- Tesla HR Execs' Lawsuit Blames HR Manager for Retaliationon August 28, 2025 at 2:37 PM
Former Tesla HR execs Linda Peloquin, Adam Chow, Tiara Paulino, Sharnique Martin, Gregory Vass and Ozell Murray just filed a lawsuit against Tesla Inc., in the United States District Court for the Northern District of California Case 3:25-cv-06690-AMO. The lawsuit concerns the automaker’s Fremont, California, facility that has been at the center of several previous discrimination lawsuits.
These former Tesla HR professionals alleged that they were either fired or effectively forced to resign after attempting to surface other employees’ race discrimination and retaliation complaints at the company’s Fremont, California, plant.
According to the Peloquin complaint, one of Tesla’s HR managers, Nicole Burgers, was a “common denominator” in the various claims made by the plaintiffs. They alleged that the manager, the overall HR manager for the entire Fremont facility, “had an irrational fixation on fostering the delusion that the environment and culture at Tesla is one of tolerance and innovation, rather than racism and retaliation.”
Allegations continue to say that "Much of Tesla’s workplace toxicity stems from its rapid sales growth and manufacturing demand, and the breakneck pace at which it hired employees to work in its plants and overall operation. Since its introduction in 2020, Tesla’s “Model Y,” for instance, has become the Company’s top-selling vehicle line - and, by most estimates, one of the top-selling electric vehicles in the world. Thus, there was, and remains, constant pressure to keep the Model Y’s sales trajectory high."
"Yet, as a consequence of this desire to produce vehicles at such a rapid pace, the Company has failed to cultivate a healthy working environment at the Fremont facility, and instead fostered one that is beset with racism, sexism, cronyism, and outright physical violence."
Plaintiffs claim "even employees that had been terminated for instances of workplace violence were loopholed back in via temp agencies. That meant, then, that oftentimes the employee who had been previously victimized had to actually resume working with their attacker and tormentor."
"In fact, that Senior Security Manager himself was attacked and suffered a serious injury when he attempted to stop a loopholed employee - one who had been returned to work after being terminated for cause - after that employee came back aboard and attacked another worker."
At some point plaintiffs allege that Tesla "turned its ire on the HR professionals that had merely investigated and substantiated the bases of the complaints. So, oddly, in most instances it was the HR official that wound up being penalized and pushed out for substantiating the alleged wrongdoing rather than the wrongdoer themselves. Consequently, a dizzying number of HR professionals - the Plaintiffs here: Peloquin, Chow, Paulino, Martin, and Vass, among them - have either been outright fired for substantiating complaints of discrimination and retaliation, or resigned because they saw a termination coming and did not want that type of disciplinary stain on their job history.
Details of the complaint allege "A common denominator in many of these terminations is a HR Manager named Nicole Burgers. By all accounts, Burgers has had an irrational fixation on fostering the delusion that the environment and culture at Tesla is one of tolerance and innovation, rather than racism and retaliation. By all accounts, given that Burgers was the overall HR manager for the entire Fremont facility, she believed that she would be held accountable for further instances of racism and misconduct at the Fremont location - particularly in light of the pending State, Federal, and private litigation against the Company. Thus, rather than undertake to change the culture and environment that fostered those types of instances of racism, Burgers instead undertook to weed out the HR professionals beneath her that merely investigated and substantiated the occurrence of that type of depravity."
Page 24 of the 159 page complaint continues to provide details by writing "Karen Draper was one of the first dominos to fall in what became a long line of retaliatory terminations by Burgers and her Texas-based counterparts - Allie Arebalo, Bert Somsin, Jenifer Romero, and Leah Allen - or, instances where other HR professionals simply resigned under protest because they knew Burgers had begun to target them.
- Fresno Superior Court Judge Charged With Multiple Felonieson August 28, 2025 at 2:36 PM
Adolfo M. Corona was a judge of the Superior Court of Fresno County in California. He assumed office in 2003. He left office on May 1, 2024. Corona was appointed by Gov. Gray Davis in 2003. His legal career included working as an attorney at Dowling Aaron & Keeler Inc. in Fresno from 1986 to 2003 and serving as a judge pro tem for the Fresno County Superior Court from 1992 to 2003. He was also a member of the Central Valley Chapter of La Raza Lawyers Association. At the time of his retirement, he was presiding over juvenile court cases.
State charges were first filed against Corona in September 2024 following a state grand jury indictment by the Fresno County District Attorney. Prosecutors charged him on one count of felony sexual penetration by force, fear, or duress and one count of misdemeanor sexual battery, stemming from an alleged assault on a court employee on March 14, 2024, at the Fresno County Superior Court. He pleaded not guilty, was released on $70,000 bail, and is represented by attorneys Michael Aed and Margarita Martinez-Baly.
The two renowned local defense attorneys have represented the likes of Assemblymember Joaquin Arambula. Aed reportedly would not answer questions about the timing of the judge’s resignation, weeks after the alleged incident. “He is entitled to counsel of his choice. This case came out of the blue without any pre-warning. He made certain decisions at the beginning of the case. He expects a vigorous and complete defense, and we intend to give him that,” Aed reportedly said.
Now in August 2025, the U.S. Justice Department announced that a federal grand jury in Fresno returned a five-count indictment charging 66 year old Corona with federal offenses for sexually assaulting a court employee (Victim 1), making false statements to cover up the assault, and with obstructing the investigation into allegations that he sexually assaulted another court employee (Victim 2) in his chambers.
Assistant Attorney General Harmeet K. Dhillon of the Justice Department’s Civil Rights Division, U.S. Attorney Eric Grant of the Eastern District of California, and Special Agent in Charge Siddhartha Patel of the FBI Sacramento Field Office made the announcement regarding the new federal case.
The indictment alleges that on March 14, 2024, Corona, while serving as a California Superior Court Judge, led Victim 1 into a courthouse stairwell where he sexually assaulted her. The indictment further alleges that Corona, during separate interviews with the FBI and court administrators, made false statements about the circumstances of his assault on Victim 1.
Additionally, the indictment alleges that Corona obstructed the investigation into allegations that he sexually assaulted Victim 2. Corona was alone with Victim 2 in his chambers for approximately two hours on Dec. 5, 2023, and she was later found alone in the judge’s chambers after being passed out. The indictment charges that Corona falsely told the FBI that he left Victim 2 alone in his chambers while he drove to pick up a motorcycle. Corona allegedly attempted to persuade a motorcycle dealership employee to change company records to falsely reflect that he had picked up his motorcycle in order to corroborate his alibi.
If convicted, Corona faces a maximum sentence of 40 years in prison on the sexual assault charge and 20 years on each of the obstruction charges. Any sentence, however, would be determined at the discretion of the court after consideration of any applicable statutory factors and the Federal Sentencing Guidelines, which take into account a number of variables. The charges are only allegations; the defendant is presumed innocent until and unless proven guilty beyond a reasonable doubt.
This case is the product of an investigation by the Federal Bureau of Investigation and the Fresno County Sheriff’s Office. Assistant U.S. Attorney Karen Escobar for the Eastern District of California and Special Litigation Counsel Michael J. Songer of the Civil Rights Division’s Criminal Section are prosecuting the case.
Anyone with information about this investigation is encouraged to contact their local FBI office, call 1-800-CALL-FBI (1-800-225-5324), or submit a tip to tips.fbi.gov.
- Musk's X Reaches Tentative Settlement $500M Class Actionon August 27, 2025 at 4:25 PM
Elon Musk's social media company, X Corp, has reached a tentative settlement in a lawsuit filed by former employees who claimed they were owed $500 million in severance pay.
The lawsuit, filed as a proposed class action in the U.S. District Court for the Northern District of California (Case No. 23-03461, McMillian et al. v. Musk et al.), was initiated in July 2023 by former Twitter employees Courtney McMillian (former head of total rewards, overseeing employee benefits) and Ronald Cooper (former operations manager).
They alleged that Twitter's 2019 severance plan, established under the company's previous ownership, entitled laid-off employees to substantial payouts: two months of base pay plus one week for each year of service for most workers, and up to six months for senior employees like McMillian.
