Kaiser Permanente has been experimenting with AI in its patient portal, increasing patient engagement and experience in the process.

“Care is local, but at the same time it’s virtual and it’s become a global commodity,” Khang Nguyen, MD, assistant executive medical director for care transformation at Southern California Permanente Medical Group and chief medical officer of care navigation for the Permanente Federation, told Becker’s. “So patients are really expecting artificial intelligence to support healthcare in a way that is supporting other industries, in the sense that people are able to describe what they want versus being given choices.”

A new study, published in npj Digital Medicine in partnership with Seoul National University Bundang Hospital, focused on the deployment of the Kaiser Permanente Intelligent Integration (KPIN) system by the Southern California Permanente Medical Group (SCPMG), which serves 3.9 million patients. Implemented in October 2024, KPIN is an advanced patient portal system designed to enhance care navigation and patient experience.

KPIN replaced older systems (Microsoft’s LUIS and VSN Query Report) and integrated natural language processing (NLP) to generate clinical alerts for high-acuity cases and recommend appropriate care pathways. It supports multiple channels, including a web-based portal, mobile app, and self-service interactive voice response (IVR) system, ensuring consistent care navigation. The system verifies patient identity and guides them through booking processes, redirecting emergencies to 911 or hospitals.

October 1, 2024, to March 1, 2025, KPIN facilitated 2,960,945 digital visits, with 1,046,504 unique patients interacting with the system. Demographic data showed 36.6% of users were aged 30–49, 47.8% were female, and 38.9% were of Hispanic origin.

The study evaluated KPIN’s Clinical Alert System (CAS) and Virtual Safety Net (VSN) models for detecting high-acuity symptoms (e.g., chest pain, dyspnea) and guiding care navigation. Metrics included accuracy, precision, recall, F1-score, and area under the curve (AUC).

KPIN processed an average of 193,134 encounters daily, with a peak of 19,364. The adjusted successful booking rate was 53.8%, reflecting effective appointment scheduling. The abandonment rate was low at 0.94% (IQR: 2.7–3.1%), indicating high user engagement, attributed to a streamlined interface limiting interactions to nine per page.

Patient surveys showed an 8.6 percentage point increase in positive sentiment, suggesting improved user satisfaction. The system struggles with vague “Reason for Visit” entries, which can affect care pathway accuracy.

The authors of the study concluded that “KPIN’s integration into the patient portal significantly improved care navigation, clinical alert accuracy, and patient satisfaction within an integrated value-based care model, demonstrating the effectiveness of advanced digital tools in healthcare delivery.”

Dr. Nguyen called that the “biggest surprise” from the findings. “We all know with websites, if you want to bury anything on a website, just make it two clicks away, and then no one can ever find it,” he said. And when patients abandon the app because they can’t locate what they need, they typically contact the call center.

A Glendale woman was sentenced to 108 months in federal prison for participating in a scheme in which hundreds of thousands of dollars in illegal kickbacks were paid and received for patient referrals that resulted in the submission of approximately $10.6 million in fraudulent claims to Medicare for purported hospice care.

Nita Almuete Paddit Palma, 75, of Glendale, was sentenced by United States District Judge Dolly M. Gee, who also ordered her to pay $8,270,032 in restitution.

At a separate hearing, Judge Gee sentenced Percy Dean Abrams, 75, of Lakewood, to three years of probation, which will include two years of home confinement.

At the conclusion of a six-day trial, a federal jury in December 2024 found Palma guilty of 12 counts of health care fraud and 16 counts of paying illegal kickbacks for health care referrals. The jury also found Abrams guilty of six counts of receiving illegal kickbacks for health care referrals.

Palma was excluded from Medicare, a federal health insurance program for people aged 65 and older, because of prior federal convictions for receiving illegal kickbacks. While she was excluded from Medicare, Palma purchased Magnolia Gardens Hospice through her daughter and bought C@A Hospice through her husband in 2015 and concealed her ownership interest in both hospices from Medicare.

Palma then paid “marketers”, including Abrams, hundreds of thousands of dollars in illegal kickbacks for patient referrals that Palma could bill to Medicare for purported hospice care.

Hospice is only for those who are terminally ill and have a life expectancy of six months or less. Hospice provides comfort care to a patient instead of trying to cure the patient’s illness, and a patient forfeits certain benefits under Medicare when electing hospice.

Consistent with instructions provided by Palma, Abrams falsely represented to prospective patients that they did not need to be dying to be on hospice. After collecting personal identifying information from prospective patients that were not dying, Abrams sent the information to Nita Palma so she could bill Medicare for purported hospice care.

Through Magnolia Gardens Hospice and C@A Hospice, Palma caused the submission of approximately $10.6 million in fraudulent claims to Medicare beginning in 2015 for purported hospice care for patients that were not dying. Palma received approximately $6,000 each month a patient was billed to Medicare for hospice. In turn, Palma paid Abrams and other marketers up to $1,000 per month in illegal kickbacks for each patient referred to her that was billed to Medicare for hospice. Many of the patients that were billed to Medicare through Magnolia Gardens Hospice did not know they were signed up for hospice, and some patients only found out after they were denied medical coverage for services they needed.

During the health care fraud scheme, Medicare requested additional documentation from Magnolia Gardens Hospice to support the purported hospice claims. In response, Palma and her husband directed employees to create fake patient charts and had those fake patient charts submitted to Medicare. Court documents allege that while awaiting trial in this matter, Palma took control of three other hospices and caused the submission of approximately $4.8 million in claims for purported hospice care.

The United States Department of Health and Human Services Office of Inspector General and the FBI investigated this matter.

Assistant United States Attorney Roger A. Hsieh of the Major Frauds Section and Matt Coe-Odess of the Domestic Security and Immigration Crimes Section prosecuted this case.

U.S. District Judge Anthony Battaglia has finally approved a sweeping settlement requiring the San Diego Sheriff’s Office to make major changes to jail conditions for people with disabilities. The case is Darryl Dunsmore et al. v. San Diego County Sheriff’s Department, et al.; S.D. Cal. No. 3:20-cv-00406-AJB-DDL.

In June 2023, the Sheriff’s Office and plaintiffs reached a partial ADA settlement agreement that focused on incarcerated persons with mobility disabilities at San Diego Central Jail, as well as incarcerated persons with hearing disabilities who use sign language at all county jails.

Between August 25, 2023, and November 20, 2024, the parties participated in seventeen settlement conferences with Magistrate Judge David D. Leshner including several all-day, in-person conferences.Moreover, in coming to agreement on the ADA Settlement terms, the parties exchanged numerous draft written proposals over six months. The San Diego County Board of Supervisors approved the ADA Settlement as to Plaintiffs’ third claim on December 11, 2024. On December 12, 2024, the parties filed the ADA Settlement Agreement as a joint motion. The final approved settlement agreement resolves the remainder of the ADA claims.

The Sheriff’s Office said it has taken significant steps to increase access for persons with disabilities in county jails. This includes the creation of a dedicated Sheriff’s ADA Unit, updating policies, procedures and training, construction renovations and acquiring assistive technologies such as video phones with video relay services or closed captioning.

The Sheriff’s Office also created a process for identifying and providing necessary accommodations to incarcerated persons with disabilities, including housing accommodations and effective communication.

In addition to specific construction modifications at the Las Colinas Detention and Reentry Facility, George Bailey Detention Facility, Vista Detention Facility, Rock Mountain Detention Facility and South Bay Detention Facility, some of the other changes that will be or have already been made include:

– – Informing incarcerated persons with disabilities of their ADA rights and providing effective communication during the booking and orientation process.
– – Revising policies and training as necessary to ensure compliance with the ADA and the terms of the settlement agreement.
– – Providing initial and annual ADA training to county jail staff and contractors.
– – Identifying and tracking incarcerated persons with disabilities who report and/or have been identified as requiring disability accommodations while in custody.
– – Ensuring that incarcerated persons with disabilities are properly placed in housing that is safe and appropriate for their disability.
– – Providing reasonable accommodations to ensure that qualified incarcerated persons with disabilities are able to participate in all programs, services and activities while in custody.
– – Practicing effective communication with incarcerated persons with disabilities.
– – Making sure that incarcerated persons with disabilities who require assistive devices, health care appliances, or durable medical equipment have access to these accommodations, subject to removal for individualized safety or security reasons.
– – Developing policies, procedures and training to ensure that incarcerated persons with disabilities are accommodated during evacuations and other emergencies in the jails.
– – Ensuring that incarcerated persons with intellectual, learning, and developmental disabilities are identified and provided appropriate accommodations, including adequate support.
– – Making sure that incarcerated persons with disabilities receive reasonable accommodations during searches, counts, application of restraint equipment and transport.
– – Providing reasonable accommodations to persons with mental health disabilities, including during the discipline process.
– – Developing a quality assurance and auditing program to ensure ADA compliance.

As part of the settlement agreement, the County of San Diego will hire neutral experts to ensure compliance with the agreement. The ADA Settlement Agreement does not involve monetary damages and none will be awarded. The ADA Settlement Agreement allows Plaintiffs’ counsel to ask the Court to have Defendants pay for their attorneys’ fees and costs in obtaining the ADA Settlement Agreement.

The Sheriff’s Office operates a system of seven detention facilities throughout San Diego County with a combined average daily population of approximately 4,000 incarcerated persons. According to the ACLU the San Diego County jails have the highest death rate of any large county in California. Well over 200 people have died in Sheriff department custody since 2006.

In 2018, Disability Rights California released a report highlighting the factors that contribute to the high suicide rate in San Diego County jails. These factors include over-incarceration of people with mental health needs, failure to provide adequate mental health treatment, overuse of solitary confinement, and lack of meaningful, independent jail oversight.In 2021, county jail deaths were largely attributable to suicide, overdoses, homicide and medical neglect – deaths that are often preventable with adequate policies, practices, training and supervision in place.

After a comprehensive audit by California State Auditor, it reported in February 2022 that “Given the ongoing risk to the safety of incarcerated individuals, the Sheriff’s Department’s inadequate response to deaths, and the lack of effective independent oversight, we believe that the Legislature must take action to ensure that the Sheriff’s Department implements meaningful changes. Until the Sheriff’s Department makes such changes, the weaknesses in its policies and practices will continue to jeopardize the health and lives of the individuals in its custody.”

Bradley Hirdman sued Charter Communications, LLC in October 2019, asserting a single cause of action for civil penalties under PAGA based on alleged violations of sections Labor Code § 246 (failure to pay sick time at the correct rate of pay), 201 to 204 (failure to timely pay wages upon termination), and 2802 (failure to reimburse necessary work-related expenses).

In September 2020, Hirdman filed his first amended complaint against Charter, asserting the same cause of action and clarifying that he sought to represent other commissioned employees in his PAGA action. In February 2023, the parties filed cross-motions for summary adjudication on the issue of Charter’s alleged failure to pay sick time at the correct rate of pay.

The material facts upon which the parties based their cross-motions are undisputed. Charter employed Hirdman as a sales representative, and it classified him as exempt from overtime requirements under the outside salesperson exemption pursuant to Labor Code.§ 1171.

The relevant statute, Labor Code § 246, subdivision (l), provides three methods by which employers may calculate paid sick leave. For “nonexempt employees,” employers must calculate paid sick time either “in the same manner as the regular rate of pay for the workweek in which the employee uses paid sick time” (§ 246, subd. (l)(1)) or “by dividing the employee’s total wages, not including overtime premium pay, by the employee’s total hours worked in the full pay periods of the prior 90 days of employment” (id., subd. (l)(2)). For “exempt employees,” paid sick time “shall be calculated in the same manner as the employer calculates wages for other forms of paid leave time.” (Id., subd. (l)(3).)

The statute does not define “exempt employees” or “nonexempt employees.” The parties asked the trial court to determine, as a matter of law, whether section 246, subdivision (l)(3) applies to employees like Hirdman who are classified as outside salespersons.

Hirdman contended that employers cannot calculate paid sick leave using the method provided in Labor Code section 246, subdivision (l)(3) for outside salespersons because the meaning of “exempt employees” includes only those employees who are exempt under the administrative, executive, or professional exemptions. (Lab. Code, § 515, subd. (a); Cal. Code Regs., tit. 8, § 11040.

In support, Hirdman relied on (1) an analysis of the bill from the Senate Committee on Labor and Industrial Relations, and (2) an October 2016 Division of Labor Standards and Enforcement (DLSE) opinion letter based on that report, which concluded that employees like Hirdman and other outside salespersons paid by commissions must be paid for sick leave per Labor Code section 246, subdivision (l)(1) or (l)(2). Hirdman thus argued that Charter was required to calculate paid sick leave for its outside salespersons using one of the methods in Labor Code section 246, subdivisions (l)(1) and (l)(2), which apply to “nonexempt employees.”

Charter, on the other hand, argued that section 246, subdivision (l)(3) applies to all exempt employees, not just those employees classified as exempt under the administrative, executive, or professional exemptions.

According to Charter, the statutory language was plain and unambiguous, and the trial court should therefore end its inquiry there because the plain meaning of the word “exempt” controls. In other words, “exempt employees” in section 246, subdivision (l)(3) means employees like Hirdman who are exempt under any exemption, including the outside salesperson exemption. Charter thus argued that it correctly calculated paid sick leave for Hirdman and other outside salespersons.

