AB 5 is expected to eventually pass the California Legislature, and result an estimated 2 million workers would be transformed from independent contractors to employees. The transformation would increase those covered by workers’ compensation, and the industry activity would increase accordingly.

According to an update published by Littler, the California Senate Appropriations Committee briefly considered AB 5 on August 30. The proposed law is the legislature’s response to the California Supreme Court’s 2018 opinion in Dynamex v. Superior Court (Dynamex). In Dynamex, the court changed the state’s longstanding law governing worker classification and exposed thousands of California businesses to potential retroactive liability.

AB 5 previously came before the Senate Appropriations Committee on August 12, 2019, when the Committee temporarily put the bill on hold. The Committee has now voted the bill to the Senate floor.

The Appropriations Committee heard no testimony or public comment regarding the bill. Only Committee Chair Portantino spoke very briefly on the subject, stating: “[AB 5] is out with amendments to refine the operation of the ABC test, modify the industrial categories under the Borello test, and make clarifying changes.”

Chair Portanino’s brief statement is the first official confirmation that the bill is undergoing further revision.

Assemblymember Gonzalez first introduced AB 5 on December 3, 2018. The initial bill included an expression of intent to “include provisions that would codify [Dynamex] and would clarify the decision’s application in state law. The substantive portion of the bill was 34 words (not including the citation to the Dynamex opinion). There have been four major revisions since then. The current version, published July 11, 2019, contains approximately 2,500 words.

In the weeks after the August 12, 2019 hearing, legislators have reportedly been working behind closed doors to make one more major revision to the bill with no information publicly available.

This revision is likely the final opportunity for interested parties to provide input on the bill. There will be virtually no time for further debate and subsequent revisions. The legislature has only 10 business days (including August 30, 2019) to pass the bill before the legislative session ends on September 13, 2019.

Due to this time pressure, legislators will have to choose between advancing the revised bill or facing potential criticism for failing to pass any legislative “fix” to Dynamex during the current session. It is expected that some legislators who believe changes should be made to the bill may nonetheless vote to pass it this session with the belief that additional changes will be made through separate legislative efforts in the next session.

In the face of growing uncertainty, some employers are eyeing a possible 2020 ballot initiative to advance an AB 5 countermeasure. For now, employers across the country are anxiously awaiting publication of the amended version of AB 5, which is expected to be published after Labor Day.

The Mexican Navy in the Port of Cardenas discovered 52,000 pounds of fentanyl powder in a mismarked container from a Danish ship arriving from Shanghai, China.

The cargo manifest for the 40-foot ocean container stated that the powder content was 23,368 kilograms of inorganic calcium chloride, commonly used as an electrolyte in sports drinks, beverages, bottled water and as a non-sodium flavoring for pickles. The fentanyl was bound for the Sinaloa Cartel home-base in Culiacan, 300 miles north of the port.

Mexican Customs seized 931 sacks of the substance weighing about 25.75 tons. The total weight of the fentanyl powder seizure is preliminary, with authorities still evaluating the purity of fentanyl seized. But if the seizure is confirmed as pharmaceutical-grade fentanyl, it could be pressed into tens of millions of tablets.

Drug cartels favor fentanyl or fentanyl precursors imported from China because it can be diluted with fillers and marketed by street-dealers as cocaine, heroin or meth. Fentanyl can also be pressed into pills and sold on the street as oxycodone.

The National Institute on Drug Abuse warns that pharmaceutical-grade fentanyl is 50 to 100 times more potent than morphine. Fentanyl is extremely dangerous to handle because as little as 0.25 milligrams absorbed through the skin can be lethal.

The Port of Lazaro Cardenas fentanyl seizure follows the U.S. Drug Enforcement Administration (DEA) Aug. 15 announcement of cumulative year 2019 seizures of 1,138,288 illicitly created fentanyl pills by its Phoenix DEA Field Office in cooperation with Arizona law enforcement agencies. That is nearly triple the 380,000 fentanyl pills seized in year 2018, and over 56 times the 20,000 fentanyl pills seized in year 2016.

Former Sinaloa Cartel crime boss Joaquin Guzman Loera (“El Chapo”) was extradited to the United States in January 2017. He was earlier convicted in Mexico for trafficking cocaine, heroin and fentanyl. But he successfully escaped from two Mexican prisons.

Guzman was sentenced by a U.S. district judge in July 2019 to a life term in a maximum-security U.S. prison, with the addition of 30 years, and ordered to pay $12.6 billion in forfeiture for being the principal leader of the Sinaloa Cartel and for 26 drug-related charges, including a murder conspiracy.