Following Elon Musk's $44 billion acquisition of Twitter in October 2022 and the subsequent rebranding to X, approximately 6,000 employees were terminated as part of cost-cutting measures. The plaintiffs claimed that X Corp. violated this plan by offering at most one month of severance pay, with many receiving nothing, resulting in an estimated $500 million in owed benefits.
On July 9, 2024, U.S. District Judge Trina L. Thompson dismissed the case without prejudice. The core of her ruling centered on the inapplicability of the federal Employee Retirement Income Security Act (ERISA), which governs employee benefit plans and provides federal jurisdiction for such disputes. Judge Thompson determined that Twitter's severance arrangement did not qualify as an ERISA-governed plan because it lacked an "ongoing administrative scheme.
However, Judge Thompson allowed the plaintiffs the opportunity to amend their complaint to pursue alternative claims not reliant on ERISA, such as potential state law breach-of-contract allegations.
The plaintiffs appealed the dismissal to the U.S. Court of Appeals for the Ninth Circuit (Case No. 24-5045, McMillian v. Musk) shortly after the district court's decision. In their appeal, the former employees argued that Twitter's severance policy did indeed qualify as an ERISA plan because it involved ongoing benefit payments, even if administered without individualized discretion. They received support from the U.S. Department of Labor, which filed an amicus brief endorsing this view, emphasizing that ERISA coverage applies to plans paying benefits on a continuing basis regardless of administrative complexity.
In response, Musk and X Corp. filed a brief on January 9, 2025, urging the Ninth Circuit to affirm the dismissal. Their key arguments included:
- - No formal ERISA plan existed, as the employees failed to produce official plan documents (e.g., summary plan descriptions) or evidence of widespread communications to workers about the severance terms prior to Musk's acquisition.
- - References to a "severance matrix" (a confidential document allegedly taken by McMillian) and general corporate statements at most indicated offers of simple lump-sum payments, which do not constitute an ERISA-governed scheme requiring ongoing administration.
- - This lack of a qualifying plan was "fatal" to the class action, as it undermined the basis for federal jurisdiction.
Oral arguments were scheduled for September 17, 2025, in San Francisco.
However, as of August 21, 2025, the parties reached a tentative settlement agreement, the financial terms of which were not disclosed. In a joint court filing, both sides requested a postponement of the hearing to finalize the deal, which would resolve the class action and compensate the affected former employees. The Ninth Circuit granted the delay on August 22, 2025, effectively pausing the appeal process. This settlement does not impact other ongoing related lawsuits, such as those in Delaware and California courts involving different claims or plaintiffs.
In summary, the appeal remains unresolved on the merits due to the impending settlement, marking a potential end to this specific dispute without a full appellate ruling on the ERISA question.
Other related lawsuits, including one by former executives like ex-CEO Parag Agrawal, remain pending. This settlement aims to resolve the dispute over severance pay for the affected former employees.
- Group Studies Ethical & Social Risks of Exoskeleton Use for Safetyon August 27, 2025 at 4:25 PM
Construction continues to be one of the most dangerous industries, with workers constantly exposed to physically demanding and repetitive activities. Exoskeletons are emerging as ergonomic interventions that amplify human strength and agility while reducing muscle fatigue and discomfort. However, like any robotic technology, exoskeletons may have unintended consequences.
While studies have examined the health and safety risks of exoskeletons in construction, there is a significant gap in the literature regarding their ethical and social risks. Issues related to privacy concerns, exoskeletons’ design, and discrimination, among many others, are housed in the ethical risks, and social risks often include questions regarding exoskeletons’ affordability, accessibility and impact on social identity and communication, among others.
A new study just published by The Center for Construction Research and Training addresses that gap by investigating the ethical and social risks associated with exoskeleton use in construction, assessing their impact on workers' health and safety and exploring how they can be designed to minimize these risks. This study further developed a comprehensive and practical worker-centric guide aimed at advancing the safe and ethical implementation of exoskeletons in the construction industry.
This research leverages a systematic literature review, a Delphi technique (consisting of three rounds of surveys), and a focus group discussion to achieve the research objectives. The study developed a practical, worker-centric guide that examines exoskeleton preferences for construction trades, ethical and social risks of exoskeletons, the impacts of these risks on construction workers’ health and safety, the impact of these risks on the implementation of exoskeletons in the construction industry, and strategies to mitigate these identified ethical and social risks. The study further highlights barriers to implementing the identified strategies.
1. Ethical and Social Risks: A total of 34 ethical and social risks were identified from the literature review. Out of the 34, 18 were verified by experts in the construction industry and used in this study. These risks are categorized under design, autonomy, dehumanization, stigmatization, vulnerability, affordability, and accessibility.
2. Risk Criticality: Experts rated the identified risks on a Likert scale of 1 to 5 (with 1 being not critical, 2 less critical, 3 moderately critical, 4 very critical, and 5 extremely critical). Results show inaccessibility and unaffordability are examples of Very Critical risks, and stigmatization and loss of identity are examples of Less Critical risks.
3. Exoskeleton Suitability: Passive exoskeletons are suitable for repetitive overhead work and awkward postures, while active exoskeletons are better for heavy lifting. Back-support exoskeletons are most suitable for trades such as plumbers and carpenters, while full-body exoskeletons suit laborers.
4. Risk Impact on Workers’ Health and Safety: The findings revealed that ethical and social risks related to design, autonomy, privacy, unauthorized access, dependency, exoskeleton weight, and overdependence pose significant health and safety concerns to workers.
5. Mitigating Strategies: Seventy strategies to mitigate identified ethical and social risks were proposed and evaluated.
6. Barriers to proposed strategies: Fifteen barriers to effective risk mitigation were identified.
7. Worker-Centric Guide: A comprehensive guide was developed to facilitate the implementation of exoskeletons such that the ethical and social risks are minimized.
CPWR - The Center for Construction Research and Training is a nonprofit dedicated to reducing occupational injuries, illnesses and fatalities in the construction industry. A copy of the 74 page document can be downloaded without charge by using this link.
- WCRI Studies Back and Shoulder Injuries With a $65K+ Price Tagon August 26, 2025 at 3:32 PM
A new study from the Workers Compensation Research Institute (WCRI) examines the key factors associated with high-cost workers’ compensation claims involving back and shoulder injuries, where medical expenses exceed $65,000 within 36 months of injury.
“In a previous WCRI study, we identified factors that increase the likelihood of high medical payments by looking at all injury types together,” said Sebastian Negrusa, WCRI’s vice president of research. “This new study refines that analysis by focusing on back and shoulder injuries to better understand what contributes to higher claim costs.”
The study looks at four back conditions (neurologic back pain; disc disorders; degenerative back conditions; and sprains, strains, and non-specific pain) and three shoulder injuries (rotator cuff disorders, frozen shoulders, and shoulder osteoarthritis).
Key questions the study explores include the following:
- - How prevalent are high-cost claims for these injuries, and how do they compare in terms of medical costs and duration of temporary disability
- - What characterizes high-cost claims versus other claims within each injury category?
- - What factors are associated with elevated medical payments?
- - How do degenerative conditions and comorbidities influence treatment choices and affect costs?
The analysis is based on about 194,000 workers’ compensation claims with more than seven days of lost time, from 32 states. These claims involve injuries that occurred between October 1, 2015, and March 31, 2019, with detailed treatment and billing data tracked for up to 36 months after the injury, through March 31, 2022.
The full report, Patterns and Trends of High-Cost Claims Involving Back and Shoulder Injuries, is authored by Dongchun Wang, Kathryn L. Mueller, and Randall D. Lea. It is available to WCRI members and can be purchased by nonmembers at www.wcrinet.org.
- Wildfire Survivors Vent Anger at Insurance Carriers For Claim Delayson August 26, 2025 at 3:32 PM
Assemblymember John Harabedian (D–Pasadena), in partnership with the Eaton Fire Survivors Network, held a press conference on Monday, August 25th, calling on the California Department of Insurance (CDI) to take immediate action to protect wildfire survivors and ensure insurance companies comply with state law.
“Our responsibility is clear: to protect survivors, give them the time and resources to rebuild their home and their lives, and ensure they can do so with security and peace of mind. That’s why I am leading this effort - calling on the California Department of Insurance to act swiftly and decisively, enforce the law, expedite claims, and provide every protection available - so families can recover with dignity and hope for the future,” said Assemblymember John Harabedian (D-Pasadena).
Assemblymember Harabedian underscored the urgency of reforms to:
- - Expedite the State Farm Market Conduct Exam
- - Guarantee smoke coverage under the FAIR Plan
- - Enforce California law to keep families housed
- - Require transparency in loss estimates
- - Make CDI’s complaint process transparent
The press conference also highlighted AB 238 (Mortgage Forbearance), legislation authored by Assemblymember Harabedian that allows disaster-impacted homeowners to pause mortgage payments for up to one year while they recover and rebuild.
“We paid our premiums faithfully for decades, trusting insurers to protect us. Now they’re using illegal delays and denials to profit from our pain. Families are maxing out credit cards, draining savings, and living in contaminated homes. We call on the California Department of Insurance to stand with survivors, not with the insurers breaking the law” said Joy Chen, Co-Founder and CEO, Eaton Fire Survivors Network.
“For months, I have been leading the call to launch an investigation into the hundreds of insurance complaints by Eaton Fire victims. These residents should not be pushed aside during their greatest time of need,” said Senator Sasha Renée Pérez. “Insurance companies should not be allowed to raise rates before we get answers into how they are treating their policyholders following this disaster. I will continue to fight alongside my constituents for the fair and timely resolution of their insurance claims.”
“The Eaton and Palisades fires have caused devastation in the lives of hundreds of California families. While we cannot undo what nature has done, we can attempt to ease the pain of those suffering from nature’s wrath,” said Assemblymember Jacqui Irwin. “AB 238 minimizes the financial impact through temporary mortgage relief and AB 493 assures victims that banks are required to pay interest on money deposited as a result of insurance payouts. In addition to these legislative efforts, we need the Department of Insurance to step up and enforce the law to protect victims from further harm caused by insurers. Those of us representing fire-impacted communities are committed and will continue to address these issues as they arise. Thank you, Assemblymember Harabedian, for being a voice for these victims when they need it most.”
“The Eaton Fire devastated residents in my district and exposed glaring issues in the insurance market,” said Supervisor Kathryn Barger. “Too many continue to face undue claims delays, underpayments, and denials that compound their hardship and loss. Continued vigilance in oversight and enforcement are vital, and new reforms are needed from our state regulators and legislature. I applaud Assemblymember Harabedian’s leadership and partnership to pass critical legislation on this important issue.”
“Behind every delayed insurance claim is a family forced to wait in limbo. Survivors of the Eaton Fire deserve to be treated as people, not numbers. We’re asking the Department of Insurance to stand with Altadena and NOT with insurers to deliver justice for those who’ve already lost so much” said Altadena Town Council Chair Victoria Knapp.
These reforms, together with AB 238, are intended to unlock billions in delayed insurance payouts and deliver immediate relief to wildfire survivors across California. Watch the full press conference here.
- Supreme Ct. Limits Employer Wage/Hour Good Faith Defense Ruleon August 25, 2025 at 12:37 PM
Laurance Iloff lived and worked in an unincorporated area of Humboldt County known as Bridgeville, on property owned by Bridgeville Properties, Inc. and managed by Cynthia LaPaille.
Iloff’s employers rented out the property, which includes small houses, cabins, and other structures. For several years, Iloff performed maintenance on Bridgeville’s structures, grounds, and water system, and LaPaille provided him instructions, directions, and approvals in relation to this work. Under an informal arrangement, Iloff’s employers allowed him to live rent-free in one of the houses but did not provide him any other benefits or compensation for his services.
After his employers terminated this arrangement, Iloff filed claims against them with the Labor Commissioner, initiating a process for adjudicating wage claims informally known as “the Berman process.” The employers argued that Iloff was an independent contractor, but the Labor Commissioner determined that he was an employee and as such, was entitled to unpaid wages, liquidated damages, penalties, and interest.
The employers appealed, seeking de novo review of the Labor Commissioner’s ruling in the superior court. In response, Iloff — now represented by an attorney from the Labor Commissioner’s office — filed a notice of claims. In this notice, Iloff reasserted the wage claims he had raised before the Labor Commissioner and added new claims, including a claim for penalties under the Paid Sick Leave law.
Following a bench trial, the superior court found that Iloff was an employee. Applying the framework set out in Dynamex Operations West, Inc. v. Superior Court (2018) 4 Cal.5th 903, the court reasoned that Iloff was properly classified as an employee, rather than an independent contractor, because he was not “free from [the employers’] control and direction” and he performed work that was within the “usual course” of their business. (Id. at p. 964.) The court ruled that Iloff was entitled to unpaid wages, penalties, and interest.
On the two issues addressed by the California Supreme Court in this case, the superior court ruled in favor of the employers. First, the court ruled that Iloff was not entitled to liquidated damages because his employers had acted in “good faith” in not paying him and had “reasonable grounds for believing” they were complying with the law governing minimum wages. (§ 1194.2, subd. (b).) The court based this ruling on its findings that the employers and Iloff intended and expected Iloff to perform his services in exchange for free rent and that neither he nor the employers understood or believed, at any time before his termination, that he would be paid wages or treated as an employee. Second, the court rejected Iloff’s claim for penalties under the Paid Sick Leave law, concluding that the statute did not authorize Iloff to seek those penalties in the context of the employers’ Berman appeal. (§§ 246, subd. (i), 248.5, subds. (a) & (b).)
Iloff appealed, and the Court of Appeal affirmed in part and reversed in part, affirming the trial court’s judgment in the employers’ favor on the liquidated damages and Paid Sick Leave law issues. (Seviour-Iloff v. LaPaille (2022) 80 Cal.App.5th 427, 447–451 (Seviour-Iloff).) The Supreme Court granted review to address these two issues.
This case addresses two issues concerning the rights of California workers whose employers fail to pay them the minimum wage or provide them paid sick leave benefits. The first issue relates to the good faith defense to the default rule that employees who prove minimum wage violations are entitled to liquidated damages. (Labor Code, § 1194.2.) The Supreme Court held that to establish the good faith defense, an employer must show that it made a reasonable attempt to determine the requirements of the law governing minimum wages; proof that the employer was ignorant of the law is insufficient.
The second issue relates to the process for raising claims under the Healthy Workplaces, Healthy Families Act of 2014 (§ 245 et seq.; the “Paid Sick Leave law”). Specifically, we must determine whether a court may consider a Paid Sick Leave law claim that an employee raises in the context of their employer’s appeal to the superior court of a Labor Commissioner ruling. (§ 98.2, subd. (a).) We hold that a court may do so.
The Court of Appeal reached the opposite conclusion on both issues, thus the Supreme Court reversed in the published case of Iloff v. LaPaille - S275848 (August 2025).
- Psychiatric Group Agrees To Pay $2.75M for Fraudulent Claimson August 25, 2025 at 12:37 PM
American Psychiatric Centers, Inc., doing business under the name Comprehensive Psychiatric Services (CPS), has agreed to pay $2.75 million to resolve allegations that CPS violated the False Claims Act by submitting false claims to government healthcare payors for certain psychotherapy services.
CPS, which is headquartered in Walnut Creek, Calif., provides behavioral medicine services for individuals and families in the State of California. Since at least 2015, CPS and its healthcare providers have submitted claims to government payors using Current Procedural Terminology codes 90833 and 90836, which are “add-on” codes to be used when psychotherapy services are performed in conjunction with an evaluation and management visit, and which require specific documentation.
The settlement announced today resolves the government’s allegations that, from Jan. 1, 2015, through Dec. 31, 2022, CPS submitted fraudulent claims using these add-on codes in instances where its healthcare providers either had not provided the services described by those codes or had failed to sufficiently document that such services had been provided. CPS will pay $2,615,569.32 to the United States and $134,430.68 to the State of California.
Assistant U.S. Attorney Kelsey Helland handled this matter for the government, with the assistance of Garland He. The investigation and settlement resulted from a coordinated effort by the U.S. Attorney’s Office for the Northern District of California, HHS-OIG, DCIS, VA OIG, OPM OIG, and the California Department of Justice, Division of Medi-Cal Fraud and Elder Abuse.
