Some insurance carriers delay or deny a patient’s medically necessary care, despite recommendations by doctors or other health professionals, in order to reduce costs and increase profits.

A delay or denial can happen to anyone with a health care plan. However, firefighters are particularly vulnerable because, as government employees, their plans are not protected by the Employee Retirement Income Security Act of 1974 (ERISA) in the United States.

Protections For Firefighters

Without the protections of ERISA, insurance carriers can more easily get away with delaying or denying claims without significant pushback – which can ultimately harm the patient and lead to exacerbated injuries. However, some states, such as Florida, have protections in place so that firefighters and other similarly situated workers can seek legal recourse.

We discussed the issue with Leslie M. Kroeger, a partner at the law firm Cohen Milstein Sellers and Toll. She serves as co-chair of Cohen Milstein’s Complex Tort Litigation practice. Kroeger has also led several managed care abuse cases, spoken at conferences on this topic, and currently serves as President of the Florida Justice Association.

TheBigRedGuide.com: What is “managed care abuse” and why is it an important topic?

Kroeger: Managed care abuse occurs when your medical insurance provider or HMO breaches its fiduciary duty or contractual responsibilities to you by denying you access to medically necessary care or medication in violation of its healthcare policies and the law. It is often the result of the company prioritizing cost-cutting and profit-making over patient care. This obviously puts the health of the patient at risk. Cohen Milstein has extensive experience litigating managed care abuse claims against insurance companies and HMOs.

Read Why Firefighters Are at Risk of Managed Care Abuse

The proposal allows hearing officers to impose additional supervision requirements for brokers involved in disciplinary matters

A Finra proposal to increase supervision of brokers going through disciplinary proceedings is a step in the right direction to address problems related to rogue brokers, investor lawyers and advocates say.

The Financial Industry Regulatory Authority Inc. filed on April 3 with the Securities and Exchange Commission a rule proposal that would allow hearing officers to impose on firms stronger supervision requirements for brokers who are appealing a disciplinary matter to the National Adjudicatory Council.

In addition, the proposal would impose strengthened supervision of brokers who are appealing statutory disqualification and would require a BrokerCheck disclosure of firms designated as a “taping firm” that must tape the conversations of its registered representatives because of previous disciplinary problems.

The final prong of the rule would require firms to seek approval when wants to hire someone who has one or more “final criminal matters” or two or more other specified disciplinary events in the last five years. That also extends to promotions of existing employees into leadership roles.

In the proposal, Finra said it is trying to target brokers who have checkered disciplinary pasts earlier than it can through examinations or enforcement actions.

“FINRA is taking steps to strengthen its tools to respond to brokers with a significant history of misconduct and the firms that employ them,” the proposal states.

. . .

Finra has been under pressure for years to crack down on recidivist brokers, sometimes known as rogue brokers, who have long disciplinary records.

The proposal it sent last week to the SEC was first floated in 2018. It is one of several steps it’s taken over the last few years to address the problem.

Another proposal Finra is poised to file with the SEC would impose increased capital requirements on firms that hire a high percentage of brokers with long disciplinary histories.

Ultimately, investors must be able to easily understand that a firm and brokers are being targeted as repeat offenders. Experts aren’t sure the Finra proposal would produce such illumination.

“It’s not clear it would be meaningful to investors doing their homework and trying to understand what’s going on,” said Laura Posner, a partner at Cohen Milstein. “In an ideal world, there would be something in BrokerCheck that would allow an investor to understand that some form of disciplinary proceeding is underway and that the broker is subject to higher supervision by the firm.”

The SEC must approve Finra rules. The agency could put the Finra proposal out for public comment.

Company now says it’s too expensive to remove PFAS compounds, including GenX, to comply with consent order.

The North Carolina Department of Environmental Quality has rejected a groundwater cleanup plan proposed by Chemours, which would have left at least 70 square miles contaminated with the chemical GenX.

“The proposed plan is clearly deficient,” said DEQ Secretary Michael Regan in a statement released yesterday. “Chemours will not receive approval from this department until they address appropriate cleanup measures for the communities impacted by the contamination and meet the terms of the Consent Order.”

DEQ received over 1,240 public comments on the plan, most of which denounced Chemours’ plan as insufficient to meet the needs of the community and the demands of the law.

Chemours spokeswoman Lisa Randall told Policy Watch the company “feels strongly the Corrective Action Plan is robust and in full compliance with the environmental laws of North Carolina and the approved 2019 Consent Order. We are surprised and disappointed by the NCDEQ’s public statement given they have not yet provided Chemours with comment on the plan. We look forward to learning the details behind their comments.”

In a February 2019 consent order with DEQ and Cape Fear River Watch, Chemours agreed to several cleanup provisions, including removing GenX contamination to meet state groundwater standards — the lowest concentration level laboratories can measure, or as close to that “as is economically and technologically feasible.

