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Tag: 2022 News

Survey Shows Fading Enthusiasm for Hybrid Work From Home

As the world gets closer to the eventual end of the virus pandemic, more than ever, white-collar workers worldwide are working remotely, and last year most said they want to keep that arrangement with employers. Just 3% of white collar workers wanted to return to the office five days a week, according to a poll by Accenture Research last year. But this year, the love affair with hybrid work may be fading.

A full 86% of employees wanted to work from home at least two days a week, the report said after surveying nearly 10,000 people around the world last year, across areas including finance, technology and energy. All age groups felt the same way, they added. Workers reported a preference for commuting into cities on Tuesdays, Wednesdays and Thursdays, raising the prospect of empty offices for the rest of the week.

Many banks geared up for flexible working after two years of COVID lockdowns, with the likes of Citigroup Inc., HSBC Holdings Plc and NatWest Group Plc allowing hybrid working for many staff. Some fintech companies like Revolut Ltd. and Eigen Technologies Ltd. are even allowing staff to work entirely remotely.

NatWest expects around 87% of its 60,000 staff to split work between home and the office in the longer term. For now about 10,000 of its staff, including traders and employees in branches and data centers, still work entirely in the office, Sam Bowerman, one of the bank’s human resources directors, said in an interview earlier this month.

“We’re keen to avoid mandating X number of days per week. It’s customer led,” Bowerman said. “So far we’ve seen no detriment to productivity and the flexibility has produced a lot of goodwill.”

In theory, hybrid offers the best deal for both employer and employee. It combines pre-Covid-19 patterns of office-based working with remote days, in a working schedule that would allow both in-person collaboration and team building, as well as greater flexibility and the opportunity for focused work at home.

But in reviewing the phenomena, the BBC claims in a story reported in January, that emerging data is beginning to back up anecdotal evidence: many workers report, that hybrid work is emotionally draining.

In a recent global study by Seattle based employee engagement platform Tinypulse, more than 80% of people leaders reported that such a set-up was exhausting for employees. Workers, too, reported hybrid was more emotionally taxing than fully remote arrangements – and, even full-time office-based work.

“There was a feeling that hybrid would be the best of both worlds,” says Elora Voyles, an industrial organizational psychologist and people scientist at Tinypulse, based in California. “For bosses, it means they retain a sense of control and that they can see their workers in person. For employees, it offers more flexibility than full-time in the office and means they can work safely during the pandemic.”

However, as the novelty of hybrid working has faded, so too has workers’ enthusiasm. “We found that people were less positive about hybrid through 2021 as the year went on,” explains Voyles.

Optimism among workers soon gave way to fatigue. In Tinypulse’s survey of 100 global workers, 72% reported exhaustion from working hybrid – nearly double the figures for fully remote employees and also greater than those based fully in the office. Voyles says the small sample size reflects a wider trend; she believes it’s the disruption to employees’ daily routines – and the staccato nature of hybrid – that workers find so tiring.

Physically carrying work back-and-forth between home and the office may also come with a psychological impact for some. A recent study found 20% of UK workers reported difficulties switching off from work and feeling ‘always on’; struggling to adapt to hybrid, and the permeable boundaries between home and work, was cited as a major factor.

Contracting Company Owners Get Jail Time for $1M Comp Fraud

Carmen Hall Soruco, 70, and her husband Antonio Soruco, 75, both of Novato, were sentenced last week after pleading guilty to workers’ compensation fraud charges.

Carmen Hall Soruco was sentenced on multiple felony counts to two years of probation with full search and seizure, 120 days in jail, and ordered to pay over $925,000 in restitution to State Compensation Insurance Fund and Employment Development Department.

Antonio Soruco was sentenced to one year of probation with full search and seizure, 120 days in jail, and was also ordered to pay over $925,000 in restitution to SCIF and EDD after pleading guilty to multiple misdemeanor charges.

The Department of Insurance began an investigation into Soruco Structures, a general contractor company, after a worker filed a Workers’ Compensation claim alleging to be injured on a job site while working.

The business had not reported employees or payroll on their Workers’ Compensation policy until the claim was filed. Although Soruco Structures was licensed as a sole proprietorship under Carmen Hall Soruco, Antonio Soruco, Hall’s husband, also operated the business.

The investigation revealed Hall and Soruco committed Workers’ Compensation insurance premium fraud by failing to report employees and payroll to SCIF from October 15, 2013 through December 8, 2016.

The investigation further revealed unreported payroll to SCIF, leading to a premium loss of approximately $585,666. Investigators also discovered Hall and Soruco committed payroll tax evasion by failing to report employees and payroll to California’s EDD from October 15, 2013 through February 6, 2019 which resulted in a payroll tax loss to EDD of approximately $342,405.

This case was prosecuted by the Marin County District Attorney’s Office.

Last Guilty Plea Wraps Up Fraud Case Involving SUI Investigator

A San Fernando Valley woman pleaded guilty to federal criminal charges for conspiring to defraud health insurance companies by causing millions of dollars in fraudulent claims to be submitted to provide patients with “free” cosmetic procedures, including Botox injections. The indictment included several co-conspirators, including an insurance company SIU investigator who helped her avoid detection.

Roshanak Khadem, 54, a.k.a. “Roxanne Khadem” and “Roxy Khadem,” of Sherman Oaks, pleaded guilty to one count of conspiracy to commit health care fraud and one count of subscribing to a false income tax return. She was the last of the group to plead guilty.

According to her plea agreement, she owned and operated facilities that provided aesthetic services to clients, including R&R Med Spa in Valley Village and Nu-Me Aesthetic and Anti-Aging Center in Woodland Hills.

Khadem caused patients to visit her clinics to receive cosmetic procedures, including Botox injections, facials and laser hair removal. Khadem knew these procedures were not covered by the patients’ health insurers. Khadem also knew that her employees informed some patients that, if they turned over their health insurance information to the Khadem-owned clinics, the patients could receive free or discounted cosmetic procedures pursuant to a “credit” they would earn.

Health insurance information from these patients was provided to the insurance biller for the clinics, knowing and intending that the information would be used to submit false and fraudulent claims to the health insurers for medical procedures that Khadem knew were either not actually provided to the patients or were not medically necessary.

Then, based on the amount that the health insurers paid on those false and fraudulent claims, Khadem and others would calculate an amount, which the co-conspirators referred to as a “credit,” that the patients could use to receive free or discounted cosmetic procedures from the clinics. Those patients would then come into the clinics to receive the free or discounted cosmetic procedures.

Khadem and her co-conspirators submitted claims, which included false and fraudulent claims for which those companies paid out at least $1,361,200.  Prosecutors estimate the amounts paid based on false and fraudulent claims submitted as part of the health care fraud conspiracy in which Khadem participated could be as much as $7,991,406.

Khadem failed to report this income on her income tax returns for 2013, 2014 and 2015. Khadem’s underreporting of her income for these three years caused a total tax loss of $453,451.

A June 27 sentencing hearing hearing has been scheduled, at which time she will face a statutory maximum sentence of 13 years in federal prison.

44 year old Gary Jizmejian, who lives in Santa Clarita, and who was a former senior investigator at the Anthem Special Investigations Unit, the anti-fraud unit within Anthem, previously pleaded guilty to using his cell phone to send text messages to co-defendants as part of a this commercial bribery scheme was also sentenced to 18 months in federal prison.

The indictment alleged that, in return for cash payments, Jizmejian assisted Khadem and others by providing them with confidential Anthem information that helped them submit fraudulent bills to Anthem. In September 2012, Jizmejian gave Khadem insurance billing codes – CPT Codes – that Jizmejian knew could be used to submit fraudulent claims to Anthem without Anthem detecting the fraudulent claims. Jizmejian gave Khadem the billing code for an allergy-related lab test and instructed her to submit to Anthem large numbers of bills with this CPT code. Khadem and other members of the conspiracy used this billing code to submit approximately $1 million in fraudulent claims to Anthem, according to the indictment.

The indictment further alleged that Jizmejian worked to prevent the insurance companies from detecting the fraud at the clinics, which included helping Khadem to avoid responding to inquiries from fraud investigators, diverting attention of other Anthem SIU investigators away from the clinics, and closing Anthem investigations into fraud that was being committed at the clinics.

In September 2015, based on confidential information obtained from Anthem, Jizmejian tipped Khadem off about a federal criminal investigation into the clinics, according to the indictment.

The remaining three defendants in this case each have pleaded guilty. Lucine Ilangezyan, 42, of North Hills, pleaded guilty to one count of conspiracy to commit health fraud, and was sentenced to 18 months in federal prison. Dr. Roberto Mariano, 63, of Rancho Cucamonga, a physician who helped operate the clinics, and Marina Sarkisyan, 52, of Panorama City, who was the office manager at the clinics, await sentencing.

DWC Posts Annual Report of Inventory Reminder

Claims administrators are reminded that the Annual Report of Inventory (ARI) must be submitted in early 2022 for claims reported in calendar year 2021.

The California Code of Regulations, title 8, Section 10104 requires claims administrators to file, by April 1 of each year, an ARI with the Division of Workers’ Compensation (DWC) indicating the number of claims reported at each adjusting location for the preceding calendar year.

Even if no claims were reported in the prior year, the report must be completed and submitted to the DWC Audit Unit. Each adjusting location is required to submit an ARI unless its requirement has been waived by DWC.

When ARI requirements are waived, claims administrators must file an annual report of adjusting locations. This report is to be filed annually on April 1 of each calendar year for the adjusting location operations as of December 31 of the prior year.

Claims administrators are required to report any change in the information reported in the ARI or annual report of adjusting location within 45 days of the effective date of the change. Penalties of up to $500 per location for failure to timely file this Report of Inventory may be assessed under Title 8, California Code of Regulations, Section 10111.1(b)(11) or 10111.2(b)(26).

The form for 2021 is located on the DWC website under the Audit and Enforcement Unit page.

Questions about submission of the ARI or the annual report of adjusting locations may be directed to the Audit Unit:

Insurers 1997 “Full Satisfaction” Stips Ends CIGA Other Insurance Recovery

Juan Suarez sustained a cumulative injury to his low back and neck through September 8, 1993 (ADJ365717) while employed by Haley Brothers insured by Unicare Insurance and a specific injury to his low back and neck on July 27, 1986 (ADJ3469175) while employed at T.M. Cobb Company insured by Liberty Mutual.

In a 1997 Stipulations with Request for Award, Liberty Mutual paid Unicare $25,000.00 in full satisfaction of its contribution issue to resolve any and all future claims for contribution. Unicare agreed to assume full and sole responsibility for all future payment of benefits

Unicare is now insolvent and its claims are administered by the California Insurance Guarantee Association (CIGA). CIGA took the position that Liberty Mutual was “other insurance” despite the wording of the Stipulation. Thus the issue submitted at a January 2020 trial was: “Is Liberty Mutual liable for the administration of this claim and possible reimbursement and contribution to the California Insurance Guarantee Association.”

The WCJ agreed with CIGA and found that Liberty Mutual is available “other insurance” and ordered that Liberty Mutual take over administration of applicant’s medical care and resolve reimbursement and contribution issues with CIGA.

But Liberty Mutual’s Petition for Reconsideration of this order was granted in the panel decision of Suarez v Haley Bros/TM Cobb et.al. (ADJ365717 – ADJ3469175) (Feb 2022)

In order to obtain reimbursement or a change of administrators, CIGA must show that Liberty Mutual is jointly and severally liable for medical treatment.

The panel discussed the Court of Appeal decision in California Ins. Guarantee Assn. v. Workers’ Comp. Appeals Bd. (Lopez) (2016) 245 Cal.App.4th 1021 (81 Cal.Comp.Cases 317), where a final award apportioning liability between insurers did not change the joint and several nature of defendants’ liability.

In Lopez, the insurers agreed, in a compromise and release agreement, that the insurers would apportion liability for the remaining liens according to proof and with rights to contribution and reimbursement between the two being reserved. The Lopez Court noted that the carriers understood their liability remained joint and several even after settlement and apportionment

However in this case, Unicare Insurance settled its contribution rights as part of the Stipulated Award, and, significantly, the award issued solely against Unicare. Applicant was a signatory to these stipulations, including the stipulation that only Unicare would be liable for benefits. Therefore, after the settlement, Liberty Mutual no longer had any liability for benefits to Mr. Lopez and he could only obtain medical treatment benefits from Unicare.

There cannot be joint and several liability where one party has no liability. Accordingly, the panel granted reconsideration and found that Liberty Mutual is not liable for applicant’s medical treatment and CIGA is not entitled to reimbursement from them.

Psychiatrist With Criminal & Disciplinary Record – Sentenced for WC Fraud

A San Francisco psychiatrist was sentenced in federal court Wednesday to serve 120 days in prison and pay $1.4 million restitution after he pleaded guilty to a scheme to submit false reports for non-disabled clients to receive federal benefits to which they were not entitled.

According to the U.S. Attorney’s Office, 76 year old George Demetrius Karalis pleaded guilty Aug. 11 and was sentenced Wednesday by U.S. District Judge Charles Breyer.

The government’s sentencing memorandum describes meetings between Karalis and undercover agents where the defendant instructed his clients on how to obtain federal and state government benefits to which they were not entitled.

According to his plea agreement, Karalis admitted that between August 2015 and June 30, 2020, he treated U.S. Postal Service employees who were receiving Federal Employees’ Compensation Act (FECA) workers’ compensation benefits for alleged stress and psychological disorders.

Karalis counseled his non-disabled clients on how to continue receiving benefits to which they were not entitled. Karalis also admitted that he submitted false reports and certifications about his clients so that they could continue receiving FECA benefits.

Karalis admitted that the total loss attributable to his conduct and is between $550,000 and $1,500,000. He also agreed to pay $1,400,000 in restitution, $920,000 of which will be paid to the U.S. Postal Service and $480,00 of which will be paid to the California Employment Development Department.

This is however, not the first public record of allegations of worker’s compensation insurance fraud and also grand theft against him.

Records (131 pages) from the Medical Board of California in its disciplinary case D1-90-3188, show a 1996 stipulated resolution of allegations of fraudulent billing pertaining to liens filed in several pending workers’ compensation cases. The attached liens were against multiple carriers including SCIF, Travelers, Industrial Indemnity, Atlantic Mutual and perhaps others. However he specifically denied “any allegations of fraud, dishonesty, corruption, gross negligence, or incompetence.” Nonetheless his probation was continued for three years from June 9, 1995.

His license was restored to “cleared” status following completion of probation on July 31, 1998.

Records from a 1990 disciplinary action against him in disciplinary case D-3800 he was accused of unprofessional conduct claiming that “on or about August 24, 1987, respondent was convicted by a guilty plea in the Superior Court, of County of Alameda, Case No. 89328, on one count of violation of Penal Code section 487(1) [grand theft]. The Accusation said this involved property of Computer Sciences Corporation and the State of California (Medi-Cal Program). He was placed on three years probation, and did not serve any jail time.

He admitted these allegations in his Stipulation and was placed on probation by the Medical Board for 5 years.

He was admitted to practice medicine in California on September 1, 1971 after graduation from the University of California, Irvine College of Medicine in 1970. He is currently still licensed with no current disciplinary charges pending against him.

A six-month CBS News investigation reported in 2021 raised new questions about how effectively state medical boards hold bad doctors accountable and protect patients. It reported from an insider who sits on California’s medical board, which is responsible for licensing and disciplining more than 150,000 doctors. This is one of many similar media stories over the years on the same issue.

Hartford Survey Shows 61% Workplace Pandemic Burnout Rate

New research from The Hartford found that 43% of U.S. workers have delayed routine health care appointments since the COVID-19 pandemic began. The delay in care comes as many also report declines in their mental health (42%), social well-being (41%), financial security (32%) and physical health (29%).

A national omnibus online survey was conducted in the U.S. among approximately 2,000 adults aged 18+, including 1001 full-time and part-time employed respondents. The research was conducted Jan. 5-7, 2022. The margin of error is +/- 3% at a 95% confidence level.

The Hartford, which has been tracking workplace burnout levels among U.S. workers throughout the pandemic, found that the burnout rate has remained high at 61% in January – the same level reported in February and July of 2021. This burnout rate and declining health is manifesting in the way many U.S. workers feel about their jobs. Most respondents (63%) said their overall health/wellness impacts their productivity at work. Thirty percent noted they’re less engaged with their work and 25% said they have trouble concentrating or focusing.

