Tag: 2022 News

California’s push to create the country’s first single-payer health care system dissolved quietly late Monday as the bill’s progressive author nixed a scheduled vote due to a presumed lack of support in the heavily Democratic state Assembly.

According to the report in Courthouse News, Assemblyman Ash Kalra acknowledged he was unable to wrangle enough votes before a key legislative deadline, citing “substantial misinformation” from a group of well-funded opponents. Nonetheless, Kalra claimed there’s still a viable path to universal health care in the nation’s most populous state, even though he couldn’t secure a majority vote in a chamber dominated by members of his own party.

“Despite heavy opposition and substantial misinformation from those that stand to profit from our current health care system, we were able to ignite a realistic and achievable path toward single-payer and bring Assembly Bill 1400 to the floor of the Assembly,” Kalra said in a statement.  “However, it became clear that we did not have the votes necessary for passage and I decided the best course of action is to not put AB 1400 for a vote today.”

Though voters rejected a universal health care initiative in 1994 and lawmakers most recently snubbed the idea in 2017 due to a lack of funding, the single-payer vision has leapt back into the Golden State’s political agenda.

Coined the “Guaranteed Health Care for All Act,” AB 1400 proposed a single-payer program to be administered and overseen by a new state agency known as CalCare. Kalra, D-San Jose, reintroduced the bill this month and two committees quickly signed off, setting up a presumed showdown on the Assembly floor.

Supporters, including the California Nurses Association and cities like San Jose, Sacramento and Long Beach, jumped behind the effort. In support letters, newspaper editorials and committee testimonies, the proponents said the switch to universal health care would trim existing administrative costs, coalesce the state’s buying power and reduce labor union strikes that often stem from disputes over health care benefits.

As was the case with recent single-payer attempts, the daunting price tag likely derailed the latest version.

According to the most recent estimates, adopting single-payer could cost between $314 and $391 billion annually. Further, if the federal government signs off and contributes to California’s transformation, the state will have to come up with at least $158 billion to launch AB 1400.

To help fund the transition, supporters proposed raising taxes on businesses and residents through an accompanying ballot measure. They said the tax hikes paled in comparison to the over $400 billion Californians currently spend on health care and that single-payer would save the state money in the long run.

But a coalition of critics consisting of hospital groups, insurers and the GOP lined up to fight the idea of government-run health care, casting it as the “largest tax increase in state history.”

Adding to the intrigue was whether Governor Gavin Newsom would get behind the single-payer push or the corresponding tax hike during an election year. Pundits predict several tight congressional races and expect California to factor heavily into who takes control of the House in 2023.

Newsom, who promised to pursue a single-payer system on the campaign trail in 2018, declined to endorse AB 1400 at this early stage in the legislative process. Instead, the former San Francisco mayor has introduced drastically cheaper plans to extend subsidized health coverage to all residents regardless of immigration status.

By abandoning Monday’s vote, Kalra freed Assembly Democrats – and Governor Gavin Newsom – from having to take a formal position on the polarizing topic in an election year.

The CEO of several Southern California-based medical imaging companies was sentenced today to 60 months in federal prison for running a scheme that submitted more than $250 million in fraudulent claims through the California Workers’ Compensation System for medical services procured through bribes and kickbacks to physicians and others.

40 year old Sam Sarkis Solakyan, who lives in Glendale, was sentenced and also ordered him to pay $27,937,175 in restitution to the victim insurers. She also banned him from working in the health care and workers compensation industries for his three-year term of supervised release once he completes his prison sentence.

During an eight-day trial that concluded on July 2, a jury found Solakyan guilty of one count of conspiracy to commit honest services mail fraud and health care fraud, and 11 counts of honest services mail fraud.

Federal prosecutors had sought more than 15 years in prison for Solakyan.

“Despite overwhelming evidence of his criminality and the myriad fraudulent and unnecessary services that he generated, defendant refused to accept such responsibility and instead proceeded to trial, where he obstructed justice by testifying falsely time and again,” lawyers for the Justice Department said in their sentencing memorandum.

“[Solakyan] paid some $9 million in kickbacks in order to generate over $250 million in fraudulent medical billings, the vast majority of which were for MRIs [magnetic resource images] that were…..totally medically unnecessary,” prosecutors wrote in a sentencing memorandum. “[Solakyan] devised, and through his kickbacks fueled, a cross-referral scheme that incentivized [co-conspirators] to herd patients to physicians who overprescribed ancillary services in exchange for cash and other economic benefits.”

In their sentencing request, his lawyers had asked for a prison term of no more than six months. They said that Solakyan had come with his family to California as refugees from Armenia when he was a boy and had become the main provider for his family by the time he was 17.

His lawyers also cited Solakyan’s trauma for sexual abuse as a child, his mental health issues, marital problems and his drug addiction in their request for leniency.