While Chemours touts the test results of its new air emission reduction equipment at its Fayetteville facility, the company is being called out for not doing enough to cut back on the amount of chemicals it releases into the Cape Fear River.

Chemours announced in late March that per- and polyfluoroalkyl substances, or PFAS, at the Fayetteville Works plant are being controlled at an efficiency of more than 99%.

Results of the tests run on the plant’s thermal oxidizer, which was installed last year, were turned over to the North Carolina Division of Air Quality officials on March 30.

“We are currently reviewing the report to verify the data,” Zaynab Nasif, the division’s public information officer, said in an email. “It generally takes some time to verify the data, likely a few weeks.”

DAQ staff were on site to observe the testing process of the plant’s thermal oxidizer, she said.

A thermal oxidizer heats volatile organic compounds to the point those compounds are broken down and destroyed before entering the atmosphere.

Chemours Fayetteville Works’ thermal oxidizer in January and February “demonstrated a 99.99%” PFAS destruction efficiency, according to a company press release dated March 30.

When Jamye Coffman, medical director of the Texas Cook Children’s Center for Prevention and Child Abuse and Neglect, found out that two children, both under the age of four, died in the hospital she worked at because of abuse-related injuries, she decided to sound the alarm.

Those two children were part of a group of seven children under age four who had all been admitted to the hospital for abuse over the course of one week. Normally, Cook Children’s Medical Center sees an average of six children a year die due to abuse, but on one day that week, two pre-schoolers died.

…

“We know from previous research that abuse and domestic violence are often fueled by economic stress and unemployment, and with the pandemic, that is obviously at a historic high,” Takisha Richardson, a lawyer who works on child abuse cases, told Insider.

…

In summer months, there tends to be a significant decrease in reported child abuse cases because kids aren’t in school, according to Richardson.  That’s because teachers are the biggest reporters of child abuse. “If the child has to leave the home and be seen by teachers or peers or counselors, the abuser is less likely to inflict abuse on them that’s going to leave lasting scars and things that people can see,” said Richardson.

…

“It’s probably going to be quite some time before we can actually even quantify how much abuse actually took place during this pandemic,” said Richardson. That’s both because states only submit Child Protective Services (CPS) data to the government twice a year, but also because the number of official child abuse reports have dipped significantly during the pandemic.

…

During the 2008 recession, there was a rise in infant deaths from abusive head trauma. During the West Africa Ebola outbreak in 2014, schools were closed for months, leading to surges in abuse, neglect, and child labor.

Richardson, who is based in Florida, knows that when there are hurricanes, incidences of abuse go up. “People are basically on lockdown in their homes with their abusers during hurricanes,” said Richardson. “But hurricanes don’t last as long as what we’re experiencing here. I think there’s going to be a much broader scale of abuse once this all subsides.”

Their marriage wasn’t perfect before the couple started working from home amid the shutdown during the coronavirus pandemic, but the underlying problems bubbled dangerously close to the surface with their forced isolation and constant contact, the wife told CBS News.

Like millions of other Americans, the couple has been forced into this situation because of the pandemic sweeping the country. Non-essential workers are working from home, or have been furloughed or laid off, and the ripple effects can be seen in millions of unemployment claims filed over the past month.

The couple has been married for a few years, and spending so much time together with their active toddler these past few weeks has put them both on edge, she said. The wife was previously in an abusive relationship, and she said she now recognizes the red flags that have recently emerged in her marriage. She requested anonymity due to concerns about her personal safety.

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Takisha Richardson, an attorney at the firm Cohen Milstein Sellers & Toll in Florida who represents domestic violence victims, noted that children are often able to escape domestic violence by going to school, and raise awareness about their home situation to trusted adults. The same is true of adult victims who may find relief and support at work.

“Most of those calls or cries for help don’t come when the survivor is at home,” Richardson said.

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Richardson also advocated for a policy of “see something, say something.”

“When you suspect something is happening, you might be the difference between saving someone’s life and them ending up dead,” Richardson said. She noted that stay-at-home orders don’t prevent people from making runs to the grocery store, and suggested that victims try to visit shelters or make calls to hotlines while conducting necessary errands if they are able.

“Chemours will not receive approval from this department until they address appropriate cleanup measures for the communities impacted by the contamination and meet the terms of the consent order,” the state Department of Environmental Quality said in a news release.

Due to inadequacies in the plan, the N.C. Department of Environmental Quality is requiring Chemours to make extensive revisions to its corrective action proposal, the state agency said in a news release.

Chemours submitted the plan, which is intended to alleviate the GenX “forever chemical” contamination of river water and groundwater south of Fayetteville, on Dec. 31.

