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2024 Was Another Bad Year For US Health Care Cyberattacks

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SecurityWeek has conducted an analysis of the healthcare breach database maintained by the US Department of Health and Human Services Office for Civil Rights (HHS OCR), which stores information on incidents impacting the protected health information of over 500 individuals.

The OCR was informed about 720 incidents between January 1, 2024, and December 31, 2024. Adding up the numbers from each breach suggests that roughly 186 million people are impacted.
Impacted information can include names, contact details, dates of birth, Social Security numbers, insurance information, medical information, and even financial information.

Of the total number of data breaches, approximately 520 affected healthcare providers. Another commonly impacted type of entity was healthcare business associate, which accounted for 120 incidents. Health plans were involved in nearly 100 incidents.

Close to 600 incidents were described as ‘hacking/IT incident’, which includes ransomware attacks. The second most common type of incident involved unauthorized access or disclosure.

Roughly 450 breaches involved network servers, and roughly 160 involved email, which is typically used by threat actors for phishing and malware delivery.

The OCR database also keeps track of the state where the impacted organization is located. Texas and California accounted for the highest number of incidents (roughly 60 each), followed by New York (46), Illinois (43), Florida (37), Pennsylvania (31), Ohio (29), Massachusetts (29), Tennessee (25) and Michigan (22).

The biggest healthcare data breach of 2024 impacted Change Healthcare. A ransomware attack aimed at the company resulted in the information of roughly 100 million individuals getting stolen.

The list of organizations impacted by major data breaches also includes Kaiser Permanente (13.4 million), Ascension Health (5.5 million), HealthEquity (4.3 million), Concentra Health Services (3.9 million), Centers for Medicare & Medicaid Services (3.1 million), Acadian Ambulance Service (2.8 million), A&A Services, dba Sav-Rx (2.8 million), WebTPA (2.5 million), and Integris Health (2.3 million).

HIPPA Journal reports that between 2009 and 2023, 5,887 healthcare data breaches of 500 or more records were reported to OCR. Those breaches have resulted in the exposure or impermissible disclosure of 519,935,970 healthcare records. That equates to more than 1.5x the population of the United States. In 2018, healthcare data breaches of 500 or more records were being reported at a rate of around 1 per day. Fast forward 5 years and the rate has more than doubled. In 2023, an average of 1.99 healthcare data breaches of 500 or more records were reported each day, and on average, 364,571 healthcare records were breached every day.

John Riggi, national adviser for cybersecurity and risk at the American Hospital Association was quoted by Modern Healthcare as saying “I have never seen the healthcare sector so engaged in cybersecurity,” he said, “from the [C-suite] level all the way down to operational staff.”

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Sutter Health to Invest $1B in AI Imaging With GE HealthCare

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Sutter Health is a comprehensive, integrated health system in northern California with 27 hospitals, 300 ambulatory sites, and imaging modalities.

Sutter Health and GE HealthCare just announced a seven-year strategic enterprise partnership, known as a Care Alliance, that aims to increase access to innovative imaging services and create a more seamless and coordinated experience for clinicians and patients across the Sutter Health system. This Care Alliance marks one of GE HealthCare’s largest ever enterprise strategic partnerships.

According to a report by Bloomberg the agreement is expected to generate $1 billion in revenue over the span of the partnership, GE Healthcare said. It marks one of the largest deals for the medical technology company since the firm was spun off from General Electric Co. two years ago.

GE HealthCare CEO Peter Arduini said he expects to enter into more strategic partnerships as consolidation of the health system continues and as the firm evolves from an imaging company to providing a variety of health-care solutions. Since the spinoff, the company has entered into more than 25 strategic partnerships, including a research and product development program with the Mayo Clinic and a 10-year partnership with the Ohio-based University Hospitals.

The first key focus area of the Care Alliance is an accelerated technology program across the Sutter Health system that will focus on some of the most advanced AI-powered imaging technology and digital solutions available to patients, including PET/CT, SPECT/CT, MRI, CT, X-ray, nuclear medicine and ultrasound. GE HealthCare’s interventional, mammography, diagnostic cardiology, maternal and infant care and anesthesia solutions will also be included in Sutter Health’s ambulatory care centers, helping to address the growing need for care outside of the traditional hospital setting.

This comprehensive technology refresh covers the breadth of GE HealthCare’s portfolio of solutions, providing clinicians with innovative options to meet changing patient needs more efficiently and quickly.

Imaging and ultrasound solutions, enabled by digital and AI advancements, will be implemented across the entire healthcare system over several years, reducing variation and providing the innovation clinicians need to best serve patients. Innovative new solutions include GE HealthCare’s Omni Legend PET/CT, StarGuide SPECT/CT and Vscan Air™ SL ultrasound with Caption AI™ software. Notably, GE HealthCare’s AIR™ Recon DL MR image reconstruction will be deployed and utilizes deep learning algorithms to improve image quality and MRI scan times. By optimizing image reconstruction AIR™ Recon DL reduces artifacts, and enhances image clarity and scan times, enabling clinicians to obtain high-quality diagnostic images while improving patient comfort and workflow efficiency.

The strategic partnership also supports Sutter Health’s larger access strategy, which includes opening dozens of new care sites across Northern California in the next few years. Additionally, it will further support the health system’s expansion of advanced service lines and destination centers of excellence including areas such as heart and vascular care, cancer care and neurosciences. This includes access to new technology and digital optimization to expand clinical procedures and services, helping enable precise, high-quality patient care from early screening to diagnosis to treatment to monitoring.

For example, Sutter Health plans to build a new cancer center on Sutter’s Memorial Medical Center campus in the California Central Valley and recently announced two new flagship campuses in Silicon Valley with specialty care focuses. Potential future areas of enhanced services across the Sutter Health system could include mental health, orthopedics, women’s health and pediatrics.

Sutter Health will adopt technology at a more rapid pace with an accelerated upgrade schedule, including the latest software releases to prevent obsolescence and keep technologies current over the long-term. The service delivery model will help ensure consistent operations and minimize unexpected disruptions—with patient safety, efficiency and reliability in mind.

The agreement will also include significant investment in Sutter Health’s workforce development programs to include ongoing training and education for technologists, nurses and physicians through Sutter Health University and other learning opportunities, which includes supporting the next generation of clinicians who are reflective of the communities they serve.

GE HealthCare plans to assist Sutter Health in the design of a scalable workforce and talent development program that includes talent pathway community outreach, collaborations with radiologic technologist schools, as well as talent acquisition, development and retention, including leadership and clinical learning journeys. The program will aim at addressing the critical clinician shortage and support healthcare providers’ clinical staffing needs.

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Palisades Firefighters Participate in First-of-its-Kind Cancer Study

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Established in July 2016 with funding from the Federal Emergency Management Agency (FEMA), the Fire Fighter Cancer Cohort Study (FFCCS) gathers nationwide data on firefighter health, including surveys, biomarkers, and exposure information related to cancer-causing substances. This partnership with the fire service aims to understand the health impacts of these exposures and prevent associated risks.

The long-term goal is to track the health of 10,000 firefighters from multiple fire departments across the nation over a span of 30 years.

Firefighters are exposed to multiple carcinogens in the workplace through inhalation, skin contamination, and ingestion. Cancer is a leading cause of fire service morbidity and mortality, and the International Agency for Research on Cancer (IARC) has determined that occupational exposure as a firefighter causes cancer.

As of September 30th, 2024, 6,287 firefighters from over 275 departments across 31 states are participating in the FFCCS.

And now, according to a report by Fox40.com, The Wildfire Conservancy is conducting a first-of-a-kind cancer study on firefighters battling the Palisades Fire. The goal is to track how wildland and urban interface firefighters’ extreme conditions increase their risk of cancer.

The initiative is a collaboration with Cal Fire, the National Firefighter Cancer Cohort Study, and the University of Arizona. This comes after the International Agency for Research on Cancer officially classified firefighting as a carcinogenic profession.

The doctor leading the study describes the conditions of the Palisades Fire as a “toxic soup of air and ash.“ “This is the equivalent of a 9/11 scale exposure incident and we need to start treating them like this,” Dr. Matt Rahn, Executive Director of Wildfire Conservatory.

The firefighters battling the Palisades blaze are being exposed to hazardous substances like carbon monoxide, and heavy metals which can lead to cancer, respiratory issues, and neurological damage.

The 50 participating firefighters get their blood drawn, provide a urine sample, and share personal details. They’re also given silicone wristbands that absorb contaminants like ash, soot, and smoke that will be tested.

“We are making plans with Cal Fire and others in the study to do a post-exposure, post-fire blood sample,” the Doctor continues. “One of the things that we’re able to look at is micro-RNA in the blood because it’s a marker of how much DNA damage has been done.”

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FDA Continues Resisting Production of Pfizer Vaccine Documents

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Public Health and Medical Professionals for Transparency (PHMPT) is a not-for-profit organization. It’s members include over 30 accomplished academics, professors, and scientists from the medical schools and related departments of our most prestigious universities, including Yale, Harvard, UCLA, UCSF, UCI and Brown.

These academics and scientists represent a cross section of every discipline relevant to the licensure of the Pfizer vaccine and include many of the best our country has to offer when it comes to reviewing and assessing the appropriateness and validity of the FDA’s decision-making in licensing of the Pfizer COVID Vaccine.

In furtherance of its mission, on August 27, 2021, PHMPT submitted the Freedom of Information Act (FOIA) Request to the FDA seeking all data and information pertaining to the application and approval of the Pfizer Vaccine. Federal law (21 C.F.R. § 601.51(e)) provides that: “After a license has been issued, the following data and information in the biological product file are immediately available for public disclosure unless extraordinary circumstances are shown.” PHMPT desires to perform its own independent analysis of the safety and efficacy the the vaccine, especially in light of the vaccine mandates being promulgated at the federal and state levels.

In the Second Joint Status Report following filing this case, the FDA assessed that there are more than 329,000 pages potentially responsive to the PHMPT FOIA request. The FDA asked that the Court limit the FOIA response to no more than 500 pages per month. This would be nearly 55 years or until about 2077.

The FDA lost the battle. On January 6, 2022 a federal judge soundly rejected the FDA’s request and ordered the FDA to produce all the data at a rate of 55,000 pages per month. In doing so the judge noted that “the Court recognizes the ‘unduly burdensome’ challenges that this FOIA request may present to the FDA.”

The January 6, 2022 order set a production schedule, which was partially modified on February 2, 2022. The production schedule required the FDA to “produce 80,000 pages on or before May 2, June 1, and July 1, 2022; 70,000 pages on or before August 1, 2022; and then 55,000 pages on or before the first business day of each month thereafter.”

On December 19, 2023, in a Joint Status Report, the FDA notified the Court that it had completed its production of responsive documents. However, on April 23, 2024, in a related case Plaintiff learned that the FDA may have identified but not produced an Emergency Use Authorization (“EUA”) file.

Thereafter, on July 17, 2024, in its response to Plaintiff’s adequacy-of-search letter, the FDA disclosed that it had in fact identified but not produced an EUA file for the Pfizer Vaccine. Because the Parties were unable to resolve this issue without court intervention, the matter was briefed. And on December 6, 2024, the Court entered an order finding that the EUA file was responsive to Plaintiff’s FOIA request and must be produced. The Court ordered the FDA to produce the EUA file on or before June 30, 2025.

This month marks three years after the 2022 court order, and the PHMPT and FDA continue litigating compliance with the federal law mandating the publics ability to review the FDA information used to justify approval of the Pfizer Vaccine. The FDA now requests that the Court not only delay the production of the EUA file, but indefinitely stay it. In its Cross-Motion for Summary Judgment, Plaintiff specifically requested that the Court order the FDA to produce the EUA file on or before February 20, 2025.

In denying the FDA’s recent request for a stay, U.S. District Judge Mark Pittman expressed his exhaustion with the agency’s “continued attempts to pause the production of information related to one of the preeminent events of our time – the Covid-19 pandemic.” He ordered that the FDA must release the requested “emergency use authorization” file by June 30, 2025.

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Public Self-Insured Paid & Incurred Losses Increase

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A California Workers’ Compensation Institute (CWCI) review of the initial report on fiscal year (FY) 2023/24 California workers’ compensation public self-insured data shows that an 18.7% increase in average medical payments and a 5.3% increase in average indemnity payments drove public self-insureds’ total paid losses up nearly $42.6 million to $552.9 million last year even though the number of claims fell by 1.8%.

At the same time, public self-insured total incurred losses (paid plus reserves for future payments) jumped nearly $150 million to a record $1.69 billion as average incurred medical rose 14.8% and average incurred indemnity jumped 9.4%.

