Health Care & Reproductive Rights

Thirteen attorneys general, all but one are Republican, are rushing to kill the federal healthcare bill by filing lawsuits alleging that the bill violates states' rights. Here in California, a handful of Republican leaders have followed suit and are asking that I join in. Accordingly, I've instructed deputies in my office to carefully review these claims in light of applicable constitutional principles. Health care is not the place, with people's lives at stake, to engage in poisonous partisanship. At this critical time in our nation's history, we need to come together to forge a common purpose.

Los Angeles—Attorney General Edmund G. Brown Jr. today announced that his office has filed documents with the Los Angeles Superior Court on behalf of the California Medical Board to ask the court to restrict the medical license of Michael Jackson’s former doctor, Conrad Murray, preventing him from practicing medicine in California until the criminal proceedings against him are completed.

“Murray administered a lethal dose of propofol, as well as other drugs to Michael Jackson,” alleged Brown in his filing. “We will argue in court that Murray was reckless in giving Jackson such a dangerous drug and has demonstrated a serious lack of judgment that should prohibit him from practicing medicine.”

The Los Angeles County District Attorney’s Office filed a criminal complaint last month alleging that Dr. Murray committed involuntary manslaughter last year when he gave Michael Jackson the lethal dose of propofol. Jackson was under Dr. Murray’s care at the time of his death.

Brown’s office is representing the California Medical Board, the agency charged with protecting the public from dangerous, incompetent or impaired physicians and surgeons.

Copies of the court filings are attached.

Los Angeles—Attorney General Edmund G. Brown Jr. today announced the arrests of six former employees of New Beginnings Recovery Treatment Center Inc., a Los Angeles-based drug and alcohol rehabilitation center, who “stole tens of thousands of dollars” from Medi-Cal by billing the state for drug treatment sessions that were never performed.

The six individuals were arrested today on charges of felony grand theft and filing false Medi-Cal claims. The maximum sentence for conviction on both felonies is three years in state prison. Bail has been set at $68,000 for Tatyana Yakovenko and at $40,000 for the other five defendants.

“These individuals stole tens of thousands of dollars from the state’s alcohol and drug treatment programs,” Brown said. “In this time of economic crisis, it’s brazen and offensive that these individuals chose to rip off public health programs instead of helping substance abusers get their lives together.”

Between July 1, 2005 and May 30, 2009, New Beginnings owner Tatyana Yakovenko and her associates submitted 1,642 fraudulent claims totaling more than $68,000 to the California Department of Alcohol and Drug Programs (ADP.)

Under a contract established with the Los Angeles County Alcohol and Drug Programs Administration, New Beginnings provided alcohol and drug treatment services to Medi-Cal patients. Certified as a Substance Abuse Clinic in January 2002, New Beginnings operated four treatment centers in Los Angeles County.

In late 2008, Brown’s office launched an investigation into allegations that New Beginnings was submitting false Medi-Cal claims to ADP.

Brown’s investigation found that New Beginnings owner Tatyana Yakovenko and five members of the center’s upper management required therapists and group counselors to “ghost write” counseling sessions that were never performed and forge group therapy sign-in sheets. The investigation uncovered that as many as half of the Medi-Cal claims filed by New Beginnings were fraudulