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Tag: 2022 News

California Closes Troubled COVID-19 Lab and $1.7B Contract

According to a report by CapRadio.com, the Newsom administration has quietly ordered the closure of its central COVID-19 testing laboratory, cutting short a controversial no-bid contract worth up to $1.7 billion with global health care giant PerkinElmer.

In a letter obtained by CapRadio, dated March 31, the California Department of Public Health notified the company that it would terminate the contract in 45 days, as allowed under the agreement. The letter thanked PerkinElmer for its partnership and noted the increased availability of antigen testing and expanded commercial testing options as the reasons for terminating the contract.

The state did not mention the myriad of problems PerkinElmer faced since opening the facility, known as the Valencia Branch Laboratory, in October 2020. The issues were severe enough to threaten the lab’s license status.

The termination marks an unceremonious end to a partnership that Gov. Gavin Newsom hailed as keeping California “on the leading and cutting edge” of COVID-19 response. At the facility’s ribbon cutting, Newsom expressed hopes of expanding on the laboratory’s mission to meet the long term needs of communicable disease response and research.

The contract was set to last through October after the state renewed it late last year, despite criticism of the company’s performance. The laboratory – which the state spent $25 million to build out – will be defunct by mid-May, and its future beyond that is uncertain.

As of November, California paid PerkinElmer $716 million under the agreement, with the Federal Emergency Management Agency reimbursing the state $684 million. CDPH did not respond to CapRadio’s request for updated figures.

The state plans to transition away from its centralized test processing through the Valencia Lab and instead use “a network of commercial testing lab partners,” according to an email, obtained by CapRadio, from CDPH to a testing contractor. Details on this substitute network remain scant.

CDPH declined an interview request and instead provided an emailed statement. “This laboratory was opened in 2020 to rapidly expand the state’s testing capacity, drive down costs, and bridge equity gaps,” the statement reads. “Now, at this point in the pandemic and as part of the SMARTER Plan, testing capacity will be provided through a network of commercial partners rather than the Valencia Branch Laboratory.”

The “SMARTER Plan” is the state’s roadmap for emerging from the pandemic.

But the state’s rationale – in its letter to PerkinElmer and in its statement to CapRadio – did not cite a drop in cases or testing demand. Murray did not respond to follow-up questions seeking clarity on this matter.

PerkinElmer struggled right away with obligations laid out in the contract. Inspectors found “significant deficiencies” during a routine inspection in December 2020, only a couple months after the lab opened.

A series of investigations from CBS13 in Sacramento found laboratory technicians were literally sleeping on the job and staff failed to receive adequate training.

In November 2021, the state released a report detailing its efforts to get the laboratory into compliance after inspections found “multiple deficiencies related to documentation, record keeping, process, and training.” The state notified the company of its intent to impose sanctions on the lab late last year, but ultimately did not pursue the penalties.

The report also said it could not substantiate the findings from CBS13; in response, the station claimed its revelations had been confirmed by inspectors.

WCAB Panel Finds California Jurisdiction for Professional Athlete’s Claim

Allen Levrault claimed to have incurred continuous trauma injuries while employed as a professional baseball player for various teams. His paying history within the CT period was stipulated to be the Milwaukee Brewers June 10, 1996 to February 1, 2002 – – Oakland Athletics February 1, 2002 to October 15, 2002 – – Miami Marlins December 12, 2002 to October 15, 2003  – – and the Seattle Mariners April 14, 2004 to May 18, 2004.  Levrault resolved his claim with the Brewers by way of Compromise and Release for the sum of $3,000.

The WCJ concluded that there was no subject-matter jurisdiction over the Seattle Mariners, and that applicant cannot recover against the Miami Marlins based upon the reciprocity provisions of former Labor Code section 3600.5(b).

Reconsideration was granted in the panel decision of Levrault v Mariners, Marlins et. al. (April 2022) ADJ8763377.

Applicant contends that the WCJ erred in finding reciprocity under section 3600.5(b), because Florida’s reciprocity statute was not in effect at the time of his employment with the Marlins, and also that the WCJ should have admitted medical records submitted after the Mandatory Settlement Conference.

Labor code 3600.5 limits the general principles of WCAB jurisdiction in specific circumstances. Because applicant’s claim was filed prior to September 15, 2013, the relevant subdivision here is former section 3600.5(b).

Because Florida passed its reciprocity statute in 2011, after applicant’s injurious exposure but prior to the filing of his California compensation claim, the parties’ disagreement focuses on whether former section 3600.5(b)’s reciprocity requirements must be satisfied at the time of the injurious exposure, or whether it is sufficient that reciprocity exists at the time a claim is filed.

Here, the plain language of former section 3600.5(b) requires that the conditions for application of the exemption – including the reciprocity provisions of subdivision (b)(1)(A) & (B) – apply “while such employee is temporarily within this state doing work for his or her employer[.]” (former § 3600.5(b)(1), emphasis added.)

Accordingly, the exemption is not applicable to applicant’s claim.This result is in accord with past panel decisions such as in Roberts v. Tampa Bay Lightning (2016) ADJ9065158, 2016 Cal. Wrk. Comp. P.D. LEXIS 404.

Turning to the jurisdiction issue, the WCJ made clear that even if subdivision (b) of section 3600.5 does not apply to applicant’s claim, she would have found the claim barred by Federal Insurance Co. v. Workers’ Comp. Appeals Bd. (Johnson) (2013) 221 Cal.App.4th 1116, because applicant’s employment with the Marlins did not constitute a significant connection or nexus with the State of California.

Here, applicant testified – and defendants do not contest – that he was regularly employed in California during 1998 and 2002 while playing for the Ports and the River Cats, minor league affiliates of the Brewers and the Athletics respectively.

This constitutes a sufficient relationship between applicant’s injuries and the State of California to satisfy the Johnson due process requirement of a significant nexus between applicant’s injuries and this state.

Turning to the issue of the admissibility of post MSC medical reports. the WCJ, the most important reason she decided to find these reports inadmissible was a belief that applicant’s attorney had misled the court about applicant’s ability to appear for the original July 2017 trial date; the WCJ continued the matter as a result of representations from applicant’s attorney that applicant could not travel to California for trial because of his recent surgery, but applicant did in fact travel to California during that very period to obtain the post-surgery QME reports in question.

In resolving this issue the panel stated “Although we sympathize with the WCJ’s frustration at what appears to have been at the very minimum extremely questionable representations from applicant’s counsel, we disagree that the remedy here was to refuse to admit medical evidence that appears undoubtedly relevant to assessing applicant’s level of disability. If the WCJ believed that applicant’s attorney had misled the court in order to obtain a continuance of the trial under false pretenses, the remedy for that was sanctions against applicant’s attorney, pursuant to section 5813.”

Carlsbad Startup Developed 3-D Printed Titanium Spinal Implants

Carlsbad based Med-tech startup Carlsmed has developed patented, machine learning technology that taps a patient’s X-ray and CT scans, along with other information, to design a digital surgical plan to achieve the best spinal alignment.

Carlsmed, in coordination with the surgeon, then produces personalized, 3-D printed titanium implants based on the plan.

According to the report in the San Diego Union Tribune, the “aprevo,” implants target adults with degenerative curvature of the spine and other deformities that can lead to lower back and leg pain, among other things. These conditions affect about 6 million adults in the U.S. – a potential $9 billion market.

The current success rate for spinal surgeries to correct these ailments is not great, said Mike Cordonnier, chief executive and co-founder of Carlsmed. More than a quarter of patients require additional revision surgery within four years of their first procedure.

Conventional spinal implants come in a variety of shapes, and it is up to surgeons to find the best fit through a trial-and-error process. Because Carlsmed’s implants are designed for every patent individually, the company believes it can achieve better spinal alignment outcomes and avoid additional procedures

“Our philosophy is we are designing the optimal surgical plan – and devices for that surgical plan – so it can be the last spine surgery a patient needs,” said Cordonnier.

A couple of years ago, the U.S. Food and Drug Administration cleared Carlsmed’s implants for use in certain spine surgeries.

Then in October, Medicare authorized an additional reimbursement – on top of its standard payout – for hospitals using Carlsmed’s implants.

“It is really a program that is designed to incentivize technology that can improve the standard of care and decrease the cost of care over the lifetime of the patient,” said Cordonnier. “That has been a real door opener for us in starting our commercial rollout to be able to give the hospitals an extra economic incentive to adopt this transformative technology.”

The company plans to use the $30 million in new funding to further expand its hospital base. It brings the total raised by the Carlsbad-based company to $42.5 million since it was founded in 2018.

DFEH Lawyer Quits in Protest of Newsom’s Meddling in Activision Case

As gamemaker Activision Blizzard is embroiled in controversy and legal backlash, the situation surrounding one of the industry’s biggest companies continues to unfold.

The company is currently in the middle of a discrimination lawsuit filed by the state of California, and that case has now taken an unexpected turn. A lawyer for the state of California has announced that she is resigning from her position, citing interference from governor Gavin Newsom as the reason.

The story in the Wall Street Journal claims Newsom’s office fired a lawyer involved in the workplace-misconduct lawsuit against videogame company Activision Blizzard Inc., prompting a second attorney to quit in protest, according to a lawyer representing both attorneys.

The California Department of Fair Employment and Housing Chief Counsel Janette Wipper was told by Mr. Newsom’s office on March 29 that she was being fired, according to a statement from Alexis Ronickher, Ms. Wipper’s attorney. Ms. Wipper’s last day at the department was Wednesday and she is evaluating her legal avenues, including a claim under the California Whistleblower Protection Act, the statement said.

Bloomberg reported Melanie Proctor, assistant chief counsel with California’s Department of Fair Employment and Housing, told staff in a Tuesday email she was resigning in protest over the firing of Janette Wipper, the department’s chief counsel who worked on the Activision lawsuit. Proctor also said Newsom’s office asked for “advance notice” on elements of the litigation.

“As we continued to win in state court, this interference increased, mimicking the interests of Activision’s counsel,” the email said, according to Bloomberg.

Newsom’s spokeswoman Erin Mellon said claims of interference by the governor’s office “are categorically false.”  No other details about Newsom’s alleged interference have been made public. Activision spokesman Rich George did not immediately respond to an email Thursday.

However in a related story, Politico reports that a board member for Activision donated $100,000 to a campaign to stop the 2021 recall of Gov. Gavin Newsom, according to state records

Casey Wasserman, CEO of the Wasserman Media Group, is a director at Activision Blizzard, according to the company’s website, and sits on the board of directors and the board’s nominating and corporate governance committee. Just weeks after the California DFEH filed the July suit against the company, alleging rampant sexual harassment and discrimination against women, Wasserman donated $100,000 to the Stop the Republican Recall of Governor Newsom campaign, according to campaign finance records.

The Activision suit – filed in July 2021 in Los Angeles – comes after two years of investigation conducted by the DFEH. It accuses the “Call of Duty” maker of fostering a “pervasive frat boy” culture where women are paid less for the same jobs that men perform, regularly face sexual harassment, and are targeted for reporting issues. In particular, the suit claims that female employees face “constant sexual harassment,” from “having to continually fend off unwanted sexual comments” to “being groped.” When employees report issues to human resources and management, the suit says, no action is taken.

Activision has refuted many of the suit’s claims and said it has cooperated with the DFEH’s investigation.

Within a couple months of the California agency filing its original suit, the US Equal Employment Opportunity Commission filed its own lawsuit against Activision Blizzard, and agreed to settle it the same day. In March, the company agreed to an $18 million settlement with the federal Equal Employment Opportunity Commission over similar harassment and discrimination allegations.

The DFEH objected to the settlement and its small $18 million fund set up for “eligible claimants.” Among the reasons for the objection were that the settlement involved anyone receiving a portion of that $18 million to sign a waiver giving up their right to collect any other restitution over wrongdoings by Activision.

The DFEH also objected to the settlement arguing that it essentially ordered tampering of evidence relevant to its own case. The original proposed settlement required Activision Blizzard to “remove from the personnel files of each Eligible Claimant any references to the allegations related to sexual harassment, pregnancy discrimination, and/or related retaliation” and reclassify the terminations of anyone fired in retaliation as voluntary resignations.

In return, the federal EEOC accused the state agency of ethics violations because two of the DFEH attorneys looking to give Activision Blizzard more than a slap on the wrist previously had senior roles in the EEOC and led the investigation that resulted in its own lawsuit.

In January 2022, Microsoft announced intentions to buy Activision for an estimated $68.7 billion in an all-cash deal. The Seattle computing giant is expected to inherit the DFEH lawsuit should the deal pass regulation and close later this year.

Battle Lines Drawn Over California Deal With Kaiser Permanente

California counties, health insurance plans, community clinics, and a major national health care labor union are lining up against a controversial deal to grant HMO giant Kaiser Permanente a no-bid statewide Medi-Cal contract as the bill heads for its first legislative hearing Tuesday.

The deal, hammered out earlier this year in closed-door talks between Kaiser Permanente and Gov. Gavin Newsom’s office and first reported by KHN, would allow KP to operate Medi-Cal plans in at least 32 counties without having to bid for the contracts. Medi-Cal’s other eight commercial health plans must compete for their contracts.

Opponents of the KP proposal say they were blindsided by it after having spent months planning for big changes happening in Medi-Cal, which serves more than 14 million Californians. They say the deal would largely allow KP to continue picking the enrollees it wants, and they fear that would give it a healthier and less expensive patient population than other health plans.

Currently, the state allows KP to limit its Medi-Cal membership by accepting only those who have been its members in the recent past, primarily in employer-based or Affordable Care Act plans, and their immediate family members.

Kaiser Permanente said in an emailed statement that, under the terms of the deal, it would take more Medi-Cal patients with high needs and would collaborate with counties and other health plans on patient care.

The deal must win state legislative and federal approval. Opposition to the bill that would codify it, AB 2724, is being spearheaded by Local Health Plans of California, which represents the 16 local, publicly governed Medi-Cal plans that cover most of the 12 million Medi-Cal beneficiaries in managed care. The proposal would make many of them direct competitors of Kaiser Permanente, and they could lose hundreds of thousands of enrollees and millions of dollars in Medi-Cal revenue.

Among them are some of the state’s largest Medi-Cal health plans, including L.A. Care, by far the biggest, with 2.4 million members; and the Inland Empire Health Plan, with about 1.5 million members in San Bernardino and Riverside counties.

In addition, the boards of supervisors of 16 counties had registered their opposition as of April 15, as had the California State Association of Counties, at least two community clinic groups, and the National Union of Healthcare Workers, which represents thousands of KP clinicians.

The other commercial Medi-Cal plans are lying low as they bid for the state’s Medi-Cal business. The two largest, Health Net and Anthem Blue Cross, declined to comment.

Audit of California State Bar Discipline System Confirms Epic Failures

The Legislature passed a law, which became effective on January 1, 2022, requiring the California State Auditor’s Office to conduct an audit of the State Bar’s attorney complaint and discipline process. The Legislature included this requirement in the law because the State Bar did not take action against Los Angeles lawyer Tomas Girardi, husband of “Real Housewives of Beverly Hills” star Erika Jayne, for misconduct until recently, despite repeated allegations of this attorney’s misconduct over decades.

The prequel to the State Auditor’s report that was just published, was a Los Angeles Times investigation that documented how the now-disgraced attorney Tom Girardi cultivated close relationships with the agency and kept an unblemished law license despite over 100 lawsuits against him or his firm – with many alleging misappropriation of client money. Along with his family and employees, Girardi contributed more than $7.3 million to political candidates.

In months of interviews and reviews of documents, the Times found that Girardi cultivated close relationships with bar officials that at times appeared improper. Agency staffers received annual invitations to a Las Vegas legal conference, where Girardi hosted over-the-top parties at the Wynn casino featuring Jay Leno and other celebrity entertainers.

While under investigation for misconduct in 2010, Girardi bankrolled a lavish retirement bash for the chief justice of the state Supreme Court, which oversees the bar, even booking crooner Paul Anka to perform, according to news reports, court records and interviews with attendees.

He forged a particularly tight relationship with a bar investigator named Tom Layton. Over the decade and a half Layton worked at the bar, Girardi routinely treated him to pricey meals at the Jonathan Club, Morton’s and the Palm, according to Layton’s sworn testimony. The investigator rode on Girardi’s private jet and two of his children got jobs at Girardi Keese, according to the testimony and an online resume.

Another prequel was the audit by the State Bar of the Girardi situation, which it announced in June 2021. The public outcry over Girardi’s long history of complaints prompted the State Bar to conduct its own special disciplinary audit.

The announcement admitted that “The audit, commissioned by Interim Chief Trial Counsel Melanie Lawrence, revealed mistakes made in some investigations over the many decades of Mr. Girardi’s career going back some 40 years and spanning the tenure of many Chief Trial Counsels. In particular, the audit identified significant issues regarding the Office of Chief Trial Counsel’s investigation and evaluation of high-dollar, high-volume trust accounts.

Nearly a year later, the California State Auditor in its April 14, 2022 report elaborates on the Girardi case, and embellishes the issue with many more examples that go beyond accusations against Girardi, to outline a broken disciplinary process.

Among the cases the auditor’s report highlighted is an attorney who accumulated 165 complaints from 2014 to 2021 and has never been disciplined. In another case, the state bar did not analyze the attorney’s bank records until the agency received more than 10 complaints in two years. Bank records then showed the attorney misappropriated $41,000 from several clients.

The state bar closed 87 complaints against an attorney later convicted in federal court for money laundering through client trust accounts, closing some of these cases through nonpublic measures. Others, called de minimis closings, were done without ever contacting attorney because the agency considered the amount of money involved relatively small.

The State Auditor said that “Our audit of the state bar found that it failed to effectively deter or prevent some attorneys from repeatedly violating professional standards,” said acting State Auditor Michael Tilden in the report. And that the “state bar is not appropriately assessing how conflicts of interest pose a risk that staff will close cases inappropriately.”

And the written response by the Bar to the State Auditor’s report does not dispute the troubling findings. It said “Given the Board’s intense focus on the discipline system, and our understanding of the gravity of the deficiencies that the Girardi matter laid bare, some of the findings in your recent report are profoundly eye-opening and troubling.

The chair of the State Bar’s board of trustees, Ruben Duran, said in an interview that he was troubled by the audit’s findings, calling its conclusions “some of the hardest-hitting discoveries” that the State Auditor has ever made about the agency.

Assemblymember Mark Stone (D-Scotts Valley), who is chair of the Assembly’s Judiciary Committee, said the audit was “profoundly eye-opening.”

In reviewing the Auditor’s report, the Los Angeles Times said that Girardi was once a top plaintiffs’ attorney and Democratic powerbroker. His downfall in December 2020 was in part triggered by a judge finding that he had misappropriated millions from families of those killed in an Indonesian plane crash. But after the collapse of his Wilshire Boulevard law firm, scores of clients came forward saying they were swindled by Girardi and The Times documented a trail of misconduct allegations going back decades.

Earlier this month, a Chicago law firm accused Girardi and other lawyers at his defunct firm of running “the largest criminal racketeering enterprise in the history of plaintiffs’ law,” pocketing millions from clients, vendors and fellow attorneys.

NSC Helps Employers Build Business Case for Safety Innovation

The National Safety Council just released through its Work to Zero initiative a new white paper: Making the Business Case for Safety Innovation. The report builds on the initiative’s initial 2020 research and outlines how employers can calculate and leverage the lifesaving and cost-saving benefits of safety technology in the workplace.

The white paper examines the benefits of eight key technologies – ranging from solutions for fatigue monitoring to autonomous mobile robots (AMRs) for material handling and sensor technology for proximity detection and collision avoidance.

This report illustrates the return on investment using safety technology to reduce workplace injuries and fatalities across a spectrum of industries and businesses. Along with the paper, the NSC Work to Zero investment calculator was released, which allows companies to explore the value of each of these key technologies in saving lives and saving money.

“We know financial constraints are a common barrier to investing in safety technology, especially across low-margin industries. However, last year, nearly 5,000 individuals were lost to preventable workplace fatalities, which is why educating small and large businesses alike on the costs saved and earned through a broader implementation of these technologies is critical,” said Paul Vincent, NSC vice president of workplace practice. “This report ultimately provides environment, health and safety managers a quantifiable foundation for building a business case for safety innovation, which we know saves worker lives.”

Compared to maintaining a business-as-usual state, Work to Zero found businesses that invest in safety innovation not only stand to quickly recoup their initial investments, but also experience greater efficiencies in production and quality due to the prevention of serious injuries and fatalities.