Chemours has a chemical plant in Bladen County by the Cape Fear River near the Cumberland County line. In summer 2017, it was made public that perfluoroalkyl and polyfluoroalkyl substances, specifically a chemical called GenX, had gotten into the Cape Fear from the Chemours plant.

Later, the chemical was found in drinking water wells near the plant.

A long-running lawsuit that accuses Gold Standard Baking Inc and Illinois-based temporary staffing agency MVP of favoring Hispanic workers over African Americans can proceed as a class action with potentially more than 1,000 members, U.S. District Judge Sara Ellis ruled late Tuesday in Chicago.

Beyond its effect on this litigation, filed in 2013, the ruling “is the first time this kind of claim against a staffing agency has been certified as a class action,” class counsel Joseph Sellers of Cohen Milstein Sellers & Toll said in an emailed statement Wednesday.

The entire article can be accessed here.

Black workers who allege racial bias caused MVP Staffing and client Gold Standard Baking Inc. to largely exclude them from temporary assignments at the bakery’s Chicago-based production facility can pursue the case as a class action, the Northern District of Illinois ruled.

The Cicero, Ill., office of Personnel Staffing Group LLC, which does business as MVP, acted on Gold Standard’s discriminatory preference when it referred disproportionately few black applicants to temporary assignments at the facility, lead plaintiffs James Zollicoffer and Norman Green allege in the 2013 suit. Gold Standard preferred Hispanics, they say.

The ruling appears to be the first time a court has certified class claims alleging systematic racial discrimination against a staffing agency, according to Joseph Sellers of Cohen Milstein Sellers & Toll, who represents the plaintiffs.

Winning approval for a bias class action against a staffing agency requires meeting the same legal threshold that would apply against traditional employers, Sellers said. But there are factual circumstances about those agencies, including how they choose and assign mostly low-wage workers to temporary assignments, that separates them from other employers, Sellers said.

The case against MVP and Gold Standard could be the first in a wave of certified class actions alleging discrimination in the staffing industry, Sellers said. Roughly six other lawsuits against staffing agencies have been filed by plaintiffs’ firms including Cohen Milstein, while several dozen other potential cases are being investigated, he said.

. . .

Statistical and anecdotal evidence backs the workers’ bias claim and established the “uniform employment practice” needed to proceed as a class, the U.S. District Court for the Northern District of Illinois said Tuesday. Whether the class period covers two or four years depends on the applicable statute of limitations, and the court ordered additional briefing on the issue.

The statistics were compiled by the class’s expert, labor economist Marc Bendick, who found that non-Hispanic African-American applicants were referred to Gold Standard at a rate far below the expected referral rate between 2009 and 2013, and then at a rate that exceeded it in 2014 and 2015, after the lawsuit was filed, the court said.

. . .

Cohen Milstein Sellers & Toll PLLC represents the class. Korey Richardson LLC and Paul Hastings LLP represent MVP. Hannafan & Hannafan Ltd. and Laner Muchin Ltd. represent Gold Standard Baking.

Marriott International Inc. said Tuesday that roughly 5.2 million guests’ loyalty information and other personal details had been exposed in a data breach earlier this year, a disclosure that class counsel pressing multidistrict litigation over a separate major hack of the hotel giant said highlights the company’s ongoing data security failings.

In a notice posted to its website, Marriott said that it discovered at the end of February that “an unexpected amount of guest information” may have been accessed using the login credentials of two employees at a franchise property. The hotel chain said the intrusion likely dated back to mid-January, when a hacker is believed to have used the stolen credentials to access an application that hotels operated and franchised under Marriott’s brands use to help provide services to their guests.

. . .

Tuesday’s disclosure comes less than 18 months after Marriott in November 2018 revealed a separate data breach impacting up to 383 million guests at its newly acquired Starwood properties. That incident exposed a wide range of personal data, including nearly 24 million passport numbers and more than 9 million credit and debit cards.

The plaintiffs’ attorneys spearheading the sprawling MDL that was assembled in the wake of the 2018 breach told Law360 on Tuesday that they “believe that this is all related to the ongoing multidistrict litigation, in which we allege that Starwood — now Marriott — had and continues to have inadequate security measures in place to protect consumer information.”

“Although we had hoped that the company would take cybersecurity more seriously after its last major breach, we certainly will continue to push for cybersecurity reforms through injunctive relief as well as restitution for consumers who were and continue to be impacted,” co-lead counsel for the consolidated consumer class — Amy Keller of DiCello Levitt Gutzler LLC, Andrew Friedman of Cohen Milstein Sellers & Toll PLLC and James Pizzirusso of Hausfeld LLP — said in an emailed statement.

Marriott lost its bid to toss the MDL in February, when a Maryland federal judge ruled that the guests pressing the suit had adequately claimed injuries traceable to the company’s failure to detect the historic hack or stop the theft of their personal information.