The investigation and resolution of this matter illustrates the government’s emphasis on combating healthcare fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement can be reported to HHS at 800-HHS-TIPS (800-447-8477).
The claims resolved by the settlement are allegations only; there has been no determination of liability.
- Judge Approves Biggest - $2.8 B - Healthcare Settlement In Historyon August 21, 2025 at 2:43 PM
The Blue Cross Blue Shield Association (BCBSA) and its 33 member companies reached a $2.8 billion settlement in October 2024 to resolve a 12-year antitrust lawsuit filed by healthcare providers, including hospitals, physicians, and other professionals. Preliminary approval was granted on December 4, 2024, by Judge R. David Proctor, with final approval on August 19, 2025. The lawsuit, In re: Blue Cross Blue Shield Antitrust Litigation (MDL No. 2406), began in 2012 in the U.S. District Court for the Northern District of Alabama.
Providers alleged that BCBSA and its affiliates violated the Sherman Antitrust Act by engaging in anticompetitive practices, specifically by dividing the U.S. into exclusive "service areas" and agreeing not to compete in those regions, which suppressed competition, increased insurance costs, and reduced provider reimbursements. They also claimed price-fixing through the BlueCard program, which processes claims for out-of-network patients. BCBSA denied the allegations but agreed to the settlement to avoid further litigation costs and risks.
The settlement, the largest antitrust agreement in U.S. healthcare history, includes a $2.8 billion fund and operational reforms to enhance transparency and efficiency in the BlueCard program, such as faster claims processing, a cloud-based platform, and prompt payment guarantees. Eligible providers who treated Blue Plan patients from July 24, 2008, to October 4, 2024, could file claims until July 29, 2025, though nearly 6,500 providers opted out to pursue separate lawsuits.
A court document indicated that nearly 6,500 provider organizations chose to opt out of the settlement. These providers include a range of healthcare entities such as hospital systems, physician groups, clinics, and other healthcare facilities across the United States. Notable organizations that opted out include the University of Pennsylvania Health System, Geisinger, MedStar, CommonSpirit, Bon Secours Mercy Health, Temple University Health, and physician staffing firm TeamHealth.
Providers who opted out likely did so to preserve their right to pursue individual lawsuits against BCBS, believing they could achieve greater financial recovery or address specific grievances through separate legal action. The settlement required providers to release claims against BCBS for the same antitrust issues (e.g., market allocation and price-fixing through exclusive service areas and the BlueCard program). Opting out allows these providers to file their own claims, potentially seeking higher damages than what they would receive from the settlement’s $2.8 billion fund, where 92% is allocated to healthcare facilities and only 8% ($160 million after fees) to professionals like individual practitioners.
Many of the providers who opted out filed new lawsuits in federal courts in states like Pennsylvania, California, and Illinois. For example, a group led by Temple Health and Penn State Health filed a lawsuit in the U.S. District Court for the Eastern District of Pennsylvania. These lawsuits echo the original allegations, claiming BCBS’s anticompetitive practices, such as colluding to limit competition and underpaying providers, violated antitrust laws. The plaintiffs argue that BCBS’s actions resulted in payments far lower than what they would have received in a competitive market. California providers who reportedly opted out include:
- - Providence St. Joseph Health: A large nonprofit health system with extensive operations in California (e.g., hospitals in Los Angeles, Orange County, and Northern California). They opted out to seek potentially larger recoveries, including treble damages under antitrust law.
- - The Regents of the University of California (UC Health): The governing body for the University of California's health system, which operates major academic medical centers and hospitals across the state (e.g., UCLA Health, UCSF Health). They cited concerns over the settlement's release of future claims and the potential for higher individual damages.
- - NorthBay Healthcare Corporation: A community-based health system headquartered in Fairfield, California, serving Solano County with hospitals and clinics. They opted out due to dissatisfaction with the settlement's monetary allocation (e.g., only 8% for professionals after fees) and to preserve litigation rights.
- - CommonSpirit Health: While headquartered in Chicago, this system has a major presence in California through its Dignity Health division (operating dozens of hospitals statewide, including in Sacramento, San Francisco, and Southern California). They opted out for similar reasons, focusing on allegations of BCBS's "take-it-or-leave-it" contracting and reimbursement penalties.
- Employer Healthcare Costs To Increase By 9% In 2026on August 21, 2025 at 2:43 PM
Business Group on Health is the leading non-profit organization representing employers’ perspectives on optimizing workforce strategy through innovative health, benefits and well-being solutions and on health policy issues. According to a new report it published this week, for the 2nd year in a row, health care costs sharply outpace projections, largely due to prescription drugs, chronic and complex conditions, persistent delivery system flaws.
Employers will need to act with greater urgency and willingness to be bold as they head into 2026 after a second year of actual health care costs sharply outpacing projections, according to Business Group on Health’s 2026 Employer Health Care Strategy Survey, released today in Washington, D.C.
Employers predict that health care cost trend increases for 2026 will come in at a median of 9%, offset to 7.6% with plan design changes. These somber forecasts come as more employees use GLP-1s for obesity, receive cancer diagnoses and use mental health services, the survey showed. On a compounded basis, costs in 2026 are likely to be 62% higher than 2017 levels.
“In this challenging environment, employers remain firmly committed to an ongoing investment in employee health and well-being,” said Ellen Kelsay, president and CEO of Business Group on Health. “Yet they will need to make bold and strategic moves to contain costs, sometimes disrupting health care models along the way.”
Kelsay added, “For instance, we will see them rigorously evaluating benefit offerings, vendor performance and patient outcomes. We will also see more employers exploring non-traditional health plan and pharmacy benefit manager (PBM) models. And as employers urge workforces to use health plan resources and navigation tools to find high-value care, we’ll see more people using primary care and getting recommended screenings and immunizations.”
Employer respondents said other interrelated priorities for the coming year were affordability for both their businesses and workforces; a greater reliance on utilization management and weight management programs in concert with GLP-1s to ensure optimal outcomes in obesity treatment; and assessment of mental health access and appropriateness of care.
The Business Group on Health survey gathered data on key topics related to employer-sponsored health care for the coming year. A total of 121 employers across varied industries, who together cover 11.6 million people, completed the survey between June and July 2025.
Expensive obesity medications play a significant role in overall health care cost increases, and they will continue to be a challenge. Fully 79% of employers have seen an uptick in the use of GLP-1s, while an additional 15% anticipate seeing such an increase in the future. In addition, the percent of employers covering GLP-1s for conditions other than diabetes will stagnate as employers try to stabilize their health care costs, while more of those that cover these medications for weight loss will require utilization management, prescriptions from specific providers, participation in a weight management program and higher expectations from vendor partners to deliver sustainable, cost-effective financial models for this class of medications.
A systemic overhaul of the pharmacy supply chain is essential to address pharmaceutical costs for both employers and employees. While most employers use plan design approaches and other strategies offered by their PBMs, pharmacy cost pressures also have resulted from rising prices, a robust pipeline of expensive therapies and cost-shifting from proposed changes to Medicare and Medicaid. In 2024, nearly a quarter of all employer health care spend (24%) went to pharmacy expenses. Further, employers see no relief on the horizon, with a forecast of an 11% to 12% increase in pharmacy costs heading into 2026. This cannot be remedied by plan design changes, and employers need to explore PBM models that champion transparency and rely less on rebates.
Cancer is the top condition driving employer health care costs for the fourth year in a row, made worse by a growing prevalence of cancer diagnoses and the escalating costs of treatment. Accordingly, employers will have a greater focus on cancer prevention and screening coverage, including alternatives to colonoscopies, expanding coverage of breast cancer screenings and removing age restrictions on preventive care coverage. Employers also recognize that access to high-value treatments is essential, with about half offering a cancer COE in 2026, and another 23% considering doing so by 2028.
Most employers have seen an increase in the use in mental health services, making it an emerging cost driver. As employers continue to seek ways to expand access to mental health services, they want to ensure that offerings are high-quality and appropriate. Fully 73% of employers reported an increase in mental health and substance use disorder services, while another 17% anticipate a future increase.