The summary of public self-insured data issued on January 8 by the Office of Self-Insurance Plans (OSIP) offers the first snapshot of the workers’ comp experience of cities, counties, and other public self-insured entities for the 12 months ending June 30 of last year. The summary notes the number of medical-only and indemnity claims filed and the total paid and incurred losses on those claims.

Compared to the initial summary from the prior year (FY 2022/23), the new report shows California’s public self-insured work force increased by 4.5% to 2.18 million workers last year, with wages and salaries for those workers totaling nearly $174.2 billion. The public self-insured employers reported 118,114 claims last year, 2,214 (-1.8%) fewer than in the FY 2022/23 initial report, but despite that decline, both paid and incurred losses were up.

The distribution of the $552.9 million in paid losses on the FY 2023/24 public self-insured claims at first report shows indemnity payments totaled $327.9 million, $10.8 million (3.1%) more than in FY 2022/23, while medical payments totaled $225.0 million, up $31.8 million (16.5%) from the prior year.

With claim volume down and loss payments up, average benefits paid in the first reports climbed to $4,681 for the FY 2023/24 claims, 10.4% more than the initial payments on FY 2022/23 claims. The breakdown of the average payment shows public self-insureds averaged $2,776 in indemnity payments on the FY 2023/24 claims, up 5.3% from $2,636 in the prior year’s first report, while average paid medical climbed to $1,905, up 18.7% from $1,605 in the initial report for FY 2022/23.

The first report data on public self-insured incurred losses (paid amounts plus reserves for future payments) show total incurred losses on the FY 2023/24 claims of nearly $1.69 billion, 9.7% more than the $1.54 billion first report total from the prior year’s claims. With both medical-only and indemnity claim volume down, the year-over-year increase in total incurred losses was completely due to the increases in average incurred indemnity (+9.4%) and average incurred medical (+14.2%), which more than offset the 1.8% decline in claim volume, as the average incurred loss per claim jumped 11.8% from $12,744 in FY 2022/23 to $14,279 in FY 2023/24.

OSIP also compiles private self-insured claims data, which is reported on a calendar year basis rather than on a fiscal year basis, so the private self-insured data, which was posted in June, now lags the public self-insured data by 6 months. The next report on private self-insured claims will be issued next summer.

In the meantime, CWCI has issued a Bulletin that includes exhibits and additional details on the most recent public self-insurer paid and incurred losses, including comparative results from the past decade. CWCI members and subscribers may access the Bulletin by logging in at www.cwci.org. OSIP’s summaries of private and public self-insured employers since FY 2000/01 are available at https://www.dir.ca.gov/SIP/StatewideTotals.html.

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Latest Gallop Ratings of Lawyers & Judges Stay Historically Low

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Three in four Americans consider nurses highly honest and ethical, making them the most trusted of 23 professions rated in Gallup’s annual measurement. Grade-school teachers rank second, with 61% viewing them highly, while military officers, pharmacists and medical doctors also earn high trust from majorities of Americans.

The least trusted professions, with more than half of U.S. adults saying their ethics are low or very low, are lobbyists, members of Congress and TV reporters.

Of the remaining occupations measured in the Dec. 2-18, 2024, poll, six (including police officers, clergy and judges) are viewed more positively than negatively by Americans, although with positive ratings not reaching the majority level. The other nine, notably including bankers, lawyers and business executives, are seen more negatively than positively, with no more than 50% rating their ethics low.

Today’s rank-order aligns with the public’s evaluations of U.S. occupations for the past two decades. Over this period, medical practitioners, grade-school teachers and military officers have been the most trusted professions, while political, sales, business and media-related jobs have constituted the least.

Nurses have earned the highest rating in every year but one since Gallup added them to the annual survey in 1999. The exception was 2001, when firefighters — included only that year — earned a record 90% trust rating after their heroism in responding to the 9/11 attacks on the Twin Towers.

Gallup began measuring public trust in various professions in 1976, initially covering 14 jobs. Over the years, the list has changed, with some occupations added and others removed. Since 1999, 11 professions have been tracked annually, while others have been included periodically.

The average very high/high ethics rating of the core 11 professions has decreased from routinely 40% or higher in the early 2000s to closer to 35% during most of the 2010s. It rose slightly in 2020, to a seven-year high of 38%, reflecting enhanced public trust in healthcare workers and teachers during the pandemic. Thereafter, the average declined each year through 2023, when it reached 30%, and it held there in 2024. This mirrors the long-term decline in Americans’ confidence in U.S. institutions.

