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Mariner Health Stipulates to Injunction & Pays $15.5M for Poor Care Claims

The California Attorney General announced a settlement with Mariner Health Care, Inc. who operated 19 skilled nursing facilities in California. The settlement, which is linked to the Bankruptcy Reorganization Plan of two Mariner entities in Chapter 11, will provide injunctive relief for a minimum of five years, monitoring by an independent monitor for a minimum of three years, payment of $2.25 million in costs, and penalties of up to $15.5 million dollars for any violations of the injunction or law.

The settlement resolves allegations filed by the Attorney General and the District Attorneys of Alameda, Los Angeles, Marin, and Santa Cruz counties, alleging that Mariner violated California’s Unfair Competition Law and False Advertising Law by understaffing its facilities and subjecting its patients to negligent care while inflating their skilled nursing facilities advertised ratings to the Center for Medicare and Medicaid Services.  All 19 facilities, including their Alameda facility, were named in the settlement.

On April 8, 20t21, the Division of Medi-Cal Fraud and Elder Abuse (DMFEA) and the four District Attorneys filed a civil complaint against the 19 skilled nursing facilities and their corporate management entities. The complaint sought injunctive relief and claimed Mariner Health understaffed facilities leading to resident harm, unsafely discharged residents from the facilities, and, falsified staffing numbers to CMS to advertise inflated ratings.

Understaffing allegedly left residents vulnerable and the inadequate care resulted in unnecessary amputations, the spread of diseases such as lice and pests among residents, and a high number of unreported sexual assault cases, among other issues.

On January 6, 2022 the Alameda County Superior Court granted a motion for a preliminary injunction requiring Mariner Health to comply with laws and regulations regarding the staffing of five of its facilities and with the discharges from 19 of its facilities in order to safeguard the safety and well-being of their residents.

Mariner also allegedly falsified staffing numbers to government regulators in an attempt to improve their published ratings, the complaint said

NBC Bay Area’s Investigative Unit dug into the company’s inspection records which revealed a long list of issues at 10 Bay Area facilities operated by Mariner. According to records from the California Department of Public Health, inspectors found more than 170 deficiencies at those facilities and issued seven fines totaling nearly $20,000.

In two separate cases, residents left the building without supervision. One was hit by a car, and another was found eating rocks and dirt. In another case, a resident’s foot had to be amputated after inspectors say a wound wasn’t properly treated or monitored. Other deficiencies included dirty kitchens, medication errors, and other patient care issues, according to the records.

As part of the settlement, Mariner will be required to:

– – Reform and improve its practices and the services for residents in their California skilled nursing facilities.
– – Implement an independent monitor for no less than 3 years.
– – Pay $2.25 million in costs and up to $15.5 million in civil penalties.

The California Department of Justice’s Division of Medi-Cal Fraud and Elder Abuse protects Californians by investigating and prosecuting those who defraud the Medi-Cal program as well as those who commit elder abuse. These settlements are made possible only through the coordination and collaboration of governmental agencies, as well as the critical help from whistleblowers who report incidences of abuse or Medi-Cal fraud at oag.ca.gov/dmfea/reporting.

DMFEA receives 75% of its funding from HHS-OIG under a grant award totaling $87,038,485 for federal fiscal year 2024. The remaining 25% is funded by the State of California.

Setting Reserves? US Life Expectancy Rises After 2-Year Dip

Reserving is an important aspects of claim handling. Whether it is a normal run of the mill lost time claim, or a claim with benefits payable over the remaining life of the injured worker, the goal is always the same: To accurately place the proper amount of money or reserves in the claim for the duration of the claim, which may be for the life of the claimant.

One method of estimating life expectancy is to use a one-size-fits all chart or table based upon historical data. This is the method set by California regulations (§10169. Commutation Tables and Instructions) when a commutation of future benefits is ordered by a WCJ. This table is based on the U.S. Decennial Life Tables for 1989-91, a metric that is outdated by about two and a half decades.

However, a rigid life expectancy chart or table may not be the best choice when a more accurate calculation is needed, such as when estimating settlement value, or a reserve estimate.

U.S. life expectancy increased for the first time in two years, according to a new report by the CDC. The report, released this week, marks a notable reversal: People born in the U.S. in 2022 can expect to live 77.5 years, an increase from 76.4 in 2021.

The data shown in this report reflect information collected by the National Center for Health Statistics for 2021 and 2022 from death certificates filed in all 50 states and the District of Columbia and compiled into national data known as the National Vital Statistics System. Differences between death rates were evaluated using a two-tailed z test.

The 10 leading causes of death in 2022 remained the same as in 2021. Heart disease was the leading cause of death, followed by cancer. Age-adjusted death rates decreased for 9 leading causes and increased for 1. Life expectancy at birth increased 1.1 years from 76.4 in 2021 to 77.5 in 2022, largely because of decreases in mortality due to COVID-19, heart disease, cancer, unintentional injuries, and homicide.

Data from the National Vital Statistics System

– – Life expectancy for the U.S. population in 2022 was 77.5 years, an increase of 1.1 years from 2021.
– – The age-adjusted death rate decreased by 9.2% from 879.7 deaths per 100,000 standard population in 2021 to 798.8 in 2022.
– – Age-specific death rates increased from 2021 to 2022 for age groups 1-4 and 5-14 years and decreased for all age groups 15 years and older.
– – The 10 leading causes of death in 2022 remained the same as in 2021, although some causes changed ranks. Heart disease and cancer remained the top 2 leading causes in 2022.
– – The infant mortality rate was 560.4 infant deaths per 100,000 live births in 2022, an increase of 3.1% from the rate in 2021 (543.6).

The rise in life expectancy comes as overdose deaths leveled out between 2021 and 2022, according to a separate CDC report also released Thursday.  According to that report, while overdose deaths nearly quadrupled over the past two decades, they did not significantly increase between 2021 and 2022. The rate of drug overdose deaths was 32.4 deaths per 100,000 people in 2021 and 32.6 deaths per 100,000 people in 2022.

And a number of other factors can make major differences. According to the latest CDC data in 2022, the difference in life expectancy between females and males was 5.4 years, a decrease of 0.4 year. from 2021.

From 2021 to 2022, age-adjusted death rates, corrected for race and ethnicity misclassification, decreased 15.4% for Hispanic males (915.6 to 774.2) and 14.5% for Hispanic females (599.8 to 512.9).

Among the non-Hispanic population, death rates decreased 15.9% for American Indian and Alaska Native males (1,717.5 to 1,444.1), 14.0% for American Indian and Alaska Native females (1,236.6 to 1,063.6), 9.7% for Asian males (578.1 to 522.2), 9.3% for Asian females (391.1 to 354.9), 8.5% for Black males (1,380.2 to 1,263.3), 11.8% for Black females (921.9 to 813.2), 7.9% for White males (1,055.3 to 971.9), and 7.8% for White females (750.6 to 691.9).

California’s Chief Justice 2024 State of the Judiciary Address

The California Supreme Court Chief Justice Patricia Guerrero delivered the 2024 State of the Judiciary address to the California Legislature in March 19, 2024. This is the the second year of her 12-year term of office.

Among the various topics discussed, the Chief Justice reported on Increasing transparency, improving efficiencies and increasing productivity without sacrificing quality. Caseflow management is an important process in meeting these objectives and providing timely access to justice.

The California Supreme Court, has instituted internal targets for the court to meet. It’s annual number of opinions has trended up, and it also is working its way through some important landmark new laws, such as the Racial Justice Act, which is impacting workflow.

The Courts of Appeal statewide have implemented a monitoring system to manage appellate caseload inequities and ensure that they too are promptly resolving cases.

Caseflow management and time to disposition is also an important tool for trial courts. Data management and analytics help them to manage caseloads, provide interpreter coverage, and make jury duty more efficient. It also informs how they can work best with our justice system partners.

From the clerk’s window to final dispositions – and everywhere in between – caseflow management is critical for the public.The resources the legislature provides are of course crucial.