Marsha Rosenblum worked for the Lompoc Unified School District in 2008 when she had an admitted right groin and hip injury.

In February 2019 her PTP Christopher Birch, M.D., reported that he reviewed the medical records and x-rays of the right hip. He concluded that, “having failed all the applicable non-operative measures . . . [applicant] meets the criteria for a right total hip arthroplasty.” Dr. Birch confirmed his opinion in a subsequent April 2019 report, and submitted an RFA for a right total hip arthroplasty.

The RFA was submitted to UR. On April 8, 2019, a timely UR Determination issued, authorizing the right total hip replacement surgery.

On April 11, 2019, defendant objected to the medical determination made by Dr. Birch. The claims administrator sent a fax to Dr. Birch, stating that a “decision whether to authorize the RFA or send it to medical utilization review” was deferred pursuant to section 4610(g)(7) and Administrative Director rule 9792.9.1(b). It was therefore deferring surgical authorization pending a medical-legal opinion on industrial causation of the hip osteoarthritis pursuant to sections 4061 and 4062, and whether the right hip replacement surgery was related to applicant’s industrial injury.

On May 7, 2019, the matter proceeded to an expedited hearing on the primary issue of applicant’s need for a right hip replacement surgery as authorized by UR. Defendant contended the UR was fatally flawed because there was no connection between the requested surgery and applicant’s industrial injury. On May 20, 2019, the WCJ issued the disputed Expedited Findings of Fact and Order, finding that the court has no jurisdiction to determine medical treatment authorized by a timely UR. Applicant and defendant each petitioned for reconsideration.

Applicant argued that the WCJ erred by not enforcing the medical treatment authorized by UR and awarding the right hip surgery. Defendant contends the WCJ erred by finding the court lacked jurisdiction over the timely UR authorization for a right hip total arthroplasty, arguing that Labor Code1 sections 4061 and 4062 provide an alternate track to dispute an injured worker’s treatment request. Defendant argues that it properly objected to and withdrew its UR approval for the hip surgery after the UR authorization issued.

Reconsideration was granted and the WCAB addressed these contentions in the panel decision of Rosenblum v Lompoc Unified School District. It dened defendant’s Petition for Reconsideration, and granted applicant’s Petition for Reconsideration, and amend the Expedited Findings of Fact and Order to reflect that applicant is entitled to the medical treatment authorized by timely UR.

“Defendant attempted to override the timely April 8, 2019 UR determination and “withdraw” the authorization. Although section 4610(1) allows for deferral of UR while the employer disputes liability for an injury or treatment, here defendant did not dispute liability until three days after the UR authorized the right hip replacement surgery on April 8, 2019. There is no “alternative track” under section 4062 for an employer to dispute a UR determination. When defendant approved the requested treatment through UR, there was no further dispute as to the necessity of the treatment. (§ 4610.5, subd. (f)(1).) An employer may not bypass the UR process and invoke section 4062 to dispute an employee’s treatment request. (Sandhagen, supra, 44 Cal.4th 230, 237.)”.

This summer, the Sackler family, founders and owners of Purdue Pharma, announced they would pay at least $3 billion of a proposed $12 billion settlement of more than 2000 cases filed by cities, states and local government for its part in the opioid epidemic.  The Sackler portion of the settlement money would be obtained by the family selling off Mundipharma, a separate global pharmaceutical company they own.

So this announcement may raise questions about the little known Mudipharma company reportedly owned by the Sacklers.  A story just published in the Guardian sheds some light on what the Sacklers might be up to with Mundipharma.

After decades of stringent narcotics laws, borne of debilitating opium epidemics of centuries past, India is a country ready to salve its pain. For-profit pain clinics are opening by the score across Mumbai, Kolkata, Bangalore and other cities in this nation of 1.3 billion people.

And American pharmaceutical companies – architects of the opioid crisis in the United States and avid hunters of new markets – stand at the ready to fuel that demand.

Most large Indian hospitals have added pain management as a specialty in recent years. At the insistence of the professional societies that accredit hospitals in India, nurses and doctors now are required to assess pain as a fifth vital sign, along with pulse, temperature, breathing and blood pressure.

The pharmaceutical industry has kept pace. Twenty years ago only a few pharmaceutical companies marketed pain medicines in India, Today, almost every company is having pain management as a separate division.  A salesman for Sun Pharma, India’s largest drugmaker by sales, echoed the point during an interview in Chandigarh, the capital of Punjab and Haryana.

