American film studios today collectively generate several hundred films every year, making the United States one of the most prolific producers of films in the world. Most shooting now takes place in California, New York, Louisiana, Georgia and North Carolina.

California was the shooting location for 10 of the top 100 box office performers last year, trailing Canada, the U.K., and Georgia. Canada was by far the top-ranked location with 20 films, including 11 that were shot in British Columbia, noting that Canada pioneered the use of production tax credits during the 1990s. The U.K. and Georgia followed with 15 movies each.

California ramped up its tax credit program in 2015 by expanding its annual allocation of credits from $100 million to $330 million, and establishing a selection system that gave priority to the jobs created by the films. The California tax credit total as high as 25% of production costs – which is still short of the incentives elsewhere. California Gov. Jerry Brown signed legislation that extended the program for five years into 2025.

Still, California’s yearly allocation for tax credits is dwarfed by the U.K., with $822 million invested in 2017 – the largest film incentive program worldwide. Georgia had $800 million invested last year.

At this point it seems that California has given up trying to stop the exodus of California filmmaking. Instead, a new law simply requires costs of benefits for social systems of film workers who are temporarily working out of state – to shift to California employers.

California Gov. Gavin Newsom has signed a bill to ensure film and TV workers operating out of state for their jobs will have full access to the state’s unemployment insurance, disability insurance and paid family leave.

He signed the measure, SB 271, late Thursday and it will become law in January. The legislation is aimed at addressing uncertainties for California-based film and TV production workers who often must travel outside California.

“The bill would provide, for purposes of determining employment of a motion picture production worker when the service is not localized in the state but some of the service is performed in the state, that the worker’s entire service qualifies as employment if their residence is in the state,” the legislation states.

The California International Alliance of Theatrical Stage Employees Council and Entertainment Union Coalition co-sponsored the bill. The council represents over 50,000 members of the entertainment industry, while the coalition has roughly 150,000 members and comprises 17 local unions, including SAG-AFTRA.

“We can now protect thousands of our members and their families who depend upon these benefit programs, often in times of great need and economic stress because they are unexpectedly or suddenly out of work, disabled as a result of an injury or illness, or are responsible for the care of family members,” the groups said.

The flip side of this new law is that New York, Louisiana, Georgia and North Carolina will keep the film production revenue, and be protected from the costs of social benefits for workers temporarily earning a good living in their states.

The Division of Workers’ Compensation has posted an order adopting regulations to update the evidence-based treatment guidelines of the Medical Treatment Utilization Schedule (MTUS).

The updates, effective for medical treatment services rendered on or after October 7, 2019, incorporate by reference the American College of Occupational and Environmental Medicine’s (ACOEM’s) most recent Hip and Groin Disorders Guideline (April 24, 2019) to the Clinical Topics section of the MTUS.

The administrative order consists of the order and two addenda:

— Addendum one shows the regulatory amendments directly related to the evidence-based updates to the MTUS.

— Addendum two contains hyperlinks to the updated ACOEM guidelines adopted and incorporated into the MTUS by reference.

Health care providers treating, evaluating (QME), or reviewing (UR or IMR) in the California workers’ compensation system may access the MTUS (ACOEM) Guidelines and MTUS Drug List at no cost by registering for an account.

The DWC has also posted an adjustment to the inpatient hospital section of the Official Medical Fee Schedule (OMFS) to conform to changes in the 2020 Medicare payment system as required by Labor Code section 5307.1.

The effective date of the changes is November 1, 2019.

Further information and adjustments to the inpatient hospital section of the Official Medical Fee Schedule can be found on the DWC website’s OMFS page.

Pharmaceutical company Mallinckrodt ARD LLC (formerly known as Mallinckrodt ARD, Inc. and previously Questcor Pharmaceuticals, Inc., has agreed to pay $15.4 million to resolve claims that Questcor paid illegal kickbacks to doctors from 2009 through 2013 in the form of lavish dinners and entertainment, to induce prescriptions of the company’s drug, H.P. Acthar Gel for the treatment of complications from multiple sclerosis.

The Federal Anti-Kickback Statute prohibits a pharmaceutical company from offering or paying, directly or indirectly, any remuneration – which includes money or any other thing of value – with the intent to induce a health care provider to prescribe a drug reimbursed by Medicare. This prohibition extends to such practices as “wining and dining” doctors to induce them to write Medicare prescriptions of a company’s products.

The government alleges that, from 2009 to 2013, twelve Questcor sales representatives marketing Acthar provided illegal remuneration to health care providers in the form of lavish meals and entertainment expenses. The company paid this remuneration, the government alleges, with the intent to induce Acthar Medicare referrals from those health care providers, resulting in a violation of the Anti-Kickback Statute and the submission of false claims to Medicare.

The allegations relevant to this settlement were originally alleged in two cases filed under the whistleblower, or qui tam, provision of the False Claims Act. The act permits private parties to sue for fraud on behalf of the United States and to share in any recovery.

The act also permits the government to intervene in such actions, as the government previously did in the two whistleblower cases, which are captioned United States of America ex rel. Strunck et al. v. Mallinckrodt ARD, Inc., No. 12-CV-0175 (E.D. Pa.), and United States of America ex rel. Clark v. Questor Pharmaceuticals, Inc., No. 13-CV-1776 (E.D. Pa.).

The government’s pursuit of these matters illustrates its emphasis on combating healthcare fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement can be reported to the Department of Health and Human Services, at 800 HHS TIPS (800-447-8477). The whistleblowers will receive approximately $2.926 million of the settlement.