Solakyan was the CEO of several medical-imaging companies, including the Glendale-based Vital Imaging Inc., and San Diego MRI Institute. Solakyan operated diagnostic imaging facilities throughout California, including the Bay Area, Los Angeles and Orange counties, and San Diego.

From no later than mid-2013 to November 2016, Solakyan conspired with physicians and others to perpetrate a scheme in which physicians were paid bribes and kickbacks in exchange for the referral of workers’ compensation patients. The compensation offered to the corrupt doctors consisted of either cash or referrals of new patients in what is known as a “cross-referral” scheme.

The conspirators obscured the true nature of their financial relationships to conceal the bribes and kickbacks, including by entering into various sham agreements such as contracts for “marketing,” “administrative services,” and “scheduling,” when in fact the money Solakyan paid amounted to volume-based, per- magnetic resonance imaging (MRI) scan bribes and kickbacks to induce physicians to refer and continue referring patients to Solakyan’s companies.

Solakyan’s recruiters required physicians to refer a minimum number of patients to receive “cross-referrals,” and those referrals stopped if the physicians failed to meet the minimum quota. Solakyan paid more than $8.6 million in kickbacks disguised largely as sham “scheduling” fees in exchange for MRI referrals, payments which were concealed from patients and health insurers.

In total, Solakyan submitted and caused to be submitted more than $250 million in claims for medical services procured through the payment of bribes and kickbacks.

Wei Wen Wu, 54, and Feng Wen Lam, 49, both of Arcadia, are charged with 43 felony counts of insurance fraud, grand theft, and conspiracy after allegedly under reporting nearly $4.5 million in employee payroll.

The scheme fraudulently reduced their company’s workers’ compensation insurance premium resulting in a loss of approximately $1.7 million in unpaid insurance premiums.

A parallel investigation by the California Department of Industrial Relations (DIR) uncovered significant wage theft from employees at the couple’s chicken processing business in El Monte.

Lam is the owner of Golden Food Inc. (GFI), a chicken processing business employing butchers and meatpackers located in El Monte, which receives chicken carcasses and breaks them down into boxes of chicken parts for sale. Lam’s husband, Wu, operated the business.

The Department of Insurance launched an investigation after receiving a referral from State Compensation Insurance Fund, who suspected the business of fraud after comparing the payroll reported during annual audits with the payroll reported to the Employment Development Department.

After obtaining search warrants for GFI, the Department was able to obtain the true payroll records from the company’s computer and found fake tax reporting forms.

The investigation revealed between 2015 and 2021, GFI under reported its payroll to its workers’ compensation insurance carriers by $4,489,390, resulting in a loss of $1,681,138 in unpaid insurance premiums to four insurance companies, including State Fund.

In addition to the Department of Insurance investigation, the California Department of Industrial Relations investigation found employees were forced to clock out for breaks and continue to work, they were not paid overtime for work in excess of 40 weekly hours, and their pay stubs were falsified.

Also, it revealed Wu routinely deducted work hours from employees and falsely counted that pay as bonus. An audit by DIR found that Lam and Wu failed to pay at minimum $437,542 in labor to their 34 employees based on the minimum legal market value.

Additional victims of wage theft are encouraged to contact the California Labor Commissioner Office’s Criminal Investigator Eduardo Martinez at 818-901-5305 or the Labor Commissioner’s Office’s Public Information Line at 1-833-526-4636 or dlse2@dir.ca.gov.

Wu and Lam are scheduled to appear in court on March 29, 2022, in Department 30 of Foltz Criminal Justice Center. The Los Angeles County District Attorney’s Office’s Healthcare Fraud Division is prosecuting this case.

The presumptions for compensability of a COVID related workers’ compensation claim is predicated on a positive test for the presence of the virus. However, according to the California Attorney General, there are now “fake” testing sites surfacing in California.

“Throughout California, fake testing sites are sprouting up to exploit families and individuals seeking COVID tests. It is important to recognize the signs of sham testing sites to protect both your money and personal information,” said Attorney General Bonta. “I urge Californians to do their part to avoid fake testing sites by utilizing state resources, including the California Department of Public Health’s website, to find a verified COVID-19 testing site.”

It would seem prudent that the investigation of claims should not dig deeper to insure that the test offered by the claimant was not from one of the “fake” sites, and indeed is an authentic test result.

California Attorney General Rob Bonta issued this warning to Californians, so they become beware of fake COVID-19 testing locations and websites.

The alert claims that with an increased demand for COVID-19 testing due to the recent spike in cases, scammers are exploiting vulnerable individuals looking to determine whether they have the COVID-19 virus.

These unverified sites pose as legitimate companies and healthcare clinics offering COVID-19 testing. However, after receiving payment for a COVID-19 test, these fake testing sites oftentimes fail to provide their patients with their test results.