- Tesla HR Execs' Lawsuit Blames HR Manager for Retaliationon August 28, 2025 at 2:37 PM
Former Tesla HR execs Linda Peloquin, Adam Chow, Tiara Paulino, Sharnique Martin, Gregory Vass and Ozell Murray just filed a lawsuit against Tesla Inc., in the United States District Court for the Northern District of California Case 3:25-cv-06690-AMO. The lawsuit concerns the automaker’s Fremont, California, facility that has been at the center of several previous discrimination lawsuits.
These former Tesla HR professionals alleged that they were either fired or effectively forced to resign after attempting to surface other employees’ race discrimination and retaliation complaints at the company’s Fremont, California, plant.
According to the Peloquin complaint, one of Tesla’s HR managers, Nicole Burgers, was a “common denominator” in the various claims made by the plaintiffs. They alleged that the manager, the overall HR manager for the entire Fremont facility, “had an irrational fixation on fostering the delusion that the environment and culture at Tesla is one of tolerance and innovation, rather than racism and retaliation.”
Allegations continue to say that "Much of Tesla’s workplace toxicity stems from its rapid sales growth and manufacturing demand, and the breakneck pace at which it hired employees to work in its plants and overall operation. Since its introduction in 2020, Tesla’s “Model Y,” for instance, has become the Company’s top-selling vehicle line - and, by most estimates, one of the top-selling electric vehicles in the world. Thus, there was, and remains, constant pressure to keep the Model Y’s sales trajectory high."
"Yet, as a consequence of this desire to produce vehicles at such a rapid pace, the Company has failed to cultivate a healthy working environment at the Fremont facility, and instead fostered one that is beset with racism, sexism, cronyism, and outright physical violence."
Plaintiffs claim "even employees that had been terminated for instances of workplace violence were loopholed back in via temp agencies. That meant, then, that oftentimes the employee who had been previously victimized had to actually resume working with their attacker and tormentor."
"In fact, that Senior Security Manager himself was attacked and suffered a serious injury when he attempted to stop a loopholed employee - one who had been returned to work after being terminated for cause - after that employee came back aboard and attacked another worker."
At some point plaintiffs allege that Tesla "turned its ire on the HR professionals that had merely investigated and substantiated the bases of the complaints. So, oddly, in most instances it was the HR official that wound up being penalized and pushed out for substantiating the alleged wrongdoing rather than the wrongdoer themselves. Consequently, a dizzying number of HR professionals - the Plaintiffs here: Peloquin, Chow, Paulino, Martin, and Vass, among them - have either been outright fired for substantiating complaints of discrimination and retaliation, or resigned because they saw a termination coming and did not want that type of disciplinary stain on their job history.
Details of the complaint allege "A common denominator in many of these terminations is a HR Manager named Nicole Burgers. By all accounts, Burgers has had an irrational fixation on fostering the delusion that the environment and culture at Tesla is one of tolerance and innovation, rather than racism and retaliation. By all accounts, given that Burgers was the overall HR manager for the entire Fremont facility, she believed that she would be held accountable for further instances of racism and misconduct at the Fremont location - particularly in light of the pending State, Federal, and private litigation against the Company. Thus, rather than undertake to change the culture and environment that fostered those types of instances of racism, Burgers instead undertook to weed out the HR professionals beneath her that merely investigated and substantiated the occurrence of that type of depravity."
Page 24 of the 159 page complaint continues to provide details by writing "Karen Draper was one of the first dominos to fall in what became a long line of retaliatory terminations by Burgers and her Texas-based counterparts - Allie Arebalo, Bert Somsin, Jenifer Romero, and Leah Allen - or, instances where other HR professionals simply resigned under protest because they knew Burgers had begun to target them. - Fresno Superior Court Judge Charged With Multiple Felonieson August 28, 2025 at 2:36 PM
Adolfo M. Corona was a judge of the Superior Court of Fresno County in California. He assumed office in 2003. He left office on May 1, 2024. Corona was appointed by Gov. Gray Davis in 2003. His legal career included working as an attorney at Dowling Aaron & Keeler Inc. in Fresno from 1986 to 2003 and serving as a judge pro tem for the Fresno County Superior Court from 1992 to 2003. He was also a member of the Central Valley Chapter of La Raza Lawyers Association. At the time of his retirement, he was presiding over juvenile court cases.
State charges were first filed against Corona in September 2024 following a state grand jury indictment by the Fresno County District Attorney. Prosecutors charged him on one count of felony sexual penetration by force, fear, or duress and one count of misdemeanor sexual battery, stemming from an alleged assault on a court employee on March 14, 2024, at the Fresno County Superior Court. He pleaded not guilty, was released on $70,000 bail, and is represented by attorneys Michael Aed and Margarita Martinez-Baly.
The two renowned local defense attorneys have represented the likes of Assemblymember Joaquin Arambula. Aed reportedly would not answer questions about the timing of the judge’s resignation, weeks after the alleged incident. “He is entitled to counsel of his choice. This case came out of the blue without any pre-warning. He made certain decisions at the beginning of the case. He expects a vigorous and complete defense, and we intend to give him that,” Aed reportedly said.
Now in August 2025, the U.S. Justice Department announced that a federal grand jury in Fresno returned a five-count indictment charging 66 year old Corona with federal offenses for sexually assaulting a court employee (Victim 1), making false statements to cover up the assault, and with obstructing the investigation into allegations that he sexually assaulted another court employee (Victim 2) in his chambers.
Assistant Attorney General Harmeet K. Dhillon of the Justice Department’s Civil Rights Division, U.S. Attorney Eric Grant of the Eastern District of California, and Special Agent in Charge Siddhartha Patel of the FBI Sacramento Field Office made the announcement regarding the new federal case.
The indictment alleges that on March 14, 2024, Corona, while serving as a California Superior Court Judge, led Victim 1 into a courthouse stairwell where he sexually assaulted her. The indictment further alleges that Corona, during separate interviews with the FBI and court administrators, made false statements about the circumstances of his assault on Victim 1.
Additionally, the indictment alleges that Corona obstructed the investigation into allegations that he sexually assaulted Victim 2. Corona was alone with Victim 2 in his chambers for approximately two hours on Dec. 5, 2023, and she was later found alone in the judge’s chambers after being passed out. The indictment charges that Corona falsely told the FBI that he left Victim 2 alone in his chambers while he drove to pick up a motorcycle. Corona allegedly attempted to persuade a motorcycle dealership employee to change company records to falsely reflect that he had picked up his motorcycle in order to corroborate his alibi.
If convicted, Corona faces a maximum sentence of 40 years in prison on the sexual assault charge and 20 years on each of the obstruction charges. Any sentence, however, would be determined at the discretion of the court after consideration of any applicable statutory factors and the Federal Sentencing Guidelines, which take into account a number of variables. The charges are only allegations; the defendant is presumed innocent until and unless proven guilty beyond a reasonable doubt.
This case is the product of an investigation by the Federal Bureau of Investigation and the Fresno County Sheriff’s Office. Assistant U.S. Attorney Karen Escobar for the Eastern District of California and Special Litigation Counsel Michael J. Songer of the Civil Rights Division’s Criminal Section are prosecuting the case.
Anyone with information about this investigation is encouraged to contact their local FBI office, call 1-800-CALL-FBI (1-800-225-5324), or submit a tip to tips.fbi.gov. - Musk's X Reaches Tentative Settlement $500M Class Actionon August 27, 2025 at 4:25 PM
Elon Musk's social media company, X Corp, has reached a tentative settlement in a lawsuit filed by former employees who claimed they were owed $500 million in severance pay.
The lawsuit, filed as a proposed class action in the U.S. District Court for the Northern District of California (Case No. 23-03461, McMillian et al. v. Musk et al.), was initiated in July 2023 by former Twitter employees Courtney McMillian (former head of total rewards, overseeing employee benefits) and Ronald Cooper (former operations manager).
They alleged that Twitter's 2019 severance plan, established under the company's previous ownership, entitled laid-off employees to substantial payouts: two months of base pay plus one week for each year of service for most workers, and up to six months for senior employees like McMillian.
