culmination of this investigation led to the arrest of an additional 24 members of the DTO in Houston, bringing the total number of people facing charges connected to this drug ring to 42. The results of the first phase of this operation were announced in December.
DEA’s Little Rock District Office led the investigation after identifying a string of pharmacy burglaries and thefts of pharmaceutical medications throughout Arkansas. With the assistance of DEA’s Special Operations Division, this organization has been linked to more than 200 pharmacy burglaries across the United States, including Alabama, Arkansas, Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Nebraska, Nevada, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, and Wyoming.
Oxycodone, hydrocodone, alprazolam, and promethazine with codeine cough syrup were among the most common controlled substances stolen and transported to Houston to be sold illegally.
“From November 2023 to July 2024, the DEA, with our law enforcement partners, took down 42 individuals behind nearly 200 pharmacy burglaries in 31 states. This Houston-based network targeted rural pharmacies, stealing powerful drugs like Oxycodone, Xanax, and Adderall to flood the streets,” said Administrator Anne Milgram. “These criminals even crawled on floors to dodge security, but they couldn’t escape us. We dismantled their entire operation-street dealers, burglars, and all. In the fight against the opioid epidemic, the DEA is relentless in shutting down those who profit from fueling addiction.”
In addition to this announcement, DEA has released a safety alert video and additional resources to help protect against pharmacy burglaries.
This operation is part of an Organized Crime Drug Enforcement Task Forces (OCDETF) operation. OCDETF identifies, disrupts, and dismantles the highest-level criminal organizations that threaten the United States using a prosecutor-led, intelligence-driven, multi-agency approach. Additional information about the OCDETF Program can be found at https://www.justice.gov/OCDETF.
In 1996 Saul Fox and Dexter Paine formed Fox Paine & Company (FPC), a private equity management firm. Fox’s relationship with Paine deteriorated, and a business deal “fell apart,” resulting in the first of what would become a litany of litigation.
In December 2007, the Delaware lawsuit was settled, in a settlement agreement that was to effect a “complete divorce” between the Fox parties and FPC and the Paine parties.
Whatever the peace envisioned, it was short-lived, as in January 2008 Paine filed a pleading involving the settlement agreement. This was the first in a series of fights that would last for the next five years, as the Fox parties and Paine parties (including several former FPC directors and officers) became embroiled in lawsuits, arbitration proceedings, writs, and an appeal stemming from the August 2007 lawsuit and its settlement (the Fox-Paine litigation).
The Fox-Paine litigation ended with a settlement agreement in August 2012, which agreement represented it “resolved all outstanding issues among” Fox and Paine and “effectively put an end to the Fox-Paine Litigation.” However, there was more litigation to come.
In addition to other litigation in non-California jurisdictions, in 2017, eight plaintiffs sued several defendants including three excess insurers, which insurers provided $40 million in excess coverage in four layers of $10 million each. There were four causes of action, breach of contract, declaratory relief, breach of the covenant of good faith and fair dealing, and aiding and abetting breaches of fiduciary duty. The three excess insurers each filed demurrers,
The trial court overruled the demurrer of the first level excess insurer, but sustained the demurrers of the two other excess insurers without leave to amend, and entered judgments for them. Plaintiffs appealed.
The Court of Appeal affirmed in the published case of Fox Paine & Co., LLC, et al. v. Twin City Fire Insurance Co. et al. -A168803 (September 2024).
Plaintiffs’ first cause of action is breach of contract. Excess insurance ‘refers to indemnity coverage that attaches upon the exhaustion of underlying insurance coverage for a claim.’
The Court of Appeal reviewed case law that established that the interpretation of an insurance policy is a question of law. And if contractual language is clear and explicit, it governs.
The trial court order addressed the question of exhaustion as to all three of the excess insurers, in a lengthy analysis. Following that analysis, the trial court sustained the demurrers of St. Paul and Liberty Mutual without leave to amend. This was correct. The St. Paul policy is triggered only if the “total amount of” underlying limits “has been paid.” And Liberty Mutual’s policy “only provides coverage” when the underlying limit of liability “is exhausted” by the underlying insurers “paying or being held liable to pay.” Such language demonstrates that the St. Paul and Liberty Mutual policies did not attach and no obligations arose. Hence, there was no breach of contract.