Computing the financial implications of technology adoption represents arguably the most essential step towards initializing investment – to make the case to management to prioritize project budgets. The return on investment (ROI) calculator is a valuable tool to help support a business case for innovation by providing a metric for profitably of the investment; comparing investment cost to how much is earned/saved from implementation.

For example, organizations in higher-risk industries can expect short payback periods, such as a large construction company analyzed to have experienced year-over-year returns, totaling nearly $1.8 million in the fifth year alone, following sensor technology implementation (see Figure 3 and Figure 4). These savings are a result of reducing missed workdays, medical costs and wage losses, among several other factors.

Funded by the McElhattan Foundation, Work to Zero aims to eliminate workplace fatalities by 2050. In addition to helping make safety innovation more accessible to employers, the initiative recently partnered with Safetytech Accelerator on a pilot program to mitigate risks around working at height.

Interest Calculation Clarified in Uninsured Employer Restitution Order

Robert Reagan, III died on July 26, 2016, while operating Ian Czirban’s bulldozer at the Soberanes wildfire in Monterey County. Reagan was ejected from the bulldozer and crushed to death by it.

Shortly after Reagan’s death, Morgan K., Reagan’s partner and the mother of their two children, discovered that Czirban did not have workers’ compensation insurance.

Attorney Thomas Tusan filed claims with the Uninsured Employers’ Benefits Trust Fund for death benefits. The case resulted in a Compromise and Release Agreement $310,218.80 for death benefits and funeral expenses, less $47,557.43 in professional fees and cost reimbursement to Mr. Tusan.

The trial court in the related criminal action convicted Czirban of a number of crimes including misdemeanor failure to secure payment of workers’ compensation insurance. Czirban was placed on felony probation for three years, and the issue of victim restitution was reserved.

Czirban appealed the judgment of conviction, which was affirmed in the published case of People v Czirban (Czirban I, – 2021) 67 Cal.App.5th 1073 .

While that appeal was pending, the trial court ordered Czirban to pay, as a condition of his probation, victim restitution in the amount of $70,667.56 to Morgan K..

The Court of Appeal reversed the award of $22,485 in interest in the new unpublished case of People v Czirban CA6 H048989 ( Czirban II – April 2022).

Czirban contends on his second appeal that (1) the trial court abused its discretion by ordering him to pay attorney fees because the Labor Code explicitly prohibits the payment of attorney fees out of a survivors’ benefit; (2) the order for payment of attorney fees as a condition of probation is unreasonable, irrationally calculated, and based on an erroneous legal standard; and (3) the trial court abused its discretion when determining the interest award. The Court of Appeal found no merit to issues 1 and 2.

In its restitution order, the trial court ordered Czirban to pay Morgan $22,485.13 in interest. The trial court calculated that figure based on $46,352 in attorney fees, $1,205.43 in costs, and $625 in unpaid wages that Czirban had promised to Reagan.

Because the earliest date Morgan could have incurred an economic loss for either the fees or costs was 2020 (not at the time of Reagan’s death), the trial court committed an error of law when it aggregated the unpaid wages, attorney fees, and costs and calculated interest using a loss date of Reagan’s death for all three categories.

The trial court did not err in setting the loss date for the unpaid wages as the date of Reagan’s death.

Sedgwick Publishes Commentary on Long COVID Claims

Long COVID is a colloquial term for the condition whose scientific name is post-acute sequelae of SARS-CoV-2 infection, or PASC. It’s also sometimes referred to as long-haul COVID, long-term COVID or post-COVID conditions/syndrome.

Long COVID is an umbrella term that encompasses cases in which people experience symptoms related to COVID-19 long after the standard expected recovery period.

Research findings on the prevalence of long COVID vary greatly. Some estimate that fewer than 10% of those who had COVID are experiencing long-term symptoms, while others have found it to be as many as half of research participants. One study hypothesizes that up to 80% of COVID patients will experience at least one long-term, persistent symptom. Because the condition is still quite new, reliable longitudinal data is not yet available.

Theories regarding the causes of long COVID vary, with some speculating that it arises from immune activation and others projecting that it stems from damage caused by the virus or a low-level presence of the virus. Based on early studies, risk factors associated with developing long COVID include initial disease severity and other pre-existing comorbidities like advanced age, being female, high blood pressure, smoking, diabetes, obesity and psychiatric disorders.