The relatively low average honesty and ethics ratings in 2023 and 2024 reflect diminished scores for a few professions, in particular, since 2021. That’s the latest year that most of the professions on this year’s list — all but funeral home directors — were rated at the same time.

– – Trust in medical doctors has fallen 14 percentage points since 2021. After reaching a historical high of 77% in 2020, doctors’ ethics rating not only returned to its 2019/pre-pandemic level of 65% but, at 53%, is now the lowest since the mid-1990s.
– – Day care providers, pharmacists, nurses and nursing home operators — all of which had enjoyed enhanced reviews during year one or year two of the pandemic — have since dropped below their average pre-pandemic ratings.
– – Judges have seen a 10-point decline to 28% in their honesty and ethics rating, by far the lowest for this profession which, before 2021, had scored between 43% and 53%.
– – Views of the police have been variable, but after earning majority trust in 2020 and 2021, their rating slipped to 45% in 2023 and 44% today.
– – Clergy have lost another six points in public esteem since 2021, continuing the long-term downward trend in trust in that profession.

Ratings of the other 15 professions measured in both years haven’t changed appreciably.

The long-term trends paint a slightly different picture, reflecting broader political and societal changes this century.

From the time Gallup started rating all 23 professions in the early 2000s through this year, there has been a 26-point decline in the perceived honesty and ethics of clergy, the most for any group. The proportion saying the clergy have high or very high ethics is down from an average 56% in 2000-2009 to 30% today.

The decline in Americans’ religiosity over this period contributes to the loss of trust in clergy, as the growing proportion of nonreligious adults express lower trust than religious adults. However, the Catholic Church’s child sexual abuse scandals also appear to have contributed to downticks in trust in clergy, including in 2002 and 2018.

The second-most-significant decline in ethics ratings this century has been for judges, who have experienced a 21-point drop since the early 2000s. Some of this change occurred early on, falling from an average 49% in 2000-2009 to 46% in 2007 and to 43% in 2020. But since then, high ratings for judges have tumbled to 28%, paralleling recent downturns in Americans’ confidence in the Supreme Court as well as the judicial system and courts more broadly. The high court’s 2022 Dobbs decision overturning Roe v. Wade as well as various legal cases against Donald Trump since 2020 could explain declines in these ratings by both major parties.

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NSC MSD Solutions Index Reveals Workplace Safety Progress

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The National Safety Council released the 2023-2024 MSD Solutions Index Pledge Community Report, a benchmarking survey which has revealed meaningful progress in addressing one of the most pervasive workplace injuries: musculoskeletal disorders, or MSDs. MSDs impact employees across numerous industries and cost U.S. businesses billions annually. Recognizing the effects these injuries have on workers and employers, NSC formed the MSD Solutions Lab in 2021 with funding from Amazon (NASDAQ: AMZN) to solve work-related MSDs.

“This year’s report reflects the dedication of the MSD Pledge community to building safer workplaces and protecting workers’ health,” said Katherine Mendoza, senior director of workplace safety programs at NSC. “With the insights from the MSD Solutions Index, we see organizations are making significant strides and identifying critical areas for improvement, proving that the MSD Pledge can drive real change in the safety and wellbeing of workers worldwide.”

The 2023-2024 MSD Solutions Index survey, conducted from December 2023 to June 2024, included responses from 44 MSD Pledge members, with data compared to the previous year’s findings. Organizations received an overall index result, as well as results for the three pledge commitment subsections, that fell into one of five categories representing MSD prevention maturity: novice, reactive, advancing, proactive and innovating. Key takeaways included:

– – Higher overall results: 81.4% of organizations achieved overall ratings in the advancing or proactive categories, with 11.6% reaching the innovating category — an improvement from the 2022-2023 cycle, where no organizations received innovating scores.
– – Enhanced use of ergonomics programs: Nearly 89% of respondents have some form of MSD prevention and ergonomics program, which is up from about 83% last year. Organizations with ergonomics programs also reported higher scores across all MSD prevention areas.
– – Increased focus on leading indicators of MSDs: This year, 65.1% of respondents reported prioritizing leading indicators over lagging ones, a significant increase from 42% in the prior year. This shift reflects a growing focus on proactive measures to prevent MSDs before they occur.
– – Broader employee involvement in safety decisions: Nearly 68% of respondents engage frontline workers in safety-related decision-making, with employees regularly consulting on workstation design, job tasks and workflow. This approach is associated with stronger safety cultures and greater trust across organizational levels.
– – Increased reporting of common MSD risk factors: Awkward postures, lifting and prolonged sitting and standing were among the top risk factors cited, with low back pain emerging as the most common MSD-related ailment — reported by 77.3% of respondents, in comparison to only 57.7% last year.
– – Expanded sharing of effective MSD solutions: This year saw a rise in organizations sharing MSD prevention successes internally and externally, with 76.7% reporting they share solutions beyond their organization. Collaborative efforts were also highlighted, with almost 87% engaging in or researching MSD prevention technologies.

While the report highlighted several areas of success among the MSD Pledge community, it also identified ongoing areas of opportunity, such as in quantifying non-physical risk factors like mental fatigue, expanding the use of technology, and engaging smaller organizations that may lack the resources of larger companies. To advance MSD prevention efforts, the report recommends organizations adopt the following strategies:

– – Engage leadership to help foster a strong safety culture, which is crucial for effective MSD prevention.
– – Prioritize employee feedback and collaboration by involving frontline workers in ergonomic assessments and decision-making.
– – Set targeted goals for risk reduction by developing clear, measurable objectives that can help guide organizations and track progress.
– – Leverage and explore new technologies and innovations, from ergonomic assessment tools to automation, to help reduce MSD risks.

The MSD Solutions Index is one of several initiatives led by NSC to achieve its goal of preventing MSDs before they start. To learn more about these efforts or sign up for the MSD Pledge 2.0, visit nsc.org/msd.

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January 6, 2025 – News Podcast

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Rene Thomas Folse, JD, Ph.D. is the host for this edition which reports on the following news stories: Supreme Court Limits ER Price Disclosure Obligations to Patients. New L.C. Whistleblower Attorney Fee Law Applies to Pending Cases. Physician Admits $3M SIBTF Fraud Naming O.C. Judge as Co-Conspirator. Ventura County Physician to Serve 2 Years for $3M Healthcare Fraud. First Pharmaceutical “Consultant” Based Opioid Criminal Case Settles for $650M. Cal/OSHA Cites City of Los Angeles Animal Services Center $563K. Cal/OSHA Issues $276,425 Citation for First Serious Willful Heat Violations. Carriers File RICO Suits Against SoCal Addiction Treatment Centers. SoCal Laboratory and Owners Resolve Kickbacks Case for $15M.

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Legislators Propose Law to Help Finance Insurance Fire Losses

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In response to the raging fires in Los Angeles County, and the threatened exodus of fire insurance companies, state legislators introduced Assembly Bill 226 on January 9 2025, a proposed law named the FAIR Plan Stabilization Act.

The California FAIR Plan Association is a joint reinsurance association in which all insurers licensed to write basic property insurance participate in administering a program for the equitable apportionment of basic property insurance for persons who are unable to obtain that coverage through normal channels.

Existing law requires the association’s plan of operation and any amendment to the plan to be approved by the Insurance Commissioner. Existing law establishes the California Infrastructure and Economic Development Bank and authorizes it to issue bonds to provide funds for the payment of costs of a project for a participating party or upon request by a state entity.

This bill would authorize the association, if granted prior approval from the commissioner, to request the California Infrastructure and Economic Development Bank to issue bonds, and would authorize the bank to issue those bonds to finance the costs of claims, to increase liquidity and claims-paying capacity of the association, and to refund bonds previously issued for that purpose.

The bill would specify that the association is a participating party and that financing all or any portion of the costs of claims or to increase liquidity and the claims-paying capacity of the association is a project for bond purposes.

The bill would authorize the bank to loan the proceeds of issued bonds to the association, and would authorize the association to enter into a loan agreement with the bank and to enter into a line of credit agreement with an institutional lender or broker-dealer.

This bill would require the association, if the above-described bonds, loan agreements, or lines of credit received the prior approval of the commissioner, to assess members in the amounts and at the times necessary to timely pay in full all obligations of the association with respect to those bonds, loan agreements, or lines of credit and related agreements, as specified.