“It is difficult to overcome the fear and fatigue we’re all experiencing amid the COVID-19 pandemic; however, it is important that people get back to prioritizing routine health visits and screenings to stay physically and mentally healthy,” said The Hartford’s Chief Medical Officer Dr. Adam Seidner. “Many health conditions, such as high blood pressure or diabetes, may not be noticeable or detected without routine screenings. These types of conditions, when they continue to develop undetected, can lead to more serious health problems.”

According to the January 2022 Future of Benefits Pulse Survey, the top five reasons workers are putting off appointments include:

– – Fear of contracting COVID-19 (47%);
– – Difficulty getting an appointment (29%);
– – The need to cancel appointments due to COVID-19 restrictions/requirements (25%);
– – Fear of other illnesses (24%); and
– – Not a current priority (21%)

“Employers play a key role in helping to remove some of the barriers to health care, which is important in helping people live active and productive lives,” Seidner said. “I encourage employers to continue to offer the flexibility needed to ensure their employees can take key steps to improve their mental and physical health – and avoid the dangers of delayed care.”

According to an analysis of The Hartford’s 2021 short-term disability claims data, the top five injuries and illnesses are:

– – Musculoskeletal injuries, such as neck or back pain
– – COVID-19
– – Digestive disorders, such as hernias or appendicitis
– – Mental health conditions
– – Rheumatologic disorders, such as osteoarthritis and rheumatoid arthritis

Seidner notes that these types of illnesses and injuries can be treated before becoming a disabling condition that prevents people from working or can be managed well following a disability claim by keeping up with routine care.

To help get back on track with appointments, Seidner recommends U.S. workers:

– – Talk to their doctor’s offices about the precautions they are taking in the office to keep patients safe;
– – Stay current on prescription medications and continue to follow the medical guidance related to an existing condition;
– – Consider a telehealth visit, if available;
– – Ask to be placed on a call-back list to be made aware of openings due to cancellations if appointments aren’t readily available; and
– – Take advantage of the online health portals available to communicate directly with your doctor.

To better engage with workers and promote their overall wellness, Seidner recommends employers:

– – Offer benefits and resources that address the overall well-being of their workforce – encompassing physical health, mental health, as well as financial resilience;
– – Communicate more often to employees to remind them of the benefits and services that are available;
– – Lead by example by making your own appointments a priority; and
– – Offer the flexibility employees need to make their appointments a priority.

The Hartford Financial Services Group, Inc., operates through its subsidiaries under the brand name, The Hartford, and is headquartered in Hartford, Connecticut.

DWC Posts Proposed Amendments to QME Regs

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

The changes are being proposed to help the Qualified Medical Evaluator program better service the community.

The draft regulations include the following:

– – Extends the time frame to schedule a medical-legal evaluation by an additional 30 days.
– – Clarifies that the time frame for scheduling of an evaluation is for both initial and subsequent evaluations.
– – Updates to allow for electronic service of documents.
– – Provides flexibility if parties agree an initial evaluation can occur at any office listed with the medical director.
– – Deletes reference to Agreed Panel QME to be consistent with Labor Code section 4062.2(c)
– – Provides for a QME or AME to reschedule an evaluation within 60 days of the date of the cancellation unless the parties agree beyond the 60 days.
– – Provides a mechanism for Remote Health Medical-Legal evaluations if specific criteria are met.
– – Provides a definition of remote health evaluations and identification of office location when a remote health evaluation is conducted.

The forum can be found on the DWC forums webpage under “current forums.” Comments will be accepted on the forum until 5 p.m. on Friday, February 25, 2022.

Bipartisan Synthetic Opioid Commission Publishes Alarming Report

The bipartisan Commission on Combating Synthetic Opioid Trafficking was charged with examining aspects of the synthetic opioid threat to the United States, and with developing a consensus on a strategic approach to combating the illegal flow of synthetic opioids into the United States. It just published it’s final report.

The Commission was composed of representatives of seven executive branch departments and agencies, four sitting members of both the Senate and the House of Representatives, and four subject-matter experts from the private sector chosen for their deep experience and expertise on this topic.