These sites may also ask for a patient’s personal identifiable information with the intention of committing fraud. The alert shared tips on how to avoid testing site scams, as well as how to search and locate legitimate, verified testing sites.

–  People should only get tested at verified COVID-19 testing sites or through medical groups: To find a testing site that is verified to perform COVID-19 testing, use the California Department of Public Health’s test site search tool.

–  Someone may also search for local testing sites through your county’s local public health department. You can find your county’s public health department website at COVID19.CA.GOV’s Hotlines and Local Info web page.

–  Also check with local medical groups to see if they offer testing services within their facility.

Should someone choose to use an unaffiliated testing site, be wary of the following:

– – If a provider insists on documenting nationality or immigration status;
– – If a provider does not offer a notice of privacy practices, or cannot explain how it will use and share personal data; or
– – If a provider insists on accessing a passport or driver’s license when they have other documents that show insurance status.

Identify and avoid “lookalike” websites: Fake testing sites may require a person to sign up online. Beware of fake websites that purposely look identical to those belonging to well-known, trusted organizations and state agencies. Before entering personal information into an online form, always make sure that the website is secure and does not display misspellings or unfamiliar names in the URL.

Be cautious of unsolicited calls regarding testing sites: A legitimate company or health clinic will not call, text, or email anyone without permission. If someone receives an unsolicited message from an individual, they should not provide the caller or sender with any personal information until having confirmed it is coming from a legitimate source. If someone feels pressured to provide personal information, just hang up.

Any of these red flags or tips would be good questions to ask a claimant for purposes of establishing the validity of any COVID test result.

Alec Baldwin’s attorneys argued in a demurrer filed on Monday that the Worker’s Compensation exclusive remedy protects him from a lawsuit stemming from the “Rust” shooting last October.

The filing comes in response to a civil suit filed in Los Angeles Superior Court by Mamie Mitchell, the film’s script supervisor, against Baldwin and other producers and crew members on Nov. 17. Mitchell is represented by Gloria Allred. The “Rust” production had a liability policy with Chubb with a $6 million limit.

Mitchell was standing just a few feet away from Baldwin when he fired the gun and was the first to call 911. She alleges that she suffered pain and ringing in her ears as well as emotional injuries. Apparently her lawyers plead the case as an “assault” by the defendants, hoping to construe Baldwin’s behavior as an intentional tort which may be actionable despite the exclusive remedy.

However the defendants challenge her claim that it was an intentional tort, and that she has any legal right to any monetary recovery

They say “the law is clear that she does not. As Plaintiff obviously recognizes, having cited the New Mexico Supreme Court case Delgado v. Phelps Dodge as the basis for each of the three causes of action in her Complaint, Plaintiff cannot bring a workplace injury claim before this Court based on alleged negligence because Defendants are generally immune from such claims under New Mexico’s worker’s compensation law.“

The New Mexico Supreme Court\’s decision in Delgado overruled the “actual intent test” and created an exception to the exclusivity provisions of the Workers Compensation Act which holds employers legally responsible for on-the-job injuries. The new standard is something less than intentional but more than negligence, purported to set the stage for a deluge of tort claims from injured employees who previously would have been precluded as a matter of law from recovering damages outside of the Act.

However, examination of Delgado and its New Mexico progeny, and comparison with case law in other jurisdictions with rules similar to those articulated by the New Mexico Supreme Court, indicate that while Delgado changed the law, legal scholars at the University of New Mexico say its application is so narrow as to have minimal impact. And that subsequent interpretations of the Delgado exception in New Mexico and other jurisdictions employing a similar standard have defined narrow boundaries and severely limited the scope of its coverage.

The demurrer goes on to argue that “despite Plaintiff’s attempt to label claims as intentional, nothing about Plaintiff’s allegations suggest that any of Defendants intentionally committed harmful conduct under New Mexico law. The underlying accident occurred when Cinematographer Halyna Hutchins (“Ms. Hutchins), Director Joel Souza (“Mr. Souza”), and Mr. Baldwin, among other film crew members, were rehearsing Mr. Baldwin drawing and pointing a prop six-shooter style revolver firearm (“Prop Gun”) for a cowboy-standoff scene.”

Mitchell’s suit alleges that Baldwin should have double-checked the gun and also accuses the producers of cutting corners, leading to unsafe conditions. In their demurrer, Baldwin’s attorneys argue that Mitchell cannot point to any intentional act that led to the shooting.

“Nothing about Plaintiff’s allegations suggest that any of Defendants, including Mr. Baldwin, intended the Prop Gun to be loaded with live ammunition,” they wrote. “Moreover, nothing about Plaintiff’s allegations suggests any of the Defendants knew the Prop Gun contained live ammunition.”

Serge Svetnoy, the gaffer who was also nearby when the shot was fired, filed a separate suit on Nov. 10. The producers have yet to respond to that complaint.

The demurrer will be heard on February 24 at 1:30 in Department 32.