The slippery slope of “medical marijuana” inches closer and closer to acceptance in many areas, including treatment of workers’ compensation claims. The 3rd District Court of Appeal helped to kick the door open when it ruled that California voters legalized recreational possession of less than an ounce of cannabis in 2016, with no exception even for those behind bars.

In the published case of People v Raybon, the court overturned the Sacramento County convictions of five inmates who had been found with marijuana in their prison cells. The court rejected multiple arguments presented by the California Attorney General, Xavier Becerra, who vigorously argued in favor of the convictions. In so doing, the court claimed that the Attorney General “recycled” old arguments in prior cases that have previously ruled against his arguments.

“The question before us is not what the Legislature intended in 1949 or 1990, but whether the voters amended Penal Code section 4573.6 by passing Proposition 64 in 2016. The drafters and voters are entitled to opt for a different approach and, in this case, they did just that. They amended the statute to eliminate criminal sanctions for possession of less than an ounce of marijuana and they retained criminal sanctions for possessing more than an ounce or for smoking or ingesting it.”

“The fact the Attorney General may not agree with the voters does not empower us to rewrite the initiative.”

“According to the plain language of … Proposition 64, possession of less than an ounce of cannabis in prison is no longer a felony,” the court ruled Tuesday. “Smoking or ingesting cannabis in prison remains a felony.”

The three-judge panel also rejected the state’s argument that guards will lose control over prisons if inmates are free to possess small quantities of marijuana, noting that possession can still be punished as a rules violation with longer prison terms or a reduction in privileges.

While prison officials can still punish inmates for violating the rules, “this ruling will prevent inmates from having years added to their sentences for simple possession, reducing overcrowding and saving $50,000-75,000 a year in unnecessary costs,” said Assistant Public Defender David Lynch.

The judges scolded the attorney general’s office for a counter-argument it said “uses arcane rules” and “twists the meaning of the words of the statute.”

Becerra’s office argued that the court’s reading of the law was absurd because it in effect allows controlled substances into prisons. But the court noted that it previously ruled that it’s not illegal for inmates to have properly prescribed medications or medical marijuana behind bars – though it may be against the rules.

“The Attorney General raises the same hackneyed and losing arguments in each case involving contraband in jails or prisons,” the judges wrote.

“The voters made quite clear their intention to avoid spending state and county funds prosecuting possession of less than an ounce of marijuana, and quite clear that they did not want to see adults suffer criminal convictions for possessing less than an ounce of marijuana,” Sacramento County Assistant Public Defender Leonard Tauman said in an email. The appeals court “quite properly honored what the electorate passed.”

“We want to be clear that drug use and sales within state prisons remains prohibited,” said corrections department spokeswoman Vicky Waters. She said the department “is committed to providing a safe, accountable environment for prisoners and staff alike and we plan to evaluate this decision with an eye towards maintaining health and security within our institutions.”

Attorney General Xavier Becerra’s office said it is reviewing the ruling and did not say if he will appeal.

Compared to smaller facilities, hospitals that provide complex care for critical illness or serious injury may find it harder to make patients happy.

The new study reviewed by Reuters Health suggests.that patients may be more likely to give top ‘5-star’ ratings to hospitals that don’t offer many commonly sought-after services like emergency rooms and intensive care units.

In an effort to help patients find high quality care, the U.S. Centers for Medicare and Medicaid Services (CMS) publishes hospital rankings based on patients’ experiences, on a website called Hospital Compare. But research to date hasn’t offered a clear picture of how much patients’ ratings, on a scale of 1 to 5, might help people find the best place to go for care, researchers note in JAMA Internal Medicine.

In the current study, researchers examined services offered and patient experience ratings for 2,798 hospitals nationwide. Compared to hospitals with lower ratings, hospitals with 5 stars were 84 to 92 percent less likely to provide emergency services, intensive care, cardiology or neurology, the study found.

These results suggest that patients shouldn’t rely exclusively on 5-star ratings to choose where to seek care, said lead study author Dr. Zishan Siddiqui of Johns Hopkins School of Medicine in Baltimore.

“This is especially true for patients with multiple medical problems and chronic illness. They are much less likely to receive comprehensive services when admitted,” Siddiqui said by email. “Hospital patient experience rating systems in general should be just one of many hospital metrics patients should look at when selecting hospitals.”

“Patient experience performance ratings are a relationship between communication and responsiveness needs of the patients and how well the hospitals perform to meet these needs,” Siddiqui added.

“If a hospital has patients only with simpler communication and responsiveness needs, they may meet these needs without necessarily performing at a higher level,” Siddiqui said. “The 5-star hospitals appear to get higher scores because they are more often taking care of patients with simpler needs.”

Patients who search for only 5-star hospitals when they need complex care may therefore be surprised to find many types of services they need are unavailable at these hospitals, the study team writes.

“Patient experience, driven in part by the hospitality of staff but largely by the quality of hospital amenities, is an important driver of where patients receive care,” Jena, who wasn’t involved in the study, said by email.

58 year old April Rose Ambrosio, a San Diego dentist, was charged with 75 felony insurance fraud counts for allegedly bilking insurance companies of hundreds of thousands of dollars by submitting claims for procedures she never performed, including more than 600 root canals. Her office was located at 10717 Camino Ruiz # 164, San Diego, CA 92126

She faces 83 years in prison if convicted of all counts.