The trial court agreed with Charter and thus granted its motion for summary adjudication, ultimately entering judgment in its favor.

The Court of Appeal affirmed the trial court in the published case of Hirdman v Charter Communications -D084304 (August 2025).

The sole issue for determination on appeal is the meaning of the phrase “exempt employees” as used in section 246, subdivision (l)(3).  “Under the facts of this case, we conclude that the statutory language is unambiguous, and “exempt employees” includes employees like Hirdman who are exempt from overtime wages.”

“In sum, we conclude that the trial court correctly determined that section 246, subdivision (l)(3) applies to outside salespersons like Hirdman and thus did not err in granting summary adjudication in favor of Charter.”

Cathie Konyen was employed by Lowe’s Home Centers, LLC, and held various positions in its stores located in Reno, Nevada, San Jose, California, and Newburgh, New York, over a period spanning at least thirteen years. She alleged in a Federal District Court case pending in a Nevada that Defendant Lowe’s Home Centers, LLC, violated her rights under the Americans With Disabilities Act of 1990, 42 U.S.C. § 12101, et seq. (“ADA”) and corresponding state laws by discriminating against her and retaliating against her on the basis of her disability.

Konyen worked in Lowe’s Reno store as an Installed Sales Coordinator from March 2014 to January 2016. In April 2015, Konyen experienced back pain and sought treatment. She was given temporary work restrictions, which Lowe’s accommodated.

In January 2016, Cathie Konyen’s husband, Gary Konyen, who was also employed by Lowe’s, was transferred to Lowe’s East San Jose, California store. Cathie and Gary moved to San Jose, and Cathie was hired as an Installed Sales Coordinator in Lowe’s South San Jose store. In February 2016, Cathie Konyen sought medical care in San Jose. She completed accommodations paperwork and received accommodations lasting one year in the San Jose store.

In April 2018, Cathie Konyen moved with her husband to New York, and Cathie Konyen was hired as an Appliance Sales Specialist at Lowe’s New York store. Cathie Konyen sought accommodations again. Lowe’s granted Cathie Konyen workplace accommodations from at least December 2018 through April 11, 2019.

After receiving the 2019 Accommodation Forms, Lowe’s employees reviewed Cathie Konyen’s restrictions and the Flooring Sales Specialist position requirements and determined that Cathie Konyen would be unable to do half of the key responsibilities of the position and that Lowe’s would be unable to meet her scheduling needs. However, they could meet her accommodations in other store positions at a lower pay. Cathie Konyen failed to decide if she would take these positions, so was placed on leave.

On June 21, 2019, Cathie Konyen began a new position at a different company. She applied for this position while she was still employed at Lowe’s and when she had not yet been placed on leave.

Cathie Konyen dual-filed a charge of discrimination with the Equal Employment Opportunity Commission and the Nevada Equal Rights Commission on February 3, 2020. Cathie Konyen filed this federal Complaint in December 2022. In her Complaint, she alleges three categories of claims: (1) disability discrimination in violation of the ADA and state law, (2) retaliation in violation of the ADA and state law, and (3) a breach of state contract law.

Substantial evidence obtained during discovery indicated that Cathie Konyen’s husband Gary forged the 2019 Accommodation forms provided to Lowe’s, and that Cathie Konyen knew about this forgery. Gary invoked the Fifth Amendment and refused to answer any deposition questions.

Defendant moved for terminating sanctions, and summary judgment as to each of Plaintiff’s claims. The Court found that Plaintiff knowingly submitted fraudulent documentation to Defendant in 2019, and this documentation is the basis for her EEOC Charge and the claims in her Complaint. Accordingly, the Court found that Cathie Konyen had engaged in willful deception and bad faith conduct.

When a party has engaged deliberately in deceptive practices that undermine the integrity of judicial proceedings, dismissal is an available sanction because “courts have inherent power to dismiss an action when a party has willfully deceived the court and engaged in conduct utterly inconsistent with the orderly administration of justice.” See Leon v. IDX Sys. Corp., 464 F.3d 951, 958 (9th Cir. 2006) (citing Anheuser-Busch, Inc. v. Nat. Beverage Distributors, 69 F.3d 337, 348 (9th Cir. 1995)). (NOTE that both of these 9th Circuit decisions are controlling law here in California.)

Defendant’s motion for terminating sanctions and summary judgment was granted as to terminating sanctions, and summary judgment is granted in the alternative, in the case of Konyen v Lowe’s Home Centers, LLC, Case No. 3:22-cv-00538-MMD-CLB – United States District Court District of Nevada (July 2025)