Tag: 2024 News

The former longtime head of the accounting department at the now-shuttered Los Angeles plaintiffs’ personal injury law firm Girardi Keese pleaded guilty to enabling the embezzlement of tens millions of dollars from the firm’s injured clients and to embezzling money from Girardi Keese itself.

Christopher Kazuo Kamon, 51, formerly of Encino and Palos Verdes and who was residing in The Bahamas at the time of his November 2022 arrest, pleaded guilty to two counts of wire fraud.

According to his plea agreement, from 2004 until December 2020, Kamon was the head of the accounting department at Girardi Keese, a plaintiffs’ personal injury law firm based in downtown Los Angeles. In this position, Kamon worked closely with Thomas Vincent Girardi, 85, formerly a resident of Pasadena but who now resides in Seal Beach, as well as other senior lawyers at the law firm.

In December 2020, Girardi Keese’s creditors forced the once-prominent law firm into bankruptcy proceedings. The law firm dissolved in January 2021 and the State Bar of California disbarred Girardi in July 2022. On August 27, a federal jury in Los Angeles found Girardi guilty of four counts of wire fraud. Girardi’s sentencing hearing is scheduled for December 6.

In addition to supervising the law firm’s accounting department, Kamon oversaw facilitating payment of the law firm’s expenses. Kamon had a duty to keep accurate books and records of Girardi Keese, including accounting of money held in its attorney-client trust accounts. Typically, Girardi determined and directed which clients would be paid, how much they would be paid, when they would be paid, and signed all outgoing checks to clients. Kamon had signatory authority on additional Girardi Keese bank accounts.

From at least 2010 until December 2020, Girardi and Kamon schemed to defraud Girardi Keese clients out of their settlement money, using the misappropriated funds to pay the law firm’s payroll, the law firm’s credit card bills, and to pay Girardi and Kamon’s personal expenses.

Specifically, one victim – a Girardi Keese client who suffered severe burns all over his body when a natural gas pipeline exploded in San Bruno, California, in September 2010 – had a $53 million settlement negotiated. This deal was negotiated and agreed to without the client’s prior approval. Per the terms of the settlement, $25 million was invested into an annuity. The remaining $28 million was wired into a Girardi Keese client trust account in January 2013. Girardi, assisted by Kamon, misappropriated, and embezzled that client’s settlement money and used the funds to pay other Girardi Keese expenses and liabilities unrelated to this client, including payments to other law firm clients whose own settlement funds previously had been misappropriated by Girardi and others.

To prevent the victim from discovering Girardi’s embezzlement, Girardi lied to the client by saying the funds had been transferred into a separate interest-bearing account. In fact, no such transfers had been made and no such interest-bearing account containing these funds existed.

Girardi and Kamon sent lulling payments to the victim as purported “interest payments” deriving from the purported interest-bearing account. In July 2019, they sent the victim a $2.5 million check, purportedly as disbursement of the victim’s settlement funds. In fact, Girardi and Kamon knew these settlement proceeds belonged to other Girardi Keese clients. Girardi already had spent the victim’s settlement funds through disbursements unrelated to the victim’s case.

In a separate criminal case, Kamon admitted to running a years-long scheme in which he embezzled Girardi Keese funds for his personal enrichment. From at least 2013 to December 2020, Kamon utilized co-schemers to pose as “vendors” who were providing goods and services to the law firm. Kamon caused the supposed vendors to issue fraudulent invoices to Girardi Keese for goods and services that they purportedly provided to the law firm.

Kamon caused Girardi Keese to pay the amounts due on the fraudulent invoices. In fact, the law firm was paying the “vendors” for Kamon’s personal benefit, including for construction projects at his homes in Palos Verdes and Encino.

According to evidence presented at the recent trial of Tom Girardi, part of Kamon’s scheme involved payments to a female companion amounting to hundreds of thousands of dollars, including a monthly stipend of $20,000, out of the Girardi Keese operating accounts despite the woman having no employment relationship with Girardi Keese.

United States District Judge Josephine L. Staton scheduled a January 31, 2025, sentencing hearing, at which time Kamon will face a statutory maximum sentence of 20 years in federal prison on each count. Kamon has been in federal custody since December 2022.

Kamon – along with Girardi and David R. Lira, Girardi’s son-in-law, and a former Girardi Keese lawyer – also faces federal fraud charges in Chicago. Trial in that case is scheduled for March 3, 2025.

IRS Criminal Investigation and the FBI investigated this matter.

Assistant United States Attorneys Ali Moghaddas of the Corporate and Securities Fraud Strike Force and Scott Paetty of the Major Frauds Section are prosecuting this case.

A man banned for life from California’s workers’ compensation system after being twice convicted of workers’ compensation insurance fraud has been charged along with a San Diego-based neurosurgeon and two other co-conspirators in connection with billing nearly $100 million in fraudulent fees as part of an extensive workers’ compensation fraud scheme.

The charges follow a three-year investigation by the Orange County District Attorney’s Office into twice convicted felon David Wayne Fish who is accused of continuing to control clinics and providers who would see patients, refer them to specific providers in order to receive illegal referral payments, and then unlawfully bill workers’ compensation insurance companies for these services.

Fish, 55 of Laguna Niguel, Martin Brill, 78 of Los Angeles, and Robert Lee, 61 of Rancho Mirage, formed Southern California Injured Workers (SCIW), a management company which offered medical management services, including marketing, billing, and collections. Fish worked for the company as a “consultant,” but exercised complete control over the operation.

David Fish was convicted back in 2010, as part of Premier Medical Management, of Workers’ Compensation kick-back schemes and permanently suspended from participating in the California Workers’ Compensation System. He was convicted in Los Angeles County Superior Court in 2010 for receiving compensation or inducement for the referral of clients. Fish organized dozens of lawyers and doctors to steer more than 4,000 cases to preferred medical providers in order to run up high bills. Fish was ordered to pay $10,000 in restitution and approximately $390,000 in unpaid taxes.

In the current case, these three codefendants, along with San Diego neurosurgeon Dr. Vrijesh Tantuwaya – who is listed as a QME with five offices – also created a medical group called Injured Workers Medical Group (IWMG), which was the main client for SCIW. Dr. Tantuwaya was named the owner and CEO of this medical professional corporation.

The four co-defendants have been charged with 13 separate felony counts which include violations of Labor Code 3215 (referral of clients for compensation), Penal Code 182(a)(1) (conspiracy to commit a crime), Penal Code 549 (false and fraudulent claim) and Penal Code 550 (b)(3) (insurance fraud).

Using the medical group,Southern California Injured Workers he allegedly controlled patient referrals to a limited network of providers which contracted with SCIW to pay for the patient referrals. In three years, these defendants billed nearly $100 million dollars to numerous workers’ compensation insurance carriers, and were illegally paid referral fees from providers of services such as diagnostic testing and compound pharmacies.

“The Orange County District Attorney’s Office remains fiercely committed to prosecuting bad actors who exploit the workers’ compensation system to line their own pockets rather than helping injured workers,” said Orange County District Attorney Todd Spitzer. “At a time when families across America are struggling to keep up with increasing prices for everything from gas and rent to just being able to put food on the table for their families, criminals like these only increase the cost of insurance premiums and put the American dream just that much further out of reach for so many hardworking people. I am incredibly proud of the men and women of our Insurance Fraud team and their continued dedication to fighting for the rights of workers.”

According to the Coalition Against Insurance Fraud, insurance fraud is responsible for more than $308.6 billion in theft every year from American consumers. The California Department of Insurance reports that insurance fraud totals $17.2 billion each year and costs California residents an average of $440 a year through higher premiums, higher taxes, and higher prices. Investigating and prosecuting this fraud benefits all Californians.

If convicted, Fish faces maximum sentence of 18 years and four months in prison. Brill faces maximum of 12 years and four months in prison, Tantuwaya faces 13 years, four months in state prison and Lee faces 12 years and four months in prison.

Deputy Dstrict Attorney Kelly Albright of the Insurance Fraud Unit is prosecuting this case.