The Chief Justice was advocating for a stable budget that the judicial branch can count on to make public access to justice a reality for all 58 counties. For this budget year, she was grateful for Governor Newsom’s continued support of her mission to advance access to justice and for protecting essential funding for critical programs and services.

She went on to discuss what is called the Strategic Plan for California’s Judicial Branch. The Strategic Plan provides is a foundational document for the court system..

Since the first strategic plan was developed in 1992, the process has served to articulate their mission and direction, set governance structures and priorities, and helped to navigate some of the most significant reforms, improvements, and challenges in the history of California’s court system.

At periodic intervals they have updated our long-term goals as California and the needs of its residents have evolved.Most recently, in December 2022, the Judicial Council amended the number one strategic goal of “Access, Fairness, and Diversity,” to add “Inclusion.”

“Although this may seem like a small change, as one of our council members shared at the time, ‘As important as diversity is, if you’re not included, it doesn’t matter.’ We saw this as an opportunity to speak out louder and make more explicit the branch’s commitment to an inclusive court system in which all individuals are – and feel – respected and engaged, and their contributions are valued.”

And this first goal guides all facets of the Judicial Council’s review, analysis, and deliberations.

On the topic of Modernization of Management and Administration, the Chief Justice has asked Administrative Presiding Justice Mary Greenwood and Judge Arturo Castro to help lead the branch’s efforts to identify the foundational questions that must be asked to consider the opportunities and challenges that are associated with AI.

Their efforts will facilitate consideration of what might be appropriate uses of AI in relation to the judiciary with the guiding principle of safeguarding the integrity of the judicial process.

No discussion of modernization is complete without a discussion of remote technology. Court users themselves are choosing to access these new services and tools – including 24/7 eFiling, access to online records and research, self-help resources, and remote appearances.

The Chief Justice said that accessing court services remotely works! “We know this from court users and staff alike.” A recent Judicial Council report on this issue showed that:

– – Approximately 150,000 remote civil proceedings are conducted statewide each month;
– – More than 90% of court users and 98% of court staff reported positive experiences; and
– – Very few technical issues were reported.

As always, more work remains to be done. “But we can build on these successes.” Addressing remote access is one example of effective three- branch solutions to better serve the state.

Key California Health Care Players are Divided Over PBM Regulation

Key California health care players are divided over whether the state should impose new regulations on pharmaceutical middlemen to bring down spiraling drug prices in the largest market in the nation.

Those middlemen, the pharmacy benefit managers, came under the microscope Tuesday at “Corrective Action: How to address prescription drug costs,” a POLITICO Live event. And according to the report by Politico “It was somewhat hostile territory for the industry, featuring its chief antagonist in Sacramento: State Sen. Scott Wiener.”

Wiener has authored legislation, Senate Bill 966, that would impose new rules on PBMs, represented on the panel by industry advocate Caitlin Berry.

Anthony Wright, executive director of Health Access California, a consumer advocacy organization, supported the goal of the legislation though not its specifics while a third panelist, UC Law San Francisco professor Robin Feldman argued that California can in fact act more boldly to bring down drug prices in the state.

Here are five takeaways from the event:

1) A chief antagonist of pharmacy benefit managers does not want to eliminate them. Wiener did not go as far as others nationally who seek to abolish the middlemen who negotiate with manufacturers over drug prices. He’s carrying legislation that would, among other things, require PBMs to be licensed with the California State Board of Pharmacy and to pass down drug rebates to consumers. The proposal is expected to dominate health care regulation discussions in Sacramento this legislative year.

Caitlin Berry, a senior principal with Prime Therapeutics, opposes the bill and argued her industry bolsters competition through negotiations and actually helps limit prices. “We build networks that stoke competition in between pharmacies to capture business from the insurance members in order to lower costs for the payer,” she said.

2) States have been limited in their ability to regulate the drug industry. That could be changing. UC Law San Francisco professor Robin Feldman argued a 2023 Supreme Court ruling allowing California to set rules for pork ranchers has reframed the Constitution’s Commerce Clause in a way that would allow states to regulate pharmaceuticals, too.

3) A group representing consumers didn’t back one proposed regulation of PBMs.Wiener’s SB 966 does not yet have the approval of Health Access California. Anthony Wright, it’s executive director said “we agree that there should be regulation of the industry,” but did not sound sure of which entity should license PBMs.

4) Drug pricing remains the elephant in the room. Pharmaceutical prices have risen faster than inflation, prompting finger-pointing between industry players and skeptics in government over who’s to blame.

5) Artificial intelligence could bring down drug costs. Wiener pointed to an antibiotic developed by artificial intelligence as evidence that the technology presents major promise for drug development. And using AI to help design treatment could help bring down the costs of doing so, including speeding the designing of generics, said Feldman.

East Bay Doctor Sentenced and License Revoked for Illegal Drug Prescriptions

Parto Karimi, a former Bay Area doctor, has been sentenced to one year and one day in federal prison for distributing powerful opioids outside the scope of medical practice, announced United States Attorney Ismail J. Ramsey and Drug Enforcement Administration (DEA), San Francisco Field Division, Special Agent in Charge Brian M. Clark.

The sentence was handed down on March 15, 2024, by the Hon. Jon S. Tigar, United States District Judge.

Karimi, 59, of Alamo, California, pleaded guilty in July 2023 to one count of distributing hydrocodone, a Schedule II controlled substance, outside the scope of professional practice, in violation of 21 U.S.C. § 841(a)(1) and (b)(1)(C).

According to the government’s sentencing memorandum, Karimi practiced medicine from an accessory dwelling unit on the grounds of her suburban home from roughly 2011 to 2022. Her practice operated under the name “Mindful Medicine.” Karimi was a licensed practitioner of internal medicine who had previously worked as an emergency room doctor at an East Bay hospital and was authorized to prescribe controlled substances as part of her medical practice.

According to the government’s sentencing memorandum, the DEA began investigating Karimi after receiving concerning information from the family of one of Karimi’s former patients, who had passed away. The investigation included multiple visits by undercover agents to Karimi’s medical practice.

During one, on October 1, 2021, an undercover agent asked Karimi for 10mg Norco tablets based on a claim of leg pain resulting from work as a restaurant server. Karimi admitted in her plea agreement that she wrote the undercover agent a prescription for 60 high-dose Norco pills without conducting a physical examination, without asking follow-up questions about the undercover’s reported pain, without obtaining medical records, and without exploring alternative treatment options or trying a lower dose.

Karimi admitted that, in doing so, she knew she was acting in an unauthorized manner by prescribing a controlled substance outside the usual course of medical practice. She also admitted she knew the drug she prescribed was a powerful opioid that can be highly addictive and is liable to abuse by patients.

The government argued in its papers that Karimi wrote medical prescriptions for opioids like Norco in exchange for street drugs including cocaine and methamphetamine, as well as cash payments.

In addition to sentencing Karimi to prison, Judge Tigar ordered the defendant to serve three years of supervised release to begin after her prison term is completed. Judge Tigar also ordered the defendant to forfeit her California medical license and to pay a $4,000 fine.

Assistant United States Attorney Daniel Pastor is prosecuting the case with assistance from Laurie Worthen. The prosecution is the result of an investigation by DEA, with assistance from the United States Department of Health and Human Services – Office of Inspector General and the California Department of Justice Division of Medical Fraud and Elder Abuse.

DOJ Sues Six Health Plans for Overpayments

The United States filed a complaint alleging that six health plans participating in the Uniformed Services Family Health Plan (USFHP) program, as well as their trade group, the US Family Health Plan Alliance, violated the False Claims Act by knowingly retaining erroneously inflated payments for healthcare services the health plans contracted to provide to retired military members and their families. The United States has also reached a settlement with Department of Defense (DOD) contractor Kennell & Associates Inc., a consulting firm, related to the conduct.

The USFHP program is one of the healthcare options available to military personnel, retirees and their families. Six health plans are eligible to participate in this program, each of which is a defendant in the government’s complaint: Brighton Marine Health Center, CHRISTUS Health Services, Johns Hopkins Medical Services Corporation, Martin’s Point Health Care, Pacific Medical Center and St. Vincent’s Catholic Medical Centers of New York.