Following Elon Musk's $44 billion acquisition of Twitter in October 2022 and the subsequent rebranding to X, approximately 6,000 employees were terminated as part of cost-cutting measures. The plaintiffs claimed that X Corp. violated this plan by offering at most one month of severance pay, with many receiving nothing, resulting in an estimated $500 million in owed benefits.
On July 9, 2024, U.S. District Judge Trina L. Thompson dismissed the case without prejudice. The core of her ruling centered on the inapplicability of the federal Employee Retirement Income Security Act (ERISA), which governs employee benefit plans and provides federal jurisdiction for such disputes. Judge Thompson determined that Twitter's severance arrangement did not qualify as an ERISA-governed plan because it lacked an "ongoing administrative scheme.
However, Judge Thompson allowed the plaintiffs the opportunity to amend their complaint to pursue alternative claims not reliant on ERISA, such as potential state law breach-of-contract allegations.
The plaintiffs appealed the dismissal to the U.S. Court of Appeals for the Ninth Circuit (Case No. 24-5045, McMillian v. Musk) shortly after the district court's decision. In their appeal, the former employees argued that Twitter's severance policy did indeed qualify as an ERISA plan because it involved ongoing benefit payments, even if administered without individualized discretion. They received support from the U.S. Department of Labor, which filed an amicus brief endorsing this view, emphasizing that ERISA coverage applies to plans paying benefits on a continuing basis regardless of administrative complexity.
In response, Musk and X Corp. filed a brief on January 9, 2025, urging the Ninth Circuit to affirm the dismissal. Their key arguments included:
- - No formal ERISA plan existed, as the employees failed to produce official plan documents (e.g., summary plan descriptions) or evidence of widespread communications to workers about the severance terms prior to Musk's acquisition.
- - References to a "severance matrix" (a confidential document allegedly taken by McMillian) and general corporate statements at most indicated offers of simple lump-sum payments, which do not constitute an ERISA-governed scheme requiring ongoing administration.
- - This lack of a qualifying plan was "fatal" to the class action, as it undermined the basis for federal jurisdiction.
Oral arguments were scheduled for September 17, 2025, in San Francisco.
However, as of August 21, 2025, the parties reached a tentative settlement agreement, the financial terms of which were not disclosed. In a joint court filing, both sides requested a postponement of the hearing to finalize the deal, which would resolve the class action and compensate the affected former employees. The Ninth Circuit granted the delay on August 22, 2025, effectively pausing the appeal process. This settlement does not impact other ongoing related lawsuits, such as those in Delaware and California courts involving different claims or plaintiffs.
In summary, the appeal remains unresolved on the merits due to the impending settlement, marking a potential end to this specific dispute without a full appellate ruling on the ERISA question.
Other related lawsuits, including one by former executives like ex-CEO Parag Agrawal, remain pending. This settlement aims to resolve the dispute over severance pay for the affected former employees. - Group Studies Ethical & Social Risks of Exoskeleton Use for Safetyon August 27, 2025 at 4:25 PM
Construction continues to be one of the most dangerous industries, with workers constantly exposed to physically demanding and repetitive activities. Exoskeletons are emerging as ergonomic interventions that amplify human strength and agility while reducing muscle fatigue and discomfort. However, like any robotic technology, exoskeletons may have unintended consequences.
While studies have examined the health and safety risks of exoskeletons in construction, there is a significant gap in the literature regarding their ethical and social risks. Issues related to privacy concerns, exoskeletons’ design, and discrimination, among many others, are housed in the ethical risks, and social risks often include questions regarding exoskeletons’ affordability, accessibility and impact on social identity and communication, among others.
A new study just published by The Center for Construction Research and Training addresses that gap by investigating the ethical and social risks associated with exoskeleton use in construction, assessing their impact on workers' health and safety and exploring how they can be designed to minimize these risks. This study further developed a comprehensive and practical worker-centric guide aimed at advancing the safe and ethical implementation of exoskeletons in the construction industry.
This research leverages a systematic literature review, a Delphi technique (consisting of three rounds of surveys), and a focus group discussion to achieve the research objectives. The study developed a practical, worker-centric guide that examines exoskeleton preferences for construction trades, ethical and social risks of exoskeletons, the impacts of these risks on construction workers’ health and safety, the impact of these risks on the implementation of exoskeletons in the construction industry, and strategies to mitigate these identified ethical and social risks. The study further highlights barriers to implementing the identified strategies.
1. Ethical and Social Risks: A total of 34 ethical and social risks were identified from the literature review. Out of the 34, 18 were verified by experts in the construction industry and used in this study. These risks are categorized under design, autonomy, dehumanization, stigmatization, vulnerability, affordability, and accessibility.
2. Risk Criticality: Experts rated the identified risks on a Likert scale of 1 to 5 (with 1 being not critical, 2 less critical, 3 moderately critical, 4 very critical, and 5 extremely critical). Results show inaccessibility and unaffordability are examples of Very Critical risks, and stigmatization and loss of identity are examples of Less Critical risks.
3. Exoskeleton Suitability: Passive exoskeletons are suitable for repetitive overhead work and awkward postures, while active exoskeletons are better for heavy lifting. Back-support exoskeletons are most suitable for trades such as plumbers and carpenters, while full-body exoskeletons suit laborers.
4. Risk Impact on Workers’ Health and Safety: The findings revealed that ethical and social risks related to design, autonomy, privacy, unauthorized access, dependency, exoskeleton weight, and overdependence pose significant health and safety concerns to workers.
5. Mitigating Strategies: Seventy strategies to mitigate identified ethical and social risks were proposed and evaluated.
6. Barriers to proposed strategies: Fifteen barriers to effective risk mitigation were identified.
7. Worker-Centric Guide: A comprehensive guide was developed to facilitate the implementation of exoskeletons such that the ethical and social risks are minimized.
CPWR - The Center for Construction Research and Training is a nonprofit dedicated to reducing occupational injuries, illnesses and fatalities in the construction industry. A copy of the 74 page document can be downloaded without charge by using this link. - WCRI Studies Back and Shoulder Injuries With a $65K+ Price Tagon August 26, 2025 at 3:32 PM
A new study from the Workers Compensation Research Institute (WCRI) examines the key factors associated with high-cost workers’ compensation claims involving back and shoulder injuries, where medical expenses exceed $65,000 within 36 months of injury.
“In a previous WCRI study, we identified factors that increase the likelihood of high medical payments by looking at all injury types together,” said Sebastian Negrusa, WCRI’s vice president of research. “This new study refines that analysis by focusing on back and shoulder injuries to better understand what contributes to higher claim costs.”
The study looks at four back conditions (neurologic back pain; disc disorders; degenerative back conditions; and sprains, strains, and non-specific pain) and three shoulder injuries (rotator cuff disorders, frozen shoulders, and shoulder osteoarthritis).
Key questions the study explores include the following:
- - How prevalent are high-cost claims for these injuries, and how do they compare in terms of medical costs and duration of temporary disability
- - What characterizes high-cost claims versus other claims within each injury category?
- - What factors are associated with elevated medical payments?
- - How do degenerative conditions and comorbidities influence treatment choices and affect costs?
The analysis is based on about 194,000 workers’ compensation claims with more than seven days of lost time, from 32 states. These claims involve injuries that occurred between October 1, 2015, and March 31, 2019, with detailed treatment and billing data tracked for up to 36 months after the injury, through March 31, 2022.
The full report, Patterns and Trends of High-Cost Claims Involving Back and Shoulder Injuries, is authored by Dongchun Wang, Kathryn L. Mueller, and Randall D. Lea. It is available to WCRI members and can be purchased by nonmembers at www.wcrinet.org. - Wildfire Survivors Vent Anger at Insurance Carriers For Claim Delayson August 26, 2025 at 3:32 PM
Assemblymember John Harabedian (D–Pasadena), in partnership with the Eaton Fire Survivors Network, held a press conference on Monday, August 25th, calling on the California Department of Insurance (CDI) to take immediate action to protect wildfire survivors and ensure insurance companies comply with state law.