Stanford Medicine leaders spotlighted innovation in artificial intelligence and reimagining cancer research and care as two of the academic health system’s key strategic priorities at the annual State of Stanford Medicine event on Oct. 1.

Appearing together before an in-person and virtual audience were Lloyd Minor, MD, the dean of the Stanford School of Medicine and vice president for medical affairs at Stanford University; David Entwistle, president and CEO of Stanford Health Care; and Paul King, president and CEO of Stanford Medicine Children’s Health. Together, they discussed their vision for the organization and what lies ahead – guided by a recently refreshed integrated strategic plan for Stanford Medicine through 2030.

Recognizing Stanford’s history as a pioneer in artificial intelligence, Stanford Medicine leaders aim to build on this legacy through responsible development and implementation of AI technologies in biomedical research, medical education and clinical care. Stanford Medicine has deployed more than 30 AI-powered applications to support clinicians in screening and diagnostics, monitoring patient conditions, predicting long-term outcomes, and informing decision-making.

In collaboration with technology companies, the health system also is pioneering the use of AI tools to support administrative work – such as creating first-draft responses to patient emails and drafting clinical notes through ambient listening technology. These tools have shown potential in reducing the clerical burden for clinicians, increasing their time with patients and improving their well-being.

As a founding partner of the Coalition for Health AI and through the RAISE Health initiative with the Stanford Institute for Human-Centered Artificial Intelligence, Stanford Medicine is leading the way in creating guidelines and guardrails to enhance the effectiveness of AI in health care and ensure that these powerful technologies are used for the benefit of all, Minor said.

“We have a real opportunity to enable or augment what we do with AI – that’s the part that I think is the most exciting,” Entwistle said. “How do we take this technology and build on the incredible clinical excellence that we already have? How do we get the right information in the right way in front of our clinicians at the right time? How do we use that technology to enable them to build on their excellence?”

With the number of cancer diagnoses worldwide increasing at a faster pace than most other diseases, Stanford Medicine is committed to continuing its leading role in addressing unmet needs through a bold vision to reimagine cancer innovation and care, the leaders said. Meeting this demand requires development of new cancer therapies, increased access to inpatient and outpatient care, specialized services leveraging advanced technologies, as well as clinical trials and cutting-edge treatment modalities.

Minor discussed Stanford Medicine’s vision to create a comprehensive, destination cancer center for adult and pediatric patients with a “bench-bedside-bench model” – bringing breakthroughs from labs to the patient care environment, then efficiently returning care insights back to scientists. Another priority is expanding access to Stanford Medicine’s world-class care, Entwistle said, citing the health system’s collaboration with Sutter Health to build an outpatient cancer center in Oakland.

“We cannot overstate the importance of cancer innovation and care at this moment in time,” King said. “Our vision is to build on Stanford Medicine’s rich legacy of groundbreaking discoveries, to translate them into the care we provide, and bringing insights from our clinics and our inpatient units back to our labs in that virtuous cycle.”

On 9/1/2022 Sonia Arteaga filed an Application for Adjudication of Claim alleging injury, while employed by Starcrest Products of California, to hernia, excretory system, back, shoulders and multiple parts during the period of 6/7/2021 through 6/7/2022.

Arteaga began treating with Dr. Haghighinia, of Medland Medical, on 10/07/2022. The initial Request for Authorization was sent by Medland to Defendant, Zenith Insurance on 10/24/2022. Zenith did send notice of the intent to defer Utilization Review on a basis other than medical necessity to Medland on 10/24/2022.

Zenith denied the claim on 11/29/2022. Nonetheless Sonia Arteaga continued to treat with Medland subsequent to the denial.

On 10/12/2023 the case settled by Compromise and Release for for $35,000, with the Order Approving Compromise and Release.

A Notice and Request for Allowance of Lien was filed by Medland on 11/9/2023, followed by a Declaration of Readiness on 11/17/2023. The matter came before the WCJ for a lien trial on 5/1/2024. The matter was submitted on 5/1/2024 and a Findings and Order issued on 6/28/2024.

Among the findings, the WCJ found that Arteaga sustained injury AOE/COE, Zenith did not retain medical control through the MPN during the delay period, Zenith was liable for the Med-Legal services performed by Medland on 2/22/2023 and Zenith was permitted to conduct retrospective UR regarding dates of service 10/07/2022 through 8/28/2023 (excluding date of service 2/22/2023).

Medland filed a Petition for Reconsideration disputing only the finding that Defendant is permitted to conduct retrospective UR regarding dates of service 10/07/2022 through 8/28/2023 (excluding date of service 2/22/2023).

The WCAB panel denied reconsideration in the case of Arteaga v Starcrest Products of California -ADJ16637235 (October 2024)

In its Petition for Reconsideration the Lien claimant contends that the WCJ erred in deferring the issue of the medical treatment lien pending retrospective utilization review. Lien claimant argues that defendant waived its ability to conduct retrospective utilization review by not timely responding to each request for authorization.

California Code of Regulation §9792.9.1(b) governs the deferral of Utilization Review when there are threshold disputes other than medical necessity. CCR §9792.9.1(b)(1) indicates that “a written decision deferring utilization review of the requested treatment unless the requesting physician has been previously notified under this subdivision of a dispute over liability..”

Defendant did issue an Utilization Review deferral notice to the initial Request for Authorization from Medland dated 10/24/2022. That notice dated 10/24/2022 was timely issued (within five business days of the date of the Request for Authorization). At the time of all subsequent Requests for Authorization, Medland was already on notice that Defendant was disputing their request for treatment of the Applicant due to a threshold issue other than medical necessity.

In his report, the WCJ agreed with the rational in the panel case of Ghattas v. O’Reilly Auto Parts, Safety Nat’l Cas. Co., 2018 Cal. Wrk. Comp. P.D. LEXIS 86, which notes that Defendant is not required to submit Requests for Authorization to Utilization Review following a timely denial of the case.

The WCAB panel concluded by saying “Here, the WCJ correctly determined that defendant was entitled to retrospective utilization review. The WCJ found that the defendant responded to lien claimant’s first request for authorization with a timely and proper notice to defer utilization review on a basis other than medical necessity.”

“As noted above, Administrative Rule 9792.9.1(b)(1) exempts the defendant from having to issue subsequent delay notices to subsequent requests for authorization if ‘the requesting physician has been previously notified under this subdivision of a dispute over liability and an explanation for the deferral of utilization review for a specific course of treatment.’ Since defendant timely and properly advised the lien claimant of the liability dispute in response to the first request for authorization, it did not have an obligation to issue any subsequent delay notices.”

The #MeToo movement highlighted concerns that compelled arbitration of sexual harassment claims can perpetuate unacceptable behavior and minimize its consequences by diverting such claims from public court proceedings into a private forum. In response, Congress enacted the Ending Forced Arbitration of Sexual Assault and Sexual Harassment Act of 2021 (EFAA; 9 U.S.C. §§ 401-402).

As codified, the EFAA amended the Federal Arbitration Act (FAA; § 1 et seq.), and was placed within the FAA’s other provisions. Section 402, added by the EFAA, states, “Notwithstanding any other provision of [the FAA], at the election of the person alleging conduct constituting a sexual harassment dispute . . . , no predispute arbitration agreement or predispute joint-action waiver shall be valid or enforceable with respect to a case which is filed under Federal, Tribal, or State law and relates to the . . . sexual harassment dispute.” (§ 402(a).)

Yongtong “Jade” Liu sued Miniso Depot CA, Inc., USA Miniso Depot, Inc., Lin Li and unnamed Doe defendants on October 5, 2023. Liu alleged that Li was the chief executive officer of the Miniso entities. According to Liu, Miniso owns and operates retail stores which sell “goods such as toys, collectables, stationary, cosmetics, and household items.”

Liu alleged she was hired by Miniso in around April 2021 as a human resources administrator, and was paid an hourly wage. In around January 2022, Miniso changed Liu’s job title and, although her duties “remained generally the same,” she was classified as exempt from various wage and hour requirements imposed by the Labor Code, Industrial Welfare Commission Wage Orders, and regulations. Liu alleged that Miniso misclassified her as an exempt employee, and as a result improperly failed to pay her for all the hours she worked, to pay her the minimum wage, to pay the required rates for overtime, and to provide her with appropriate rest and meal breaks and with accurate wage statements.

Liu, who alleges she “identifies as lesbian and dresses in a unisex non-gender specific style,” further asserted that during her employment “[she] and others in her presence were subjected to unwelcome, severe and pervasive sexual harassment, sex discrimination and race discrimination, sexual orientation/gender harassment and sexual harassment/gender discrimination.”

Liu alleged the following specific incidents and types of offensive conduct: Li and others at Miniso commented on Liu’s appearance during company meetings; Li twice suggested during meetings that if Miniso’s products looked like Liu then no one would purchase them; Li remarked that Liu was unattractive because she was “too skinny” and that she needed to eat more to have more curves. and would comment that “a man should do what a man should do, and a woman should do what a woman should do.”

Liu also alleged that Miniso asked her, in her position in human resources, to participate in practices which she considered to be illegal, including failing to pay female employees “equally or comparably to male counterparts,” “hir[ing] only young Korean employees,” and falsifying “immigration-related documents” to facilitate Miniso hiring Chinese individuals who could not legally work in the United States. Liu alleged she complained about these practices to Li and others and refused to comply. Liu alleged that after she refused to participate in various practices she believed were illegal, she faced increased harassment and discrimination.

Based on these allegations, Liu asserted the following claims: violation of various wage and hour requirements set forth in the Labor Code and California Code of Regulations, title 8, section 11040; sexual harassment in violation of the Fair Employment and Housing Act (FEHA; Gov. Code, § 12900 et seq.); sex discrimination in violation of the FEHA; sexual orientation/gender identity harassment in violation of the FEHA; sexual orientation/gender identity discrimination in violation of the FEHA; retaliation for complaining about unlawful activities in violation of Labor Code section 1102.5; retaliation for refusing to participate in unlawful activities in violation of Labor Code section 1102.5; constructive termination in violation of public policy; and intentional infliction of emotional distress. Liu sought compensatory damages, statutory penalties, punitive damages, injunctive relief, and attorney’s fees.

On January 31, 2024, Miniso filed a motion to compel arbitration of all of Liu’s claims under the Federal Arbitration Act. Miniso argued that, under the terms of the arbitration agreement, “Liu must arbitrate her entire [c]omplaint, because it consists solely of Labor Code counts, FEHA claims, and employment and other torts, all of which arise in connection with Liu’s employment with Miniso.” Miniso contended that the EFAA did not apply because Liu’s allegations of sexual harassment failed to state a claim for harassment and, thus, her complaint effectively had no harassment claim. In particular, Miniso argued that Liu’s complaint concerned “mere annoying, offensive, and stray remarks,” which could not state a viable harassment claim under the FEHA.

The trial court denied Miniso’s motion to compel arbitration in the published case of Liu v. Miniso Depot CA, Inc. – B338090 (October 2024)

Miniso’s sole appellate contention is that the trial court erred in concluding the parties’ arbitration agreement was unenforceable as to all of Liu’s claims, and not just as to the two harassment claims. In other words, Miniso contends the trial court should have compelled Liu to arbitrate all of her claims except for the two harassment claims.

“We disagree. Under the EFAA, when a plaintiff’s lawsuit contains at least one claim that fits within the scope of the act, the arbitration agreement is unenforceable as to all claims asserted in the lawsuit.”

“We agree with our colleagues in Division Three of this appellate district, who recently concluded in Doe v. Second Street Corp. (Sept. 30, 2024, B330281) ___ Cal.App.5th ___ [2024 WL 4350420] that the plain language of the EFAA exempts a plaintiff’s entire case from arbitration where the plaintiff asserts at least one sexual harassment claim subject to the act. Here, at least one of Liu’s claims is subject to the EFAA, and thus the trial court did not err in refusing to compel Liu to arbitrate any of her claims.”