Through the USFHP program, the DOD pays the plans capitated rates to provide healthcare services to their enrollees. According to the complaint, in June 2012, the plans learned of calculation errors that had inflated the rates they had been paid in prior years. Nevertheless, the plans took steps to conceal the existence of the overpayments from the government and continued to submit invoices at the inflated payment rates. The complaint alleges that during discussions about rates for the subsequent year, some of the plans even asked the government to continue paying them at the prior, inflated rates even though, by that time, those plans knew the rates were inflated by the errors.

“Contractors have an obligation to return overpayments, and we will hold accountable contractors that knowingly and improperly retain such funds,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “We are committed to ensuring that taxpayer funds for healthcare services to military members and their families are actually used for that purpose, not to enrich those charged with administering the program.”

“Protecting the integrity of the healthcare system for our military members and their families, is a top priority of the Defense Criminal Investigative Service (DCIS), the law enforcement arm of the Department of Defense Office of Inspector General,” said Acting Special Agent in Charge Brian J. Solecki of the DCIS Northeast Field Office. “The DOD expects companies to adhere to contract requirements and DCIS will continue to work with our law enforcement partners and the Justice Department to hold DOD contractors who engage in fraudulent activity at the expense of the U.S. military accountable for their actions.”

The United States filed its complaint in a lawsuit originally brought under the qui tam or whistleblower provisions of the False Claims Act by Jane Rollinson and Daniel Gregorie in the District of Maine. From 2007 to 2015, Rollinson worked at Martin’s Point Health Care, including as its Interim Chief Financial Officer. Gregorie was a consultant to the CEO and Board of Martin’s Point Health Care and later served on its Board of Trustees. The False Claims Act permits a private party to file an action on behalf of the United States and receive a portion of any recovery. The United States has the ability to intervene in such lawsuits, as it has in this case. The qui tam case is captioned United States ex rel. Rollinson v. Martin’s Point Health Care Inc., No. 2:16-cv-00447-NT.

The United States entered into a settlement agreement with Kennell and Associates Inc., a research and consulting firm located in Falls Church, Virginia, that provides actuarial consulting services to the Defense Health Agency (DHA) in connection with the USFHP program. The settlement resolves allegations that Kennell & Associates failed to notify DHA about errors in executing the rate-setting methodology that caused the USFHP rates to be overstated and their impact on DHA’s payments made to the plans. Under the terms of the settlement agreement, Kennell & Associates has agreed to pay the United States $779,951, plus interest, as well as contingent payments based on its annual contract revenue and cash reserves through the year 2025. The settlement amount is based on Kennell and Associates’ ability to pay.

The Civil Division’s Commercial Litigation Branch, Fraud Section and the U.S. Attorney’s Office for the District of Maine investigated the case, with assistance from DHA.

Attorneys Diana Cieslak, Evan Ballan and Amy Kossak of the Civil Division’s Fraud Section and Assistant U.S. Attorneys Andrew Lizotte and Sheila Sawyer for the District of Maine are handling this case.

The claims in the complaint and settlement agreement are allegations only. There has been no determination of liability.

After 3 Years 65.5% of Hospitals Non-Compliant with Price Transparency Rule

PatientRightsAdvocate.org (PRA) released a new report examining hospital compliance with the Hospital Price Transparency Rule, which went into effect over three years ago requiring all hospitals to publicly post all

PRA’s sixth Semi-Annual Hospital Price Transparency Compliance Report revealed that only 34.5% of the 2,000 hospitals reviewed were in full compliance with the federal rule, virtually unchanged from the 36% compliance found in PRA’s last report released in July 2023. Despite stagnant compliance, the Centers for Medicare & Medicaid Services (CMS) has issued penalty notices to only 14 hospitals.

The report also includes links to the hospital pricing files for the 2,000 hospitals examined for the latest review, to allow for easy access and comparison by consumers, purchasers, technology developers, and other interested parties. Additionally, PRA recently created the Hospital Price Files Finder, a first-of-its-kind free and publicly available search tool that allows consumers and researchers to access the available hospital pricing files from nearly all 6,000 hospitals throughout the U.S.