While most employees who contract COVID can return to work at full capacity within a week or two, those experiencing long-haul symptoms may have functional impairments that significantly affect productivity.

The extreme fatigue associated with long COVID can leave workers with little stamina to meet job demands. “Brain fog” can impede reaction time, memory and the ability to assimilate new information; performing simple tasks and finding the right words to communicate may become difficult.

In addition, previously healthy individuals carrying the mental burden of their long-haul symptoms – and suddenly having difficulty focusing, concentrating and thinking at work – may experience anxiety, stress, depression and even trauma as a result of not being able to perform as they once did. Further compounding these cognitive and emotional challenges is the fact that symptoms can come and go, so employees often can’t predict how they will feel or perform at any given time.

As with any significant health concern affecting the workforce, monitoring workers’ compensation, disability and leave of absence claim counts and durations is essential to grasping the scope of the organizational impact of long COVID. However, there are a few challenges worth noting with regard to tracking long COVID:

– – For now, there is no true diagnostic category for long COVID. (The ICD-10 code for post-COVID conditions is, as of the time of this publication, awaiting final approval.) Tracking COVID claims lasting at least a certain number of days may not yield completely accurate data on long COVID, as they will also include extended hospital stays and debilitating symptoms associated with the original bouts of COVID.
– – Because the symptoms of long COVID are sporadic and often differ from those that people experienced when first contracting the virus, the resulting health challenges are not always accurately identified as being associated with COVID.
– – Workers’ compensation data may not tell the whole story of long COVID. Even in U.S. states where COVID-19 diagnoses among certain categories of workers are presumed to be work-related and thus covered under WC, individuals with long-term complications have a new burden of proof to show that their lingering symptoms are directly associated with their original COVID claims. Extended durations between claim incidents can further complicate this burden of proof and the ability to demonstrate compensability.

For more information, download and read the full paper: Sedgwick: COVID-19: In it for the long haul.

Largest Hospital Systems Ignoring 2 Year Old Price Transparency Law

Under the authority of the Affordable Care Act (ACA), a federal hospital price transparency rule took effect January 1, 2021, requiring hospitals to post all prices online, easily accessible without barriers such as having to submit personal identifying information.

In July 2021, the PatientRightsAdvocate.org research team conducted its first review of hospital compliance and found widespread failure of hospitals to fully publish their prices across all payers and plans. It estimated that only 5.6% of the 500 random hospitals reviewed were compliant with the rule.

January 1, 2022 began the second year of the legal requirements for hospitals to post all prices online. This 2022 report assessed the compliance with the law by reviewing 1,000 U.S. hospitals out of the over 6,000 accredited hospitals in the country, including the original 500 hospitals it previously reviewed.

A team of four PatientRightsAdvocate.org research analysts assessed the websites for hospital compliance. Separately, an independent review and validation of the report using a substantial sample of the data were performed from January 19 to 28, 2022 for PatientRightsAdvocate.org by FireLight Health LLC, an independent healthcare price data company with expertise in hospital price transparency data.

Of the 1,000 total hospitals reviewed, it found:

– – Only 14.3% were complying with the transparency rule.
– – Only 37.9% of the hospitals posted a sufficient amount of negotiated rates, but over half were not compliant in other criteria of the rule, such as rates by each insurer and named plan.
– – Only 0.5% of hospitals owned by the three largest hospital systems in the country – HCA Healthcare, CommonSpirit Health, and Ascension – were in compliance.

Notably, only two of the 361 hospitals owned by these three hospital systems were compliant with the rule. Strikingly, for HCA Healthcare, the largest for-profit hospital system in the country, none of its 188 hospitals (0/188) were in compliance. In 2021, these three large noncompliant hospital systems’ combined total revenue approached $120 billion. The cost of compliance calculated in the rule is only $12,000 per hospital.

The most prevalent omission deeming noncompliance was non-posting or incomplete posting of all of the negotiated prices for each item and service clearly associated with all of the payers and plans accepted by the hospital.

Based on this review, it estimated that only 14.3% of the 1,000 hospitals (143/1,000), were in compliance with all of the price transparency rule requirements. It estimated that 85.7% (857/1,000) were noncompliant, because one or more price transparency requirements were not met. The largest hospital systems are effectively ignoring the law, with no consequences.