Prosecutors allege Ambrosio submitted insurance claims for as many as 28 root canals on a single patient, and also submitted claims indicating she had performed more than 100 root canals over a three-month period for a family of four.

According to court documents, an insurance company filed a suspected fraud form with the California Department of Insurance in December 2016 over the unusually high number of root canals performed on that family, and Ambrosio’s failure to provide supporting documentation for the dental work.

Ambrosio is accused of defrauding eight insurance companies in the alleged billing scheme, which took place over the course of three years. Though she received around $300,000, according to the Department of Insurance, prosecutors say she billed the insurance companies for nearly $600,000.

She remains out of custody on her own recognizance, but Superior Court Judge Laura Parsky ordered Ambrosio to surrender her passport. The judge also imposed a Fourth Amendment waiver, which means Ambrosio is subject to law enforcement searches, even without a warrant.

She pleaded not guilty to all counts and is due back in court Sept. 5 for a readiness conference.

“The audacity of this defendant’s repeated fraud is astounding,” San Diego County District Attorney Summer Stephan said. “Unfortunately, when insurance companies get ripped off, consumers ultimately pay the price through higher premiums.”

Investigators from the state Department of Insurance, working with the insurance fraud division of the San Diego County District Attorney’s Office, spent two years investigating Ambrosio.

A federal jury has found an East Hollywood-based doctor and patient recruiter guilty for their roles in a $33 million Medicare fraud scheme in which Medicare was billed for clinic, home health, hospice services and durable medical equipment that patients did not need or did not receive.

Following a seven-day trial, Robert A. Glazer, of North Hollywood, the owner and operator of the East Hollywood-based Glazer Clinic, was found guilty of one count of conspiracy to commit health care fraud and 12 counts of health care fraud. Co-defendant Marina Merino, 62, of Los Angeles, a marketer who recruited patients in exchange for kickback payments, was found guilty of one count of conspiracy to commit health care fraud and eight counts of health care fraud.

Glazer and Merino are scheduled to be sentenced on September 9 by United States District Judge Otis D. Wright II. Each defendant faces the possibility of decades in federal prison.

Glazer and Merino were charged in a 2015 superseding indictment, along with Angela Avetisyan, the officer manager of Glazer Clinic and co-owner of Fifth Avenue Home Health located in East Hollywood, and Ashot Minasyan, co-owner of Fifth Avenue.

According to the evidence presented at trial, Merino and other marketers received payments from Avetisyan and Minasyan to recruit Medicare beneficiaries to the Glazer Clinic. Thereafter, Glazer billed Medicare for office services and tests that patients did not need or did not receive.

Glazer also referred Medicare patients for a variety of services, including home health and hospice services, as well as ordered durable medical equipment that patients did not need or did not receive. Based on referrals from Glazer, Avetisyan and Minasyan billed Medicare for home health services that were not rendered or were not medically necessary through their company, Fifth Avenue.

Avetisyan, who worked as an office manager at the Glazer Clinic, also sold Glazer’s referrals to other home health and durable medical equipment agencies. Together, the defendants and their co-conspirators submitted and caused to be submitted claims of approximately $33 million, of which Medicare paid approximately $22 million, the evidence showed.

Avetisyan and Minasyan pleaded guilty to conspiracy to commit health care fraud in October 2018, and are scheduled to be sentenced on June 10.

A Los Angeles, California-based dentist was sentenced to 40 months in prison for his role in a $3.8 million health care fraud scheme in which he billed numerous dental insurance carriers for crowns and fillings that were never provided to patients.

Benjamin Rosenberg, D.D.S., 59, of Los Angeles, was sentenced by U.S. District Judge John A. Kronstadt of the Central District of California, who also ordered Rosenberg to pay $1,414,011.59 in restitution. Rosenberg pleaded guilty on Jan. 31, 2019, to one count of health care fraud.

He was originally charged with six counts of health care fraud and two counts of aggravated identity theft. He had an office at the time located at 8540 S Sepulveda Blvd, Westchester, CA 90045.

As part of his guilty plea, Rosenberg admitted that he submitted and caused to be submitted approximately $3,853,931 in false and fraudulent claims to various insurance companies for dental care that he knew had not been rendered.

Rosenberg further admitted that he submitted these false and fraudulent claims to Denti- Cal (California Medi-Cal Dental Program), Metlife, Anthem, Cigna, Delta Dental, Guardian, LMCO-DHA, United Healthcare and United Concordia (the carriers), which caused the carriers to pay Rosenberg approximately $1,415,011.

Rosenberg was originally licensed by the Dental Board of California in 1988. An Amended Accusation seeking to revoke his license was filed by Kamala Harris the California Attorney General, accused Rosenberg of misconduct dating back to 2010. The Accusation alleged multiple instances of dental insurance fraud.

In September 2017 he submitted a written request to surrender his license to resolve the disciplinary action that was pending. On January 2, 2018 the surrender was accepted and he is no longer licensed as a dentist in California.

This case was investigated by the FBI. Trial Attorney Emily Z. Culbertson of the Criminal Division’s Fraud Section is prosecuting the case.

The Fraud Section leads the Medicare Strike Force, which is part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.

Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 14 strike forces operating in 23 districts, has charged nearly 4,000 defendants who have collectively billed the Medicare program for more than $14 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.