This bill would declare that it is to take effect immediately as an urgency statute.

“AB 226 will alleviate some of the uncertainty that FAIR Plan policy holders may encounter as a result of this tragedy,” said Assemblymember Lisa Calderon, a Whittier Democrat, chair of the Assembly Insurance Committee and one of the bill’s authors, in a statement reported by Courthouse News. “We remain steadfast in acting with urgency to support the impacted communities during this difficult time.

“This bill is an excellent first step, among many we must take, to stabilize California’s insurance market by protecting the FAIR Plan,” said Assemblymember David Alvarez, a San Diego Democrat and the bill’s other author, in a statement. “When disaster strikes, Californians should be able to count on their insurance coverage to pay out valid claims.”

Assembly Speaker Robert Rivas, a Hollister Democrat, announced plans for the bill on Thursday. He said many of his colleagues are in Los Angeles to help, volunteering with local efforts and ensuring people and organizations have the resources they need.

Speaking to the media, Rivas said the Assembly will introduce legislation focused on recovery efforts, as well as a bill to expedite homeowner insurance claims.

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Dermatologicals Now Most Expensive WorkComp Drug Group

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New data from the California Workers’ Compensation Institute (CWCI) shows recent shifts in the types of drugs prescribed to injured workers in California, and in the distribution of payments for those medications, with anti-inflammatory drugs ranking first in terms of the number of prescriptions, but dermatologicals, which include a number of high-priced, private label drugs, accounting for the biggest share of the total drug spend.

A review of total payments by drug ingredient shows that from January through June of last year, the dermatological lidocaine (average payment $159: $216 brand, $151 generic) ranked first among all drugs in terms of the California workers’ compensation total drug spend, accounting for 8.5% of all payments. That was more than twice the percentage noted for the anti-inflammatory naproxen, which ranked second with 4.2% of the prescription dollars, just ahead of the anticonvulsant pregabalin, which ranked third with 4.1%. The dermatological diclofenac sodium (topical) ranked fourth, consuming 3.1% of the pharmaceutical payments, while the anti-inflammatory meloxicam and the migraine drug rimegepant sulfate rounded out the top 6 drugs, each consuming 2.8% of the total drug spend in the first half of 2024.

CWCI analysts noted the shifts in prescription drug utilization and reimbursement among the drug groups suggested an association between the ongoing decline in opioid use with the state’s adoption of the Opioid and Pain Management Guidelines into the Medical Treatment Utilization Schedule (MTUS) in late 2017, and the implementation of the MTUS Formulary in 2018.

The historical data show that anti-inflammatories such as ibuprofen and naproxen, often used as non-narcotic alternatives to treat pain, surpassed opioids to become the top drug group in 2016, and by 2021 they accounted for a record 35.3% of all prescriptions dispensed to California injured workers.

Dermatological drugs are often used to treat pain, and with opioid use declining their share of the workers’ comp prescriptions grew from 4.9% in 2016 to 12.6% in the first half of 2024. Though many different dermatologicals are used to treat injured workers, the breakdown by drug ingredients shows most of that growth was due to the increased use of prescriptions containing lidocaine and/or diclofenac sodium, which together increased from 46% of the dermatological prescriptions in 2016 to 81.6% in the first half of 2024.

In 2022, anticonvulsants, which are often used to treat neuropathic pain, surpassed opioids to become the third most prescribed workers’ comp drug group and since then they have maintained that ranking, while antidepressants surpassed opioids in 2023 (accounting for 8.0% of the prescriptions) and they remained the fourth most prescribed drug group in the first half of 2024 (8.1%).

Like opioids, musculoskeletal drugs have seen their share of the prescriptions drop sharply over the past 8-1/2 years, falling from 10.7% of the prescriptions in 2016 (third behind anti-inflammatories and opioids) to 5.8% in 2021 before they leveled off at just over 6% over the past 2-1/2 years (sixth among all drug groups). This decline coincided with the implementation of the Formulary in January 2018, as under the Formulary, musculoskeletal drugs are not exempt from utilization review except for limited special fill or perioperative use where only limited quantities can be dispensed.

CWCI has published additional details and complete lists of the top 10 California workers’ compensation therapeutic drug groups based on prescription volume and payments from 2016 through June of 2024 in Bulletin 2025-01.

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