Tag: 2021 News

The days of waiting some time for a pharmacist to fill a prescription made by your doctor may soon be behind us.

Pharmacies, doctors’ offices and other medical institutions could one day offer individual patients medications that are customized to their needs using 3D printing technology.  

Courthouse News reports that the new technology has been developed in recent years under an expanding field of pharmaceutical research aiming to understand how to shape the effect medication has on patients.

The 3D-printed pill model could spark a wave of personalized pharmacological interventions tailored to meet the unique needs of all patients, according to lead researcher of the study Sheng Qi.

Qi, a professor at the United Kingdom’s University of East Anglia, said in a statement released with the study that the current pharmacological landscape currently takes the opposite approach, manufacturing one form of medication meant to satisfy all patients.

“Personalized medicine uses new manufacturing technology to produce pills that have the accurate dose and drug combinations tailored to individual patients. This would allow the patients to get maximal drug benefit with minimal side effects,” Qi said. “Such treatment approaches can particularly benefit elderly patients who often have to take many different types of medicines per day, and patients with complicated conditions such as cancer, mental illness and inflammatory bowel disease.”

The study’s findings could one day shape an element of personalized medicine that can create a tailored pharmacological regimen at the site where patients are being treated, Qi said.

Most 3D-printed products and objects use a device that heats filament material and places tiny fragments of the filament into a custom pattern.

The personalized pills are created using a newly developed 3D printing method that can shape a pill containing the medication without the use of filaments.

The research team led by Qi has developed the ability to print pills that feature more porous structures allowing for faster or slower release of medicine when taken orally.

The findings show that the speed of medicine dispersing within the body can be regulated by pill structures created using the new technology, according to the study published Monday in the International Journal of Pharmaceutics.

The study said future research is needed to make the technology produce pills that can regulate dosing frequency.

If the technology is improved, people on complex medical regimens requiring multiple medications taken each day could one day be able to take one pill that slowly releases a day’s worth of doses.

Researchers Andy Gleadall and Richard Bibb of England’s Loughborough University also contributed to the study.

Members of the study team did not immediately respond to a request for further comment on the report.

The current issue of the National Council on Compensation Insurance, Quarterly Economics Briefing – Q1 2021, surveys recent developments related to employment and wages and considers the risk to the emerging economic recovery from a possible fourth COVID surge.

The two-month fall in coronavirus case rates, coincident with the appearance of new vaccines, has kindled optimism. The expectation that new vaccines will bring the coronavirus pandemic under control by year-end, if not sooner, is itself a powerful driver for rapid recovery of spending and jobs in the United States – if that expectation is borne out in coming months.

After stagnating during the nationwide coronavirus (COVID-19) surge last winter, the pace of job recovery picked up in February and March. The rollout of new vaccines and a fall in coronavirus case rates are creating an expectation that the COVID recession may be over by year-end, if not sooner. This is also boosting discretionary consumption and new hiring.

However, an uptick in case rates beginning in late March casts a shadow on the prevailing mood of optimism.

Key Themes and Takeaways

– – Strong employment growth in February and March, plus declining coronavirus case rates and increasing vaccinations, point to an accelerating pace of economic recovery in 2021.
– – The March national employment gap is down to -=5.4%, a shortfall of 7 million jobs relative to seasonally expected employment levels. Lost jobs remain concentrated in service sectors, especially Leisure and Hospitality. Construction and Manufacturing are recovering strongly, but both sectors face material shortages and supply chain bottlenecks.
– – Unadjusted average weekly wages rose by more than 7% in 2020, in large measure because COVID-related job losses are concentrated among low-wage workers. Adjusting for the effect of COVID-related job losses on the wage distribution, average weekly wages rose by 3% in 2020 among workers who remained employed.
– – Economic impact payments from two new federal stimulus programs enacted in December and March were distributed to households during the first quarter. Transfer payments have kept national household disposable income and savings above pre-pandemic 2019 levels. Strong household balance sheets provide wherewithal to drive a rapid rebound in discretionary consumption spending in 2021.
– – About 30% of the United States population received at least one vaccine dose by the end of March, and vaccination rates are currently on the order of 3 million people per day. New coronavirus cases in March were down to about one-third of January’s rate. However, several states reported increases in cases and hospitalizations in late March attributed to a new and more contagious variant of the coronavirus.
– – Job losses from a new COVID surge, if it develops, may be modest – like those during last winter’s surge, but much lower than in two previous virus surges in spring and summer 2020.

Read the full Quarterly Economics Briefing for an in-depth look at the economy and how it is impacting workers compensation.

The Division of Workers’ Compensation has posted proposed amendments to the Qualified Medical Evaluator (QME) regulations to its online forum where members of the public may review and comment on the proposals.

The proposed changes are necessary to bring existing regulations into compliance with amendments to the Labor Code and to clarify the Administrative Director’s authority with respect to the processes related to appointment and reappointment of Qualified Medical Evaluators, which is granted by relevant statutory authority.