In a letter to President Biden, PRA Founder and Chairman Cynthia Fisher wrote:

Our comprehensive study of 2,000 hospitals indicates nearly two-thirds (65.5%) of hospitals reviewed continue failing to fully comply with the rule, yet the Centers for Medicare and Medicaid Services (CMS) has only fined fourteen hospitals for noncompliance out of the thousands found to not be meeting all of the rule’s requirements. When hospitals don’t post their prices, they can charge whatever they want. We work with patients across the country who are struggling under the weight of unexpectedly high medical bills.

… “Fortunately, a bipartisan bill introduced in the Senate by Senators Bernie Sanders and Mike Braun – and cosponsored by several other Democrats and Republicans – would strengthen and expand current healthcare price transparency rules. The Braun-Sanders Senate Health Care PRICE Transparency Act 2.0 (S. 3548) is a bill that deserves the full support of the Biden Administration.

… “The American people support efforts to lower the costs of healthcare through price transparency. According to a poll conducted by Marist for PRA, 94% of Americans support healthcare price transparency. This remains one of the most popular and unifying issues being considered in Washington today.”

The latest review of 2,000 hospitals across the United States found:

– – Only 689 hospitals (34.5%) were fully compliant with the rule.
– – 1,311 hospitals (65.5%) were not in full compliance with the rule.
– – 87 hospitals (4%) did not post any usable standard charges file and were in total noncompliance.
– – Substantial improvements since the last report include:
– – 100% of hospitals owned by Community Health Systems,
     – – 93% of hospitals owned by Christus Health, and
    – – 84% of hospitals owned by Advocate Health were found to be in full compliance.
– – Of the hospitals reviewed, none (0%) of those owned by the largest hospital systems were fully compliant (HCA Healthcare, Tenet Healthcare, Providence, Kaiser Permanente, Avera Health, UPMC, Baylor Scott & White Health, and Mercy).
     – – While 98% of hospitals owned by Kaiser Permanente were found to be fully complying in our last report, Kaiser now posts multiple files for each hospital, instead of a single file as required by the rule, so none (0%) of Kaiser’s hospitals are now fully compliant.
– – 135 hospitals exhibited ‘backsliding,’ with an assessment of Noncompliant in the current report after having been assessed as Compliant in our prior report.
– – Analysis for this report found more hospitals posting multiple files, instead of the single file required by the rule.

View the PatientRightsAdvocate.org Sixth Semi-Annual Hospital Price Transparency Compliance Report.

PatientRightsAdvocate.org is a nonprofit organization fighting for systemwide healthcare price transparency. We seek to empower patients and consumers with actual, upfront prices, greatly reducing healthcare costs through a functional, competitive market.

Worker Convicted of Comp Fraud Ordered to Pay $140K In Restitution

In 2021 Ahmad Zaki Noori, who lived in Sacramento, was arraigned on two felony counts of workers’ compensation insurance fraud, after allegedly misrepresenting symptoms following a work-related injury, in order to receive $21,000 in undeserved benefits.

On July 16, 2019, Noori, while working as a welder, sustained a head injury and contusions on multiple parts of his body.

Following his injury, a workers’ compensation claim was filed with his employer’s insurance company and Noori began receiving workers’ compensation benefits. He presented himself as someone with severe amnesia and as someone who had difficulty performing daily functions of living, like speaking, walking or driving.

An investigation by the California Department of Insurance found Noori misrepresented his symptoms to medical professionals and those handling his claim.

Undercover surveillance showed Noori speaking, walking, and driving – all functions he claimed not to be able to do as a result of the injury. The surveillance also showed him performing duties at an automobile dismantling yard, like loading items onto a flatbed trailer and changing a spare tire.

In addition, two of his former co-workers reported they saw him out and about acting normally. One co-worker reported seeing Noori inside a retail store and that he was walking unassisted, laughing, and speaking on the phone. The second co-worker reported seeing Noori at another retail store and that he drove a vehicle into the parking lot, exited the vehicle and was able to walk with no walking aids.