Sadly, the report begins by saying the “overdose crisis in the United States claims more lives each year than firearms, suicide, homicide, or motor vehicle crashes.” And goes on to report that some two-thirds of these deaths – about 170 fatalities each day, primarily among those ages 18 to 45 – involved synthetic opioids. The primary driver of the opioid epidemic today is illicit fentanyl, a synthetic opioid that is up to 50 times more potent than heroin.

The report found that Mexico is the principal source of this illicit fentanyl and its analogues today. In Mexico, cartels manufacture these poisons in clandestine laboratories with ingredients – precursor chemicals – sourced largely from the People’s Republic of China (PRC).

The opioid crisis in the United States first gained public attention in the 2000s. Decades of an oversupply of prescription opioid pain medications beginning in the mid-1990s seeded its origins. Starting around 2014, potent synthetic opioids – mostly, illegally manufactured fentanyl – began their sharp rise in U.S. drug markets. Although they increasingly displaced prescription opioids and heroin in some places, these new drugs rapidly worsened an already-alarming public health problem.

The emergence of counterfeit tablets that contain minute quantities of synthetic opioids is particularly troubling. Drug traffickers in Mexico produce most of these tablets, but illegal pill pressing does occur to a lesser extent in the United States and Canada.

The Commission developed 21 key actions supported by 78 enabling actions that address the most-salient and -actionable challenges that the United States faces today in combating the flow and use of illegally manufactured synthetic opioids.

And as the federal government mulls over these findings and recommendations, recent studies show that San Francisco overdose deaths far exceed COVID deaths. Over the past two years, the city has seen more than 1,360 drug overdose fatalities – more than double the total COVID-19 death toll there. The majority of those deaths were in the Tenderloin and neighboring SOMA district.

San Francisco Mayor London Breed announced an “emergency declaration” for the area last month saying drug deaths, open-air drug dealing, street chaos and violence there had gotten “totally out of control.” She vowed “tough love” for those who break the law and expanded access to help for those with alcohol and substance use disorders.

However, concurrently with this new report, the Biden administration is being heavily criticized for announcing a $30M grant to fund free crack pipes, in what might appear to some as a mixed message to addicts.

On Tuesday, US Senator Marsha Blackburn of Tennessee wrote to the department of Health and Human Services, expressing “grave concerns” that a $30 million grant program from the Substance Abuse and Mental Health Services Administration (SAMHSA) could include subsidizing drug paraphernalia.

Government-funded drug paraphernalia is a slap in the face to the communities and first responders fighting against drugs flowing into our country from a wide-open southern border,” Ms Blackburn wrote in her letter. “If this is the president’s plan to address drug abuse, our nation is in serious trouble.”

Illegal Insurance Agent to Serve 4 Years for $1.4M Comp Fraud

Unlicensed insurance agent Karyl Lynn Reed, 58, formerly of Costa Mesa, was convicted last week on multiple felony counts of embezzlement and white-collar fraud enhancements after defrauding three victims of over $1.4 million. Reed was sentenced to four years in prison and ordered to pay more than $1.4 million in restitution.

Reed was arrested last year in Seabrook, Texas, and was arraigned on October 27, 2021, in Orange County after she was extradited.

An investigation by the Department of Insurance found that between 2012 and 2019, Reed acted as an insurance agent without a license and collected premiums for workers’ compensation insurance through her businesses, Envoy Business Partners and Allenn Specialty Group.

She would provide her victims with fraudulent Certificates of Insurance, causing her victims to believe they had valid coverage when there was actually none.

The investigation discovered Reed also operated a staffing company without valid workers’ compensation coverage and personally adjusted and administered employee injury claims. She collected workers’ compensation premiums and payroll, employer and employee taxes from victims, and provided them with falsified Certificates of Insurance as well leading them to believe they were covered when they were not.

The Department’s investigation revealed that one victim did not have workers’ compensation coverage for an employee who became injured. Another victim had requested an updated Certificate of Insurance from their insurance company and were told no policy or coverage was in place and found out the policy number Reed had provided them belonged to a policy for another business. The investigation further revealed another victim who discovered the money they were paying Reed to her staffing service was not being remitted to the insurance company.

Consumers can check the license status of their agent or contact the Department of Insurance at 800-927-4357 if they suspect they are victims of insurance fraud.

This case was prosecuted by the Major Fraud Unit of the Orange County District Attorney’s Office.