The draft regulations include:

– – Clarification of regard to definitions to conform to changes made by Senate Bill 863
– – Provisions prohibiting providing false information on the application or reapplication for appointment
– – Provisions to conform amended regulations with proper gender pronouns
– – Provisions for electronic service of medical-legal reports and use of electronic signatures in the QME program
– – Revision of the number of hours necessary for initial qualification of physicians as QMEs
– – Revision of continuing education requirements including hourly requirements and the addition of anti-bias training for QMEs
– – Provisions that require a QME to comply with all Administrative Director’s regulations in order to be reappointed as a QME.
– – There is also a new regulation that provides a specific implementation of existing discretionary authority of the Administrative Director pursuant to Labor Code § 139.2
– – Clarification of the use of probation as a disciplinary sanction and allowing the Administrative Director to designate hearing officers for adjudication of disputes regarding appointment and reappointment applications
– – Clerical changes to the regulation on QME unavailability
– – Provisions allowing QME reappointment hearings to be heard by other tribunals in addition to the Office of Administrative Hearings
– – Regulations that are consolidated into new subdivisions are repealed.

The forum can be found on the DWC forums webpage under “current forums.” Comments can be submitted to DWCrules@dir.ca.gov and will be accepted until 5 p.m. on Friday, May 14, 2021.

The Ninth Circuit Court of Appeals ruled that Assembly Bill 5 was not preempted by federal laws governing the trucking industry, and reversed a lower court ruling, as it ordered freight carriers to begin complying with the California employment law.

Before 2018, the California Supreme Court’s framework for classifying workers as either employees or independent contractors was set forth in S.G. Borello & Sons, Inc. v. Department of Industrial Relations, 48 Cal. 3d 341 (1989).

Almost thirty years after Borello, the California Supreme Court revisited the framework for classifying workers as employees or independent contractors for purposes of California’s Industrial Welfare Commission (IWC) Wage Orders.2 See Dynamex Operations W. v. Superior Ct., 4 Cal. 5th 903, 912, 957 (2018). Dynamex adopted a standard commonly referred to as the “ABC” test.

In September 2019, the California legislature enacted AB- 5, which codified the ABC test and expanded its applicability. See Cal. Lab. Code § 2775.

The California Trucking Association, a trade association representing motor carriers that hire independent contractors who own their own trucks, and two independent owner-operators filed suit, seeking to enjoin enforcement of AB-5. It viewed the new rule statutorily classifying a worker as an employee as effectively precluding the business model employed by CTA’s members.

In October 2018, after Dynamex was decided, CTA, along with two independent owner-operators, filed this lawsuit against Xavier Becerra, the Attorney General of California, and others, seeking a declaration that the federal law, the Federal Aviation Administration Authorization Act of 1994 (FAAAA), preempted the ABC test as applied to motor carriers.The district court allowed the International Brotherhood of Teamsters, a labor union that represents owneroperators classified as employees, to intervene.

The federal district court held that CTA was likely to succeed on the merits of its claim. It therefore enjoined the state from enforcing AB-5 against any motor carrier doing business in California. The 9th Circuit Court of Appeals reversed in the published case of California Trucking Association v Bonita.

The Supremacy Clause of the United States Constitution provides that federal law “shall be the supreme Law of the Land; and the Judges in every State shall be bound thereby, anything in the Constitution or Laws of any State to the Contrary notwithstanding.”

In Dilts v. Penske Logistics, LLC, 769 F.3d 637, 647 (9th Cir. 2014), the 9th Circuit determined that California’s meal and rest break laws, as applied to motor carriers, are not preempted by the FAAAA. See also Ridgeway, 946 F.3d at 1083-86 (holding that the FAAAA does not preempt a California minimum-wage law that would require Walmart to pay long-haul-truck-drivers minimum wages for layovers in California.

Four years after Dilts, the 9th Circuit concluded that the FAAAA does not preempt the test for classifying California workers as either employees or independent contractors. AB-5 is not significantly related to rates, routes, or services. Therefore, it concluded that the F4A does not preempt AB-5 as applied to motor carriers.

Liana Karapetyan, 41, of El Dorado Hills, pleaded guilty to one count of conspiracy to commit health care fraud and one count of conspiracy to pay and receive health care kickbacks.

According to court documents, Karapetyan and another individual owned and controlled home health care and hospice agencies in the greater Sacramento area: ANG Health Care Inc., Excel Home Healthcare Inc., and Excel Hospice Inc.

Karapetyan and another individual paid and directed others to pay kickbacks to multiple individuals for beneficiary referrals, including employees of health care facilities, as well as employees’ spouses.

The kickback recipients included John Eby, a registered nurse who worked for a hospital in Sacramento; Anita Vijay, the director of social services at a skilled nursing and assisted living facility in Sacramento; Jai Vijay, Anita Vijay’s husband; and Mariela Panganiban, the director of social services at a skilled nursing facility in Roseville.

In total, Karapetyan and others caused the agencies to submit over 8,000 claims to Medicare for the cost of home health care and hospice services. Based on those claims, Medicare paid the agencies approximately $31 million. Of that amount, Medicare paid the agencies at least over $2 million for services purportedly provided to beneficiaries referred in exchange for kickbacks paid to, among others, Eby, Anita Vijay, Jai Vijay, and Panganiban.

Because the agencies obtained the beneficiary referrals by paying kickbacks, the agencies should not have received any Medicare reimbursement.

This case is a product of an investigation by the Federal Bureau of Investigation and the Department of Health and Human Services’ Office of Inspector General. Assistant U.S. Attorney Matthew Thuesen is prosecuting the case.

Karapetyan will be sentenced on on Aug. 26. She faces maximum statutory penalties of 10 years in prison for the health care fraud conspiracy charge and five years in prison for the kickback conspiracy charge. She also faces a maximum fine of $250,000 or twice the gross gain or loss for each charge.

In separate cases, Eby, Jai Vijay, Anita Vijay, and Panganiban pleaded guilty for their roles in the kickback scheme. They await sentencing.