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Tag: 2024 News

UCLA Purchases 700,000 Sq. Ft. Space for Immunology Research Park

UCLA has acquired the former Westside Pavilion shopping mall, which the university will transform into the UCLA Research Park – bringing together scholars and industry experts from around the world to create a nexus for discovery and innovation that will benefit Southern California and beyond. The 700,000-square-foot property, located 2 miles south of the Westwood campus, will initially host two multidisciplinary research centers: the California Institute for Immunology and Immunotherapy at UCLA and the UCLA Center for Quantum Science and Engineering.

The vast new space, which straddles the southeast and southwest corners of Pico Boulevard and is connected by an enclosed pedestrian bridge over Westwood Boulevard, features a broad metal and glass facade and open areas with 17-foot ceilings, panoramic windows and expansive atriums inside and out. In addition to research labs and offices, the property has the potential for additional uses, including classrooms, lecture halls and event venues.

A fixture of West Los Angeles since its opening in 1985, the Westside Pavilion quickly became a much-visited retail location and gathering spot and continued to evolve over the following three decades. At one time, the site featured a three-level bookstore and multiple movie theaters and appeared as a backdrop to numerous movies and TV shows. Over the past decade, it suffered from a decline alongside other indoor malls across the country, leaving storefronts largely empty.

The new UCLA Research Park is made possible in part by an intended $500 million investment, with $200 million already allocated, from the state of California to establish and fund the immunology and immunotherapy institute at UCLA. The institute is also supported by a group of founding donors from the biotechnology, academic, entrepreneurship and philanthropic communities led by Meyer Luskin, Dr. Gary Michelson, Dr. Eric Esrailian, Dr. Arie Belldegrun, Sean Parker and Michael Milken.

In addition, Google – which previously leased part of the property – helped enable and support UCLA’s acquisition. Favorable real estate market conditions helped create the historic opportunity for the university as well.

The California Institute for Immunology and Immunotherapy has the potential to reshape the future of science and medicine,” said the institute’s founding donors. “We are proud to join UCLA, UC President Drake, Gov. Newsom and the state Legislature in helping make California a world leader in decoding the still-mysterious workings of the human immune system and translating breakthrough discoveries into lifesaving immunotherapies. Launching a research park that joins biosciences with quantum science and engineering – as well as other emerging technologies, like next-generation artificial intelligence – is a once-in-a-generation event, and we are honored to be a part of it all.”

The acquisition caps a multiyear effort by Dr. John Mazziotta, vice chancellor for health sciences and CEO of UCLA Health, to establish the institute at UCLA and provide it with leading-edge facilities.

UCLA’s goal is to build the immunology equivalent of Silicon Valley in Los Angeles,” said Mazziotta. “Given the university’s expertise and state-of-the-art facilities, we are expecting to attract the world’s best scientists in immunology and immunotherapy, as well as top students.”

The institute will draw on the expertise of UCLA faculty members, scholars from different higher education institutions, and other leading scientists and practitioners in clinical and biomedical scientific research, including human genetics, genomics, computer science, engineering and information science. Researchers will pursue new tools, treatments and vaccines for cancer, autoimmune and immune deficiency disorders, infectious diseases, allergies, heart conditions, solid organ transplantation and other major health-related issues.

The UCLA Research Park will also be home to the UCLA Center for Quantum Science and Engineering, which conducts research in the emerging field of quantum science and technology – including quantum computing, communication and sensing – with the aim of dramatically increasing information processing power by harnessing the unusual behavior of subatomic particles.

This latest major acquisition – UCLA’s third in the past 15 months – is part of a transformative expansion designed to broadly extend UCLA’s top-flight resources and institutional expertise, deepen the campus’ connections to Los Angeles’ diverse and dynamic communities, and meet the growing demand for top-tier higher education across the city and region. Each acquisition has been an adaptive and sustainable development, repurposing existing structures for new uses while avoiding the need for major construction.

In June of this year, UCLA bridged the gap between Westwood and downtown Los Angeles with its purchase of UCLA Downtown, a 334,000-square-foot building in downtown’s Historic Core.

And in September 2022, the university acquired its UCLA South Bay campus, including the 24.5 acres of the former Marymount California University campus in Rancho Palos Verdes and an 11-acre residential site in San Pedro — allowing UCLA to expand its offerings, serve more students and advance the University of California’s 2030 systemwide goals.

WCIRB Releases Third Quarter 2023 Experience Report

The Workers’ Compensation Insurance Rating Bureau of California (WCIRB) has released its Quarterly Experience Report. This report is an update on California statewide insurer experience valued as of September 30, 2023.
Highlights of the report include:

– – Written premium through the third quarter of 2023 of $12.1 billion is 2% higher than the same period in 2022.
– – The average charged rate for the first nine months of 2023 continues to decrease; it is 5% lower than 2022 and the lowest in decades.
– – After five consecutive increases, the projected loss ratio, including the cost of COVID-19 claims, dropped 2 points in accident year 2022.
– – After increasing over the prior five years, the projected combined ratio for accident year 2022, including COVID-19 claims, is 6 points lower than in 2021.
– – Average claim closing rates have steadily increased in 2022 and 2023 but remain below the pre-pandemic level.
– – Projected severity on indemnity claims for 2022 is 4% higher than 2021 and 16% above 2017.
– – The average severity in 2022 is the highest it has been in more than a decade, since before the SB 863 reforms.
– – Following several years of modest changes, indemnity severity has increased steadily since 2017. Accident year 2022 indemnity severity is 6% higher than 2021 and 23% higher than 2017. Recent growth in indemnity claim severities has been in part driven by above average wage inflation during the pandemic.
– – The projected medical severity for 2022 is 2% higher than 2021 and 14% higher than 2017. Some of the recent growth in medical severities may be attributable to claims staying open longer since the start of the pandemic and increasesto medical fee schedule reimbursements effective in early 2021.
– – The average paid medical service cost per claim in 2022 is higher than 2021, driven by higher payments per transaction. Some of the paidperclaim growth in 2021 and 2022 is attributable to higher fee schedule reimbursement levels for evaluation and management and medical-legal services effective in early 2021.

The full report is in the Research section of the WCIRB website

Ruling Allows Homeowners to Avoid Illegally Uninsured Comp Problems

The Labor Code provides in essence that persons employed by the owner or occupant of a residential dwelling are generally not considered employees for purposes of workers’ compensation and therefore not entitled to benefits if they work less than 52 hours, or who earned less than $100 in wages for an employer, during the period of 90-calendar days prior to the date of the alleged injury.

Those who exceed those limits are employees of the owner or occupant, and a number of cases in the worker’s compensation literature illustrate examples, such as in Fichera and Allstate Ins. Co. v. W.C.A.B. (May) (1981) 46 Cal.Comp.Cases 26 (Writ Denied), the Board held that an injured house and animal sitter was included within the definition of an employee even though she had only worked 38 hours before sustaining an injury where the Board found that the contract of employment provided for more than 52 hours of work per week.

To assist homeowners in securing coverage for workers’ compensation liability, the legislature passed Insurance Code section 11590 in 1977 which provided that no policy providing comprehensive personal liability insurance may be issued or renewed in this state on or after January 1, 1977, unless it contains a provision for coverage against liability for the payment of workers compensation, as defined in Section 3207 of the Labor Code, to any person defined as an employee by subdivision (d) of Section 3351 of the Labor Code.

Any such policy in effect on or after January 1, 1977, whether or not actually containing such provisions, shall be construed as if such provisions were embodied therein. However, such coverage shall not apply if any other existing, valid and collectible, workers’ compensation insurance for such liability is applicable to the injury or death of such employee.

Homeowners’ insurance policies in California are the method by which owners and occupants of residential properties secure coverage for industrial injuries. But not all homeowners are able to purchase homeowner policies if they live in areas where they are near the risk of forest fires or other catastrophes such as flooding. In response to insurers’ reluctance to write basic property insurance for homeowners who live in high risk or otherwise uninsurable areas, in 1968, the California Legislature enacted the “Basic Property Insurance Inspection and Placement Plan.”

The 1968 law provides for the ‘the equitable distribution among admitted insurers of the responsibility for insuring qualified property for which basic property insurance cannot be obtained through the normal insurance market by the establishment of a FAIR Plan, an industry placement facility and a joint reinsurance association.The FAIR plan provided for coverage of the property only, and did not provide for general liability or workers compensation coverage for the homeowner.