The trial court order addressed the question of exhaustion as to all three of the excess insurers, in a lengthy analysis. Following that analysis, the trial court sustained the demurrers of St. Paul and Liberty Mutual without leave to amend. This was correct.
Plaintiffs’ second cause of action was styled “declaratory judgment,” more accurately called “declaratory relief.” As noted, it is this cause of action it reads “the trial court erred in holding that plaintiffs had to establish actual exhaustion…”
Code of Civil Procedure section 1060 provides in pertinent part that declaratory relief is proper as to a contract “in cases of actual controversy relating to the legal rights and duties of the respective parties.” , Code of Civil Procedure section 1061 goes on to state that a court “may refuse to exercise the power” to grant declaratory relief “in any case where its declaration or determination is not necessary or proper at the time under all the circumstances.”
The Court of Appeal concluded that Code of Civil Procedure sections 1060 and 1061 both demonstrate that declaratory relief is not appropriate in this case.
“Even if plaintiffs had established the existence of an actual controversy – and they have not – the trial court had discretion to dismiss the declaratory relief cause of action if a declaration was not necessary or proper at the time under the circumstances.”
Plaintiffs’ third argument is that there was “no reason to dismiss plaintiffs’ other, unrelated tort causes of action,” referring to their claims for violation of the covenant of good faith and fair dealing and aiding and abetting breaches of fiduciary duty.
“Plaintiffs are wrong. There was good reason to dismiss these causes of action, as neither stated a claim.”
“It is clear that if there is no potential for coverage and, hence, no duty to defend under the terms of the policy, there can be no action for breach of the implied covenant of good faith and fair dealing because the covenant is based on the contractual relationship between the insured and the insurer.”
Workplace-related mental injuries, marijuana reimbursements, independent contractors and the gig economy, and single-payer health insurance were among the top workers compensation focuses of state legislatures in 2024 according to a new report from the National Council on Compensation Insurance (NCCI).
NCCI’s 2024 Regulatory and Legislative Trends provides an overview of developments affecting the workers compensation system in two parts: the Regulatory and Legislative Trends Report (Report) and two interactive navigation dashboards.
The annual Report offers a wealth of resources on important workers compensation-related topics, including first responder presumptions, hallucinogens and psychedelics, and marijuana legalization. Notable highlights include legislative activity by geographical zone for an overview of regional happenings across the country.
Through July 31, 2024, NCCI tracked 917 state and federal bills that could impact workers compensation stakeholders. This includes 474 bills in states where NCCI is a licensed rating or advisory organization. NCCI also monitored 266 proposed workers compensation-related regulations.
“As the regulatory and legislative landscape evolves, it is imperative for industry leaders to stay informed and adapt strategically,” said Bill Donnell, President and CEO of NCCI. “At NCCI, we are committed to delivering comprehensive updates and insights to help stakeholders navigate the road ahead.”
NCCI’s 2024 Regulatory and Legislative Trends also includes two intuitive and interactive dashboards:
– – Enacted Legislation – Interactive Dashboard provides users with easy-to-use navigation for a countrywide, state, or regional view of workers compensation-related enacted legislation.
– – Loss Cost/Rate Filing – Interactive Dashboard provides an overview of filed and approved loss cost/rate information based on the 2020-2021, 2021-2022, 2022-2023, and 2023-2024 filing seasons.
“In 2024, NCCI closely monitored over 1,000 bills and proposed regulations nationwide, covering a broad spectrum of critical issues,” said Tim Tucker, NCCI’s Executive Director of Legislative and Government Affairs. “NCCI’s annual Report provides a thorough analysis of the regulatory and legislative trends that may shape the workers compensation landscape.”
Check out the 2024 Regulatory and Legislative Trends and NCCI’s full suite of resources – including the Legislative Activity online resource, Court Case Insights tracker, and more on the NCCI website..