This matter is being handled by the Civil Division of the U.S. Attorney’s Office for the Eastern District of Pennsylvania and the Department of Justice’s Commercial Litigation Branch, with assistance from the U.S. Department of Health and Human Services’ Office of Inspector General, the Defense Criminal Investigative Service, the Federal Bureau of Investigation and the Office of Personnel Management.

For the United States Attorney’s Office, the matter is being handled by Assistant United States Attorney Colin Cherico and Auditor George Niedzwicki.

On October 6, 2015, Governor Jerry Brown signed Assembly Bill No. 1124 into law, which directed the DWC to adopt an evidence-based drug formulary in the California workers’ compensation system.

In 2017, the DWC adopted the new drug formulary linked to the California Medical Treatment Utilization Schedule (MTUS) to be effective on January 1, 2018. The drug formulary intends to reduce frictional costs mostly from UR and independent medical review (IMR); restrict inappropriate prescribing, especially that related to opioids; and ensure medically necessary and timely medications for injured workers.

The drug formulary includes an MTUS drug list of about 300 drug ingredients that are assigned a status of exempt or non-exempt from prospective UR.

All opioids and compounded drugs are non-exempt from prospective UR. Additionally, certain non-exempt drugs can be prescribed without prospective UR if fulfilling the requirements of special fill or peri-operative fill policies.

Drugs not listed on the MTUS drug list must obtain authorization through prospective UR prior to dispensing

Even before the implementation of the drug formulary, pharmaceutical costs in California had been declining sharply. Key drivers of the decrease include Senate Bill No. 863 reforms related to IMR and spinal surgeries, changes in the federal government upper-limit pricing levels, anti-fraud efforts and the public reaction to the national opioid epidemic.

While there was an even more significant drop in the utilization and cost of pharmaceuticals in 2018, it was not immediately clear how much of the decline was due to the formulary and how much was due to the continuation of the factors driving the prior year decreases

The Workers’ Compensation Insurance Rating Bureau of California (WCIRB) reviewed the impact of the new drug formulary on prescribing patterns and pharmaceutical costs based on pharmaceutical transaction information through the first year of implementation.

The WCIRB’s findings include:

— The share of prescriptions of drugs not subject to prospective utilization review (UR) in accordance with the formulary increased by 41 percent compared to the pre-2018 level, while that of drugs subject to UR declined by 18 percent.

— The use of opioids, compounds, physician-dispensed drugs and brand-name drugs with generic alternatives dropped sharply in 2018, the first year of the formulary.

— While a number of the aforementioned pharmaceutical components had been declining prior to the implementation of the formulary, the decline accelerated during 2018, suggestive of the effect of the drug formulary.

The Sackler family, which grew into one of the nation’s wealthiest dynasties through sales of the widely abused painkiller OxyContin, could emerge from a legal settlement under negotiation with its personal fortunes largely intact, according to an analysis reviewed by The Washington Post and people familiar with the discussions.

Under a novel plan to relinquish control of their company, Purdue Pharma, and resurrect it as a trust whose main purpose would be to combat the opioid epidemic, the Sacklers could raise most, if not all, of their personal share of the $10 billion to $12 billion agreement by selling their international drug conglomerate, Mundipharma, according to the documents and those close to the talks.

The analysis reviewed by The Post offers previously undisclosed information about the proposed settlement.

The proposed settlement – built on the projected value of drugs not yet on the market – offers gains for both sides if the company and more than 2,000 cities, counties, states and others that have sued Purdue and the family can craft a deal.

Purdue would produce millions of doses of badly needed anti-addiction medication and overdose antidotes for the public, free of charge; the company would also contribute hundreds of millions of dollars in cash and insurance policies that could be worth more; what’s left of the company, including its North Carolina production facility and other assets, would change hands.

Much of the benefit to the public would be funded by the continued sales of the powerful narcotic OxyContin, the abuse of which is blamed for contributing to the prescription opioid crisis that has killed more than 200,000 people since 1999.

The Stamford-Conn.-based Purdue Pharma would go into bankruptcy, and the Sacklers would be out of the drug business. They would be required to contribute $3 billion and possibly more, depending on the sale price of Mundipharma, their international drug company, over seven years.

But they would still retain much of their wealth. In fact, they might be able to keep billions of dollars that state attorneys general allege they pulled out of the company.

“No one is going to be happy after this,” said Adam J. Levitin, a Georgetown Law School professor who studies bankruptcy. “People are going to be mad that the Sacklers aren’t going to jail, that they will have money left.”

The Washington Post reviewed a detailed analysis of the settlement plan that has been valued at $10 billion to $12 billion. The plan has been at the heart of negotiations among the parties for many months. The material was confirmed by three people close to the discussions who spoke on the condition of anonymity because of the sensitivity of the negotiations.

If no deal is reached, Purdue is likely to declare bankruptcy in coming weeks, according to people familiar with the company’s strategy. A huge civil trial against Purdue and as many as two dozen drug companies is scheduled to begin in Cleveland on Oct. 21.

But the documents also indicate that if settlement talks fail and the Sacklers vote to send Purdue into Chapter 11 bankruptcy, the plaintiffs might get as little as $1.2 billion from an auction of the business’s components.

In that scenario, plaintiffs would probably have to jockey for rights to Purdue’s assets. The process could generate enormous legal bills, possibly further reducing any payout to them.