Since 1968 the difficulty for homeowners in California to obtain homeowner insurance has substantially increased. Allstate, Farmers, and USAA, have either completely stopped writing new policies or significantly limited their activity in California. Additionally, four smaller insurers: Merastar, Unitrin Auto and Home, and Unitrin Direct Property and Casualty, have announced they will not renew existing policies in California starting in 2024.

On November 14, 2019, the Insurance Commissioner issued Order No. 2019-2, which required the FAIR Plan to submit a new revised plan of operation to effectuate various business operational changes to the FAIR Plan, including requiring the FAIR Plan to sell HO-3 policies in California. An HO-3 policy is a homeowner’s insurance policy and refers to the name of the standardized insurance form issued by the Insurance Services Office, Inc.

On December 13, 2019, FAIR Plan filed a petition for writ of mandate in California Fair Plan Association v. Lara, case number 19STCP05434, challenging Order No. 2019-2. On December 19, 2019, the Commissioner issued Order No. 2019-3, in which the Commissioner promulgated his own revised plan of operation to be followed by FAIR Plan to effectuate the aforementioned business operational changes.On August 19, 2021, the Court entered its judgment granting in part and denying in part the writ petition, directing the Commissioner to set aside those parts of Order Nos. 2019-2 and 2019-3 that require the FAIR Plan to offer a comprehensive HO-3 Policy.

In response, on September 17, 2021, the Commissioner issued Order No. 2021-2, which requires FAIR Plan to offer a “Homeowners’ Policy” that “insures against, at a minimum, the following perils to the insured property not currently covered under the FAIR Plan’s dwelling fire policy: accidental discharge or overflow of water or steam; premises liability; incidental workers’ compensation; theft; falling objects; weight of ice, snow, or sleet; freezing; and loss of use, including coverage for additional living expenses and fair rental value.”

On October 14, 2021, the Fair Plan Association filed another petition seeking to nullify Order No. 2021-2. On November 27, 2023 the Superior Court of the County of Los Angeles denied the Petition for Writ of Mandate in case 21STCV38060. Thus, currently Order No. 2021-2 (as amended) remains in effect. Homeowners who are unable to obtain homeowners insurance will at least be offered a policy with workers compensation and general liability insurance under the FAIR plan, although the coverage is not the equivalent of an HO-3 policy.

Farmers Senior VP of Claims Awarded $24M for Employer Retaliation

Farmers hired Andrew Rudnicki in 1979. He worked his way up as a trial lawyer to supervising attorney, co-managing the Los Angeles office, and divisional supervisor. In 2013, he was promoted to senior vice president of claims litigation and led Farmers’s branch legal offices. The branch legal offices provide legal representation to Farmers’s insureds. In this role, Rudnicki was responsible for outside counsel that represented Farmers’s insureds, legal bill review, and legal vendors.

In 2013, Lisa Sepe-Wiesenfeld reported to Rudnicki, who tasked her with participating on a conference call with multiple attorneys to address some of their gender-based concerns regarding women in leadership/promotions. Participants included Catherine Meta Pugh, who worked in human resources, and attorneys Christine Campbell, Karen Wasson, and Bethany Soule. Rudnicki then had multiple phone conversations with these three attorneys regarding gender issues.

On April 29, 2015, Lynne Coates filed a class action lawsuit against Farmers, alleging that “Farmers systematically pays female attorneys less than similarly-situated male attorneys. Not only are male attorneys paid more, they are routinely given higher profile work assignments; are given raises and promotions more frequently; and are recognized for their accomplishments while female attorneys are not. In general, Farmers advances the careers of its male attorneys more quickly while treating its female attorneys more like support staff.” In October or November of that year, Wasson became the lead plaintiff in Coates. Farmers retained Paul Hastings, LLP to represent it in the Coates action.

In late 2015, Rudnicki went to Farmers chief claims officer, Keith Daly’s office to explain that he had been prepared by Paul Hastings and expected to give a deposition in Coates; he stated that he would be testifying about what he believed were some HR failures, specifically, the fact that the gender disparity issue had been raised and that HR denied his requests for gender demographics and pay disparity documents in 2013. Daly became red-faced and agitated. Daly unhappily said something like “I don’t see that you need to testify about that.” Rudnicki replied that he did not get to dictate which questions were asked of him.