“Our responsibility is clear: to protect survivors, give them the time and resources to rebuild their home and their lives, and ensure they can do so with security and peace of mind. That’s why I am leading this effort - calling on the California Department of Insurance to act swiftly and decisively, enforce the law, expedite claims, and provide every protection available - so families can recover with dignity and hope for the future,” said Assemblymember John Harabedian (D-Pasadena).
Assemblymember Harabedian underscored the urgency of reforms to:
- - Expedite the State Farm Market Conduct Exam
- - Guarantee smoke coverage under the FAIR Plan
- - Enforce California law to keep families housed
- - Require transparency in loss estimates
- - Make CDI’s complaint process transparent
The press conference also highlighted AB 238 (Mortgage Forbearance), legislation authored by Assemblymember Harabedian that allows disaster-impacted homeowners to pause mortgage payments for up to one year while they recover and rebuild.
“We paid our premiums faithfully for decades, trusting insurers to protect us. Now they’re using illegal delays and denials to profit from our pain. Families are maxing out credit cards, draining savings, and living in contaminated homes. We call on the California Department of Insurance to stand with survivors, not with the insurers breaking the law” said Joy Chen, Co-Founder and CEO, Eaton Fire Survivors Network.
“For months, I have been leading the call to launch an investigation into the hundreds of insurance complaints by Eaton Fire victims. These residents should not be pushed aside during their greatest time of need,” said Senator Sasha Renée Pérez. “Insurance companies should not be allowed to raise rates before we get answers into how they are treating their policyholders following this disaster. I will continue to fight alongside my constituents for the fair and timely resolution of their insurance claims.”
“The Eaton and Palisades fires have caused devastation in the lives of hundreds of California families. While we cannot undo what nature has done, we can attempt to ease the pain of those suffering from nature’s wrath,” said Assemblymember Jacqui Irwin. “AB 238 minimizes the financial impact through temporary mortgage relief and AB 493 assures victims that banks are required to pay interest on money deposited as a result of insurance payouts. In addition to these legislative efforts, we need the Department of Insurance to step up and enforce the law to protect victims from further harm caused by insurers. Those of us representing fire-impacted communities are committed and will continue to address these issues as they arise. Thank you, Assemblymember Harabedian, for being a voice for these victims when they need it most.”
“The Eaton Fire devastated residents in my district and exposed glaring issues in the insurance market,” said Supervisor Kathryn Barger. “Too many continue to face undue claims delays, underpayments, and denials that compound their hardship and loss. Continued vigilance in oversight and enforcement are vital, and new reforms are needed from our state regulators and legislature. I applaud Assemblymember Harabedian’s leadership and partnership to pass critical legislation on this important issue.”
“Behind every delayed insurance claim is a family forced to wait in limbo. Survivors of the Eaton Fire deserve to be treated as people, not numbers. We’re asking the Department of Insurance to stand with Altadena and NOT with insurers to deliver justice for those who’ve already lost so much” said Altadena Town Council Chair Victoria Knapp.
These reforms, together with AB 238, are intended to unlock billions in delayed insurance payouts and deliver immediate relief to wildfire survivors across California. Watch the full press conference here. - Supreme Ct. Limits Employer Wage/Hour Good Faith Defense Ruleon August 25, 2025 at 12:37 PM
Laurance Iloff lived and worked in an unincorporated area of Humboldt County known as Bridgeville, on property owned by Bridgeville Properties, Inc. and managed by Cynthia LaPaille.
Iloff’s employers rented out the property, which includes small houses, cabins, and other structures. For several years, Iloff performed maintenance on Bridgeville’s structures, grounds, and water system, and LaPaille provided him instructions, directions, and approvals in relation to this work. Under an informal arrangement, Iloff’s employers allowed him to live rent-free in one of the houses but did not provide him any other benefits or compensation for his services.
After his employers terminated this arrangement, Iloff filed claims against them with the Labor Commissioner, initiating a process for adjudicating wage claims informally known as “the Berman process.” The employers argued that Iloff was an independent contractor, but the Labor Commissioner determined that he was an employee and as such, was entitled to unpaid wages, liquidated damages, penalties, and interest.
The employers appealed, seeking de novo review of the Labor Commissioner’s ruling in the superior court. In response, Iloff — now represented by an attorney from the Labor Commissioner’s office — filed a notice of claims. In this notice, Iloff reasserted the wage claims he had raised before the Labor Commissioner and added new claims, including a claim for penalties under the Paid Sick Leave law.
Following a bench trial, the superior court found that Iloff was an employee. Applying the framework set out in Dynamex Operations West, Inc. v. Superior Court (2018) 4 Cal.5th 903, the court reasoned that Iloff was properly classified as an employee, rather than an independent contractor, because he was not “free from [the employers’] control and direction” and he performed work that was within the “usual course” of their business. (Id. at p. 964.) The court ruled that Iloff was entitled to unpaid wages, penalties, and interest.
On the two issues addressed by the California Supreme Court in this case, the superior court ruled in favor of the employers. First, the court ruled that Iloff was not entitled to liquidated damages because his employers had acted in “good faith” in not paying him and had “reasonable grounds for believing” they were complying with the law governing minimum wages. (§ 1194.2, subd. (b).) The court based this ruling on its findings that the employers and Iloff intended and expected Iloff to perform his services in exchange for free rent and that neither he nor the employers understood or believed, at any time before his termination, that he would be paid wages or treated as an employee. Second, the court rejected Iloff’s claim for penalties under the Paid Sick Leave law, concluding that the statute did not authorize Iloff to seek those penalties in the context of the employers’ Berman appeal. (§§ 246, subd. (i), 248.5, subds. (a) & (b).)
Iloff appealed, and the Court of Appeal affirmed in part and reversed in part, affirming the trial court’s judgment in the employers’ favor on the liquidated damages and Paid Sick Leave law issues. (Seviour-Iloff v. LaPaille (2022) 80 Cal.App.5th 427, 447–451 (Seviour-Iloff).) The Supreme Court granted review to address these two issues.
This case addresses two issues concerning the rights of California workers whose employers fail to pay them the minimum wage or provide them paid sick leave benefits. The first issue relates to the good faith defense to the default rule that employees who prove minimum wage violations are entitled to liquidated damages. (Labor Code, § 1194.2.) The Supreme Court held that to establish the good faith defense, an employer must show that it made a reasonable attempt to determine the requirements of the law governing minimum wages; proof that the employer was ignorant of the law is insufficient.
The second issue relates to the process for raising claims under the Healthy Workplaces, Healthy Families Act of 2014 (§ 245 et seq.; the “Paid Sick Leave law”). Specifically, we must determine whether a court may consider a Paid Sick Leave law claim that an employee raises in the context of their employer’s appeal to the superior court of a Labor Commissioner ruling. (§ 98.2, subd. (a).) We hold that a court may do so.
The Court of Appeal reached the opposite conclusion on both issues, thus the Supreme Court reversed in the published case of Iloff v. LaPaille - S275848 (August 2025). - Psychiatric Group Agrees To Pay $2.75M for Fraudulent Claimson August 25, 2025 at 12:37 PM
American Psychiatric Centers, Inc., doing business under the name Comprehensive Psychiatric Services (CPS), has agreed to pay $2.75 million to resolve allegations that CPS violated the False Claims Act by submitting false claims to government healthcare payors for certain psychotherapy services.
CPS, which is headquartered in Walnut Creek, Calif., provides behavioral medicine services for individuals and families in the State of California. Since at least 2015, CPS and its healthcare providers have submitted claims to government payors using Current Procedural Terminology codes 90833 and 90836, which are “add-on” codes to be used when psychotherapy services are performed in conjunction with an evaluation and management visit, and which require specific documentation.
The settlement announced today resolves the government’s allegations that, from Jan. 1, 2015, through Dec. 31, 2022, CPS submitted fraudulent claims using these add-on codes in instances where its healthcare providers either had not provided the services described by those codes or had failed to sufficiently document that such services had been provided. CPS will pay $2,615,569.32 to the United States and $134,430.68 to the State of California.
Assistant U.S. Attorney Kelsey Helland handled this matter for the government, with the assistance of Garland He. The investigation and settlement resulted from a coordinated effort by the U.S. Attorney’s Office for the Northern District of California, HHS-OIG, DCIS, VA OIG, OPM OIG, and the California Department of Justice, Division of Medi-Cal Fraud and Elder Abuse.