For Indian cancer patients who once writhed in agony, there are fentanyl patches from a subsidiary of Johnson & Johnson.  For the country’s vast army of middle-class office workers wracked with back and neck pain, there is buprenorphine from Mundipharma, a network of companies controlled by the Sackler family, the owners of Connecticut-based Purdue Pharma.

And for the hundreds of millions of aging Indians with aching joints and knees, there are shots of tramadol from Abbott Laboratories.

Palliative care advocates, who recount stories of patients enduring excruciating cancer pain or dying in agony, have persuaded reluctant government officials to allow high-powered opioid painkillers into doctors’ offices and on to chemists’ shelves.

But what began as a populist movement to bring inexpensive, Indian-made morphine to the ill has given rise to a pain management industry that promises countless new customers to American pharmaceutical companies facing a government crackdown and mounting lawsuits back home.

The lure of a pain-free life is a revelation in a country where incomes are rising for many city dwellers and 300 million to 400 million people are approaching the middle-class. Newly-minted pain doctors promise aspiring Indians that life has more to offer in a body free from pain.

As major pharmaceutical companies look to capitalize on the opportunity, the playbook unfolding in India seems familiar. Earnest advocates share heartbreaking stories of suffering patients; physicians and pharmaceutical companies champion pain relief for cancer patients and persuade regulators to grant greater access to powerful opioids; well-meaning pain doctors open clinics; shady pain clinics follow; and a spigot of prescription opioids opens – first addressing legitimate medical uses but soon spilling into the streets and onto the black market.

A looming deluge of addictive painkillers terrifies some Indian medical professionals, who are keenly aware that despite government regulations most drugs are available for petty cash at local chemist shops.

The maker of OxyContin, Purdue Pharma, and its owners, the Sackler family, are offering to settle more than 2,000 lawsuits against the company for $10 billion to $12 billion. The potential deal reported by NBC News was part of confidential conversations and discussed by Purdue’s lawyers at a meeting in Cleveland last Tuesday, Aug. 20, according to two people familiar with the mediation.

At least 10 state attorneys general and the plaintiffs’ attorneys gathered in Cleveland, where David Sackler represented the Sackler family, according to two people familiar with the meeting. David Sackler, who was a board member of the company, has recently been the de facto family spokesperson.

In a statement to NBC News, the company said, “While Purdue Pharma is prepared to defend itself vigorously in the opioid litigation, the company has made clear that it sees little good coming from years of wasteful litigation and appeals.”

At the Cleveland meeting, the company presented a plan for Purdue to declare Chapter 11 bankruptcy and then restructure into a for-profit “public benefit trust,” according to the summary term sheet that was read to NBC News and another source who is familiar with the potential deal.

The Purdue lawyers claim the value of the trust to plaintiffs would include more than $4 billion in drugs that would be provided to cities, counties and states, the people familiar with the matter said. Some of the drugs are used to rescue people from overdoses.

The in-kind drugs, combined with profits from the sale of drugs, would add up to a total Purdue settlement of $7 billion to $8 billion, according to two people familiar with the offer.

The trust would exist for at least 10 years. Three “well-recognized expert” trustees would be independently appointed by a bankruptcy court, according to the terms of the potential deal. Those trustees would in turn choose a board of directors to run the trust, according to the term sheet.

Any profits from the sale of Purdue’s drugs such as OxyContin or Nalmefene, a drug that has been fast-tracked by the FDA and would be used for emergency treatment of opioid overdoses, would go to the cities, counties and states if they agree to the settlement.

The Sackler family would give up ownership of the company and would no longer be involved, according to two people familiar with the matter.

For their part, the Sackler family, which has faced an increasingly hostile activist movement, would pay at least $3 billion. Forbes ranks the family as the 19th richest in America, with a fortune of at least $13 billion shared by an estimated 20 family members.

The Sackler money would be obtained by the family selling off Mundipharma, a separate global pharmaceutical company they own, according to a person briefed on the potential settlement deal. An additional $1.5 billion may be tacked onto the $3 billion if the sale of Mundipharma exceeds $3 billion.

Mundipharma describes itself on its website as a privately owned network of “independent associated companies” with “a presence in over 120 countries.” Mundipharma is controlled by the Sackler family.

A 2016 Los Angeles Times investigation of Mundipharma described how the global venture offered a new international pipeline for Purdue’s opioids.