After watching the video surveillance, his doctor reported the actions Noori was performing in the video were drastically different than the actions he was performing during his office visits. The doctor also reported that Noori showed no evidence of neurocognitive or orthopedic deficits during the entirety of this claim period.

Due to Noori’s misrepresentations, he received $21,000 in undeserved workers’ compensation payments and his employers’ insurance company lost an additional $80,679 in medical, legal and investigation costs.

Noori was arrested at his residence on April 13, 2021.

On March 23, 2023, Ahmad Zaki Noori was convicted of workers’ compensation insurance fraud. The amount of restitution requested by the victim, Sentry Insurance, was contested by Noori.

On March 12, 2024, a restitution hearing was conducted. The evidence proved the victim sustained losses totaling $139,130.97 in temporary disability pay and medical expenses due to Noori’s fraudulent workers’ compensation insurance claim. The Court ordered Noori to pay the victim $139,130.97 in restitution.

EEOC Recovers Record $665 Million for Workers – a 30% Increase

The U.S. Equal Employment Opportunity Commission (EEOC) released its report this month on the agency’s performance during fiscal year (FY) 2023, covering Oct. 1, 2022, through Sept. 30, 2023.

In line with its strategic plan and strategic enforcement plan, the agency’s performance during FY 2023 reflects both an increased demand for its services and significant remedies for workers who suffered discrimination. This includes handling more than 522,000 calls from the public through the agency contact center and a 10% increase in receipts of private sector charges of discrimination, while recovering more than $665 million on behalf of victims of discrimination.

During FY 2023, the EEOC implemented the newly enacted Pregnant Workers Fairness Act (PWFA), which was signed into law by President Biden on Dec. 29, 2022. The PWFA provides workers with limitations related to pregnancy, childbirth, or related medical conditions the ability to obtain reasonable accommodations, absent undue hardship to the employer. The EEOC began accepting PWFA charges on the law’s effective date, June 27, 2023, released educational resources for workers and employers, and conducted broad public outreach.

Performance highlights include:

  • Securing more than $665 million for victims of discrimination, a 29.5% increase over FY 2022, including:
    • Approximately $440.5 million for 15,143 victims of employment discrimination in the private sector and state and local government workplaces through mediation, conciliation, and settlements, and
    • More than $202 million for 5,943 federal employees and applicants, an increase of 53% over FY 2022.
  • Receiving 81,055 new discrimination charges, 233,704 inquiries in field offices, more than 522,000 calls from the public through the agency contact center, and over 86,000 emails, representing respective increases of 10.3%, 6.9%, 10%, and 25% over FY 2022.
  • Filing 143 new lawsuits, an increase of more than 50% compared to FY 2022, including 86 suits on behalf of individuals, 32 non-systemic suits with multiple victims, and 25 systemic suits involving multiple victims or discriminatory policies.
  • Obtaining more than $22.6 million for 968 individuals in litigation, while resolving 98 lawsuits and achieving favorable results in 91% of all federal district court resolutions.
  • Reducing both private and federal sector inventories, including reducing the private sector inventory by almost 300 charges, despite the 10.3% increase in new charges.
  • Reducing federal sector hearings inventory by 26.3%, the sixth consecutive annual reduction in the federal hearings inventory, and resolving 2,207 federal sector appeals that were or would have been more than 15 months old at the end of the fiscal year, substantially increasing the speed of resolutions.
  • The APR, issued in coordination with the EEOC’s FY 2025 Congressional Budget Justification, reports on the EEOC’s progress in achieving the goals and objectives outlined in the agency’s strategic plan along with performance and program results achieved for the previous fiscal year.

The EEOC, created in the crucible of the civil rights struggles of the 1960s, continues to advance its mission of equal employment opportunity for all in this 60th anniversary year of the Civil Rights Act of 1964,” said EEOC Chair Charlotte A. Burrows. “For nearly six decades, the EEOC has been entrusted with the clear mission of preventing and remedying discrimination in our nation’s workplaces. That legacy and our ongoing work are vitally important as we rebuild the economy to work for everyone and fulfill our nation’s promise of equal justice for all.”

New EPA Rule Limits Toxic Medical Sterilization Chemicals

In August 2022 Cal/OSHA opened an investigation, and later issued 18 citations, including six citations for willful-serious violations, to Parter Medical Products, Inc. in Carson California for failing to protect its employees from overexposure to ethylene oxide (EtO), a toxic chemical. The proposed penalties totaled $838,800. It’s inspection showed “this was not an isolated incident of chemical overexposure to workers. Parter Medical Products, Inc. dba Parter Sterilization Services was founded in 1984, and uses ethylene oxide gas to sterilize medical devices.

The Carson City Council unanimously voted in early 2022 to request air monitors be placed in various locations of the city to monitor air quality. South Coast AQMD was further investigating EtO emissions in the nearby residential communities and the agency was working with the City of Carson to identify additional locations to collect 24-hour samples in the nearest community and school. So far, data from residential monitors show EtO levels to be within typical background levels.

And now on March 14, 2024 the U.S. Environmental Protection Agency announced a rule that will reduce lifetime cancer risks for people living near commercial sterilization facilities across the country. The final amendments to the air toxics standards for ethylene oxide commercial sterilization facilities put in place the strongest measures in U.S. history to reduce emissions of EtO, one of the most potent cancer-causing chemicals. Through the installation of proven and achievable air pollution controls, commercial sterilizers will reduce emissions by more than 90%.

In finalizing this rule, EPA considered the latest data and science, while taking into account the importance of a safe and reliable supply of medical sterilization devices for patients and hospitals. EPA worked closely with partners  including at the Department of Health and Human Services, to develop a final rule that centers on public health. The EPA claims that this final rule provides sufficient time and flexibility for facilities to come into compliance, simultaneously affording strong public health protection for nearby communities while minimizing any potential impacts to the medical device supply chain.

In developing the final rule, EPA conducted extensive outreach to communities and stakeholders to ensure meaningful and extensive participation during the public comment period. EPA conducted public hearings, national webinars, and public meetings hosted by regional EPA offices. The considerable feedback received from the three days of public hearings, as well as the more than 40,000 comments submitted to the rulemaking docket, both informed the final rule and demonstrated the strong need to issue these vital health protections. Based on this input, EPA improved the risk assessment and strengthened the standards to ensure risk reductions for surrounding communities.

The final rule will address emissions at nearly 90 commercial sterilization facilities that are owned and operated by approximately 50 companies. Based on extensive input and review, EPA is finalizing the following amendments to the National Emission Standards for Hazardous Air Pollutants that:

  • Establish standards for currently unregulated emissions, such as building leaks (“room air emissions”) and chamber exhaust vents, to reduce cancer risk and account for technological developments in pollution control.
  • Strengthen standards that are on the books for sources such as sterilization chamber vents and aeration room vents.
  • Require continuous emissions monitoring and quarterly reporting for most commercial sterilizers that will provide communities, states, Tribes, and local governments, and EPA with data to ensure EtO emissions are not entering the outdoor air.
  • Ensure that sterilizers are subject to emission standards during periods of startup, shutdown, and malfunction so there is continuous clean air protection.
  • Other clarifying items including electronic reporting and technical revisions.

This final rule for commercial sterilizers is one of a series of coordinated actions that EPA is taking to reduce exposure to EtO. Under the Federal Insecticide, Fungicide, and Rodenticide Act, EPA’s Office of Pesticide Programs is also working on a comprehensive set of new mitigation measures for EtO to reduce exposure for workers who use EtO to sterilize products. EPA has been working to support alignment of today’s Clean Air Act rule with the action being taken under FIFRA.

EPA is also working to strengthen standards to reduce EtO and other toxic pollutants from chemical plants. Other actions to address EtO emissions and advance EtO research include:

  • Investigating additional sources of EtO (e.g., stand-alone warehouses) and opportunities for emissions controls.
  • Enforcing existing regulations as appropriate.
  • Conducting research to better understand and measure EtO.

For more information, visit EPA’s Final Amendments to Strengthen Air Toxics Standards for Ethylene Oxide Commercial Sterilizers webpage.