Thereafter, Daly treated Rudnicki with an icy chill. For example, in February and March 2016, Daly did not ask Rudnicki to speak at Farmers’s big conference, even though he had spoken there every year for the preceding 10 years. At another event, when every other department head was asked to speak, Rudnicki was excluded.

The Coates litigation settled in principle on April 13, 2016, before Rudnicki was ever deposed. One month later, on May 13, 2016, Farmers terminated Rudnicki’s employment. When asked for a reason, Daly and Elliott told Rudnicki that there were “HR issues” and that he was responsible for the Coates settlement. Elliott told Rudnicki that his “behavior ha[d] become a risk to the organization.” But, Daly did not review Rudnicki’s personnel file before terminating his employment; he was only familiar with his own reviews of Rudnicki. Elliott also did not review Rudnicki’s personnel file before Rudnicki’s employment was terminated.

On August 10, 2016, Rudnicki filed a lawsuit, alleging nine causes of action against Farmers. Only five claims survived Farmers’s motion for summary judgment/adjudication: (1) age discrimination, (2) gender discrimination, (3) disability discrimination, (4) retaliatory termination, and (5) a derivative claim for wrongful termination.

Following a 24-day trial, the jury found in favor of Rudnicki on his claim for retaliation, awarding him $5.4 million in compensatory damages and $150 million in punitive damages. The trial court reduced the punitive damage award to $18.9 million, but left the rest of the verdict standing. The Court of Appeal affirmed in the unpublished case of Rudnicki v Farmers Insurance Exchange -B321691 (January 2024).

Farmers argued that the Court of Appeal should reverse the judgment on liability because (1) Rudnicki could not prevail on a claim for retaliation; and (2) the trial court issued certain erroneous evidentiary rulings. Alternatively, if it does not reverse on liability, Farmers asks it to eliminate or substantially reduce the damage award.

The Court of Appeal was not persuaded by these arguments. It found “Farmers engaged in misconduct that can be characterized as moderately reprehensible. It caused physical harm in a foreseeable manner.”

Understanding “Kinesiophobia” is Valuable Tool for Claims

In his latest newsletter, Bill Zachary reported on “Kinesiophobia” and how well it explained some of the barriers that injured workers face during their journey to recovery from work-related injuries. The path to recovery and return to work for injured workers is fraught with challenges, and one significant obstacle is kinesiophobia – the fear of movement and physical activity due to the anticipation of pain and, particularly, the fear of reinjury.

Kinesiophobia is not only a significant barrier to optimum recovery, but it’s also one of the major obstacles preventing injured workers from returning to their jobs. It is crucial to identify when Kinesiophobia is impacting recovery and return to work and to take the necessary steps to overcome these barriers. Here are some important facts about kinesiophobia:

Discomfort (also known as pain) plays a crucial role in learning and recovery. For instance, sticking one’s finger in a pot of scalding hot oil quickly teaches the importance of avoiding such actions. However, in the context of physical therapy and rehabilitation, a certain degree of discomfort may be necessary to stretch and strengthen tissue and regain an optimum range of motion. Acknowledging the distinction between harmful pain and therapeutic discomfort is vital in addressing kinesiophobia and achieving successful recovery and return to work.

Pain is a subjective experience. What one individual perceives as excruciating and unmanageable, another may consider uncomfortable but manageable. After an intense workout in the gym, some may find muscle discomfort to be a positive experience (proof of exercising) rather than a negative one. Personal perception of pain can significantly impact treatment and recovery. Recognizing that pain tolerance varies among individuals, it’s essential to tailor rehabilitation approaches to consider each worker’s pain threshold when developing treatment programs. Physicians and therapists who are not aware of these issues may find that surgery, other treatments, and physical therapy fail when not acknowledging and understanding issues like Kinesiophobia.

Sometimes, the anticipation of pain can be more daunting for injured workers than the actual pain they will experience. Each of us brings our unique life experiences and beliefs to the experience of pain.  Part of a Physical Therapist’s job is to manage the anticipatory fears of patients and have them perform required movements at a controlled intensity.  Once the patient experiences this minor pain, the fear diminishes.

Human memory has a fascinating way of moderating our perception of pain. I have little accurate memory of how severe the pain was after my shoulder surgery. I remember that I was “uncomfortable” but do not really remember the severity of the pain in the immediate days following the surgery. You may also reflect on not remembering the severity of the pain after a broken bone or even a stubbed toe. The phrase “Time heals all wounds” can be applied to most people who have had severe pain. Their perception of the pain severity fades over time.  Repeated instances of minor pain during home exercises will aid the change in perception from daunting pain to mere discomfort.  Digital health, such as Plethy’s Recupe app, are excellent at encouraging exercise adherence, thus creating these memories of minor discomfort.

Kinesiophobia is best treated by first recognizing its existence. One of the most common tools for diagnosing and evaluating the level of kinesiophobia is the Tampa Scale of Kinesiophobia (TSK), consisting of 17 self-reporting questions that assess levels of fear, pain catastrophizing, and disability.

It is important to note that despite the fear of physical activity, physical activity can also be a form of treatment (and often is the best treatment that will facilitate full recovery). There are specific strategies or techniques to help individuals manage the anticipation of pain effectively.

Kinesiophobia can be treated through a multidisciplinary approach, involving a rehabilitation physician, a psychologist, and a physical therapist.

The focus of most treatment includes counseling, reassurance, education, relaxation training, mirror therapy, and small incremental steps in treatment.  Proven treatment includes mindfulness exercises, cognitive-behavioral techniques, medication for anxiety and limited low-dose analgesics.  Active care activities, such as exercises in the home and clinic, are also key to reducing this fear through exposure.  Here, adherence is key, especially with home exercises as the patient will spend far more time at home than in the clinic.  Thus, Recupe and other digital health show great promise towards the treatment of kinesiophobia.

In concluding his article Mr. Zachary said “It is essential for claims professionals to engage in identifying potential cases and intervene to overcome the barriers.  If an injured worker refuses to return to light or modified duties, determining the underlying reasons, such as the fear of reinjury, is crucial. Providing this information to the doctor and supporting the appropriate clinic and home treatment can facilitate a more comprehensive approach to rehabilitation and recovery.”

Prices Set to Increase This Year on Over 500 Prescription Drugs

A storm is brewing in the world of medicine, with drugmakers poised to unleash a price hike on over 500 drugs this January. According to the report in Reuters, tt’s a decision that’s sending ripples through the entire system, leaving patients, governments, and even the drug companies themselves caught in the tide.

Pfizer, Sanofi, and Takeda plan to increase prices on over 500 unique drugs in early January. This includes more than 140 distinct brands of drugs across various doses and formulations. While overall price increases have slightly decreased compared to previous years, newly launched drugs continue to see significant price hikes, reaching record levels.

This decision comes despite the Biden administration’s efforts to control drug pricing through measures like the Inflation Reduction Act (IRA), which allows Medicare to negotiate prices for some drugs starting in 2026.

On the surface, it’s a classic case of supply and demand. Drugmakers point to rising costs, from inflation to research and development, as the reason for cranking up the price tags. They argue it’s the only way to keep the wheels of innovation turning and new life-saving drugs rolling out of their labs.

But not everyone is buying it. Critics see a system rigged against affordability, where transparency is as scarce as a magic cure. They worry about patients caught in the crossfire, forced to choose between their health and their wallets. The burden, they argue, falls heaviest on those already struggling to stay afloat, with potentially life-saving medications becoming another luxury they can’t afford.

This isn’t just a domestic squabble, it’s a global game of chess. Governments, tired of footing the ever-growing healthcare bill, are flexing their muscles. The US, for example, recently passed the Inflation Reduction Act, a game-changer that gives Medicare the power to negotiate prices for some drugs. It’s a tiny pebble in the pond for now, but its ripples could create waves across the industry.

For patients, the future is as murky as a medicine bottle label. Will they have to ration their pills, switch to cheaper (but potentially less effective) alternatives, or simply forgo treatment altogether? It’s a chilling proposition, leaving many scrambling for solutions – solutions that, like the perfect pill, remain elusive.

So, where does this story go? Will the drugmakers hold firm, clinging to their pricing power? Will governments find the right formula to tame the price monster? How much of this will be reflected in the cost of administrating workers’ compensation claims? Only time will tell, but one thing’s for sure – this is a story with no happy ending in sight, at least not yet.