The investigation and resolution of this matter illustrates the government’s emphasis on combating healthcare fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement can be reported to HHS at 800-HHS-TIPS (800-447-8477).
The claims resolved by the settlement are allegations only; there has been no determination of liability. - Judge Approves Biggest - $2.8 B - Healthcare Settlement In Historyon August 21, 2025 at 2:43 PM
The Blue Cross Blue Shield Association (BCBSA) and its 33 member companies reached a $2.8 billion settlement in October 2024 to resolve a 12-year antitrust lawsuit filed by healthcare providers, including hospitals, physicians, and other professionals. Preliminary approval was granted on December 4, 2024, by Judge R. David Proctor, with final approval on August 19, 2025. The lawsuit, In re: Blue Cross Blue Shield Antitrust Litigation (MDL No. 2406), began in 2012 in the U.S. District Court for the Northern District of Alabama.
Providers alleged that BCBSA and its affiliates violated the Sherman Antitrust Act by engaging in anticompetitive practices, specifically by dividing the U.S. into exclusive "service areas" and agreeing not to compete in those regions, which suppressed competition, increased insurance costs, and reduced provider reimbursements. They also claimed price-fixing through the BlueCard program, which processes claims for out-of-network patients. BCBSA denied the allegations but agreed to the settlement to avoid further litigation costs and risks.
The settlement, the largest antitrust agreement in U.S. healthcare history, includes a $2.8 billion fund and operational reforms to enhance transparency and efficiency in the BlueCard program, such as faster claims processing, a cloud-based platform, and prompt payment guarantees. Eligible providers who treated Blue Plan patients from July 24, 2008, to October 4, 2024, could file claims until July 29, 2025, though nearly 6,500 providers opted out to pursue separate lawsuits.
A court document indicated that nearly 6,500 provider organizations chose to opt out of the settlement. These providers include a range of healthcare entities such as hospital systems, physician groups, clinics, and other healthcare facilities across the United States. Notable organizations that opted out include the University of Pennsylvania Health System, Geisinger, MedStar, CommonSpirit, Bon Secours Mercy Health, Temple University Health, and physician staffing firm TeamHealth.
Providers who opted out likely did so to preserve their right to pursue individual lawsuits against BCBS, believing they could achieve greater financial recovery or address specific grievances through separate legal action. The settlement required providers to release claims against BCBS for the same antitrust issues (e.g., market allocation and price-fixing through exclusive service areas and the BlueCard program). Opting out allows these providers to file their own claims, potentially seeking higher damages than what they would receive from the settlement’s $2.8 billion fund, where 92% is allocated to healthcare facilities and only 8% ($160 million after fees) to professionals like individual practitioners.
Many of the providers who opted out filed new lawsuits in federal courts in states like Pennsylvania, California, and Illinois. For example, a group led by Temple Health and Penn State Health filed a lawsuit in the U.S. District Court for the Eastern District of Pennsylvania. These lawsuits echo the original allegations, claiming BCBS’s anticompetitive practices, such as colluding to limit competition and underpaying providers, violated antitrust laws. The plaintiffs argue that BCBS’s actions resulted in payments far lower than what they would have received in a competitive market. California providers who reportedly opted out include:
- - Providence St. Joseph Health: A large nonprofit health system with extensive operations in California (e.g., hospitals in Los Angeles, Orange County, and Northern California). They opted out to seek potentially larger recoveries, including treble damages under antitrust law.
- - The Regents of the University of California (UC Health): The governing body for the University of California's health system, which operates major academic medical centers and hospitals across the state (e.g., UCLA Health, UCSF Health). They cited concerns over the settlement's release of future claims and the potential for higher individual damages.
- - NorthBay Healthcare Corporation: A community-based health system headquartered in Fairfield, California, serving Solano County with hospitals and clinics. They opted out due to dissatisfaction with the settlement's monetary allocation (e.g., only 8% for professionals after fees) and to preserve litigation rights.
- - CommonSpirit Health: While headquartered in Chicago, this system has a major presence in California through its Dignity Health division (operating dozens of hospitals statewide, including in Sacramento, San Francisco, and Southern California). They opted out for similar reasons, focusing on allegations of BCBS's "take-it-or-leave-it" contracting and reimbursement penalties. - Employer Healthcare Costs To Increase By 9% In 2026on August 21, 2025 at 2:43 PM
Business Group on Health is the leading non-profit organization representing employers’ perspectives on optimizing workforce strategy through innovative health, benefits and well-being solutions and on health policy issues. According to a new report it published this week, for the 2nd year in a row, health care costs sharply outpace projections, largely due to prescription drugs, chronic and complex conditions, persistent delivery system flaws.
Employers will need to act with greater urgency and willingness to be bold as they head into 2026 after a second year of actual health care costs sharply outpacing projections, according to Business Group on Health’s 2026 Employer Health Care Strategy Survey, released today in Washington, D.C.
Employers predict that health care cost trend increases for 2026 will come in at a median of 9%, offset to 7.6% with plan design changes. These somber forecasts come as more employees use GLP-1s for obesity, receive cancer diagnoses and use mental health services, the survey showed. On a compounded basis, costs in 2026 are likely to be 62% higher than 2017 levels.
“In this challenging environment, employers remain firmly committed to an ongoing investment in employee health and well-being,” said Ellen Kelsay, president and CEO of Business Group on Health. “Yet they will need to make bold and strategic moves to contain costs, sometimes disrupting health care models along the way.”
Kelsay added, “For instance, we will see them rigorously evaluating benefit offerings, vendor performance and patient outcomes. We will also see more employers exploring non-traditional health plan and pharmacy benefit manager (PBM) models. And as employers urge workforces to use health plan resources and navigation tools to find high-value care, we’ll see more people using primary care and getting recommended screenings and immunizations.”
Employer respondents said other interrelated priorities for the coming year were affordability for both their businesses and workforces; a greater reliance on utilization management and weight management programs in concert with GLP-1s to ensure optimal outcomes in obesity treatment; and assessment of mental health access and appropriateness of care.
The Business Group on Health survey gathered data on key topics related to employer-sponsored health care for the coming year. A total of 121 employers across varied industries, who together cover 11.6 million people, completed the survey between June and July 2025.
Expensive obesity medications play a significant role in overall health care cost increases, and they will continue to be a challenge. Fully 79% of employers have seen an uptick in the use of GLP-1s, while an additional 15% anticipate seeing such an increase in the future. In addition, the percent of employers covering GLP-1s for conditions other than diabetes will stagnate as employers try to stabilize their health care costs, while more of those that cover these medications for weight loss will require utilization management, prescriptions from specific providers, participation in a weight management program and higher expectations from vendor partners to deliver sustainable, cost-effective financial models for this class of medications.
A systemic overhaul of the pharmacy supply chain is essential to address pharmaceutical costs for both employers and employees. While most employers use plan design approaches and other strategies offered by their PBMs, pharmacy cost pressures also have resulted from rising prices, a robust pipeline of expensive therapies and cost-shifting from proposed changes to Medicare and Medicaid. In 2024, nearly a quarter of all employer health care spend (24%) went to pharmacy expenses. Further, employers see no relief on the horizon, with a forecast of an 11% to 12% increase in pharmacy costs heading into 2026. This cannot be remedied by plan design changes, and employers need to explore PBM models that champion transparency and rely less on rebates.
Cancer is the top condition driving employer health care costs for the fourth year in a row, made worse by a growing prevalence of cancer diagnoses and the escalating costs of treatment. Accordingly, employers will have a greater focus on cancer prevention and screening coverage, including alternatives to colonoscopies, expanding coverage of breast cancer screenings and removing age restrictions on preventive care coverage. Employers also recognize that access to high-value treatments is essential, with about half offering a cancer COE in 2026, and another 23% considering doing so by 2028.
Most employers have seen an increase in the use in mental health services, making it an emerging cost driver. As employers continue to seek ways to expand access to mental health services, they want to ensure that offerings are high-quality and appropriate. Fully 73% of employers reported an increase in mental health and substance use disorder services, while another 17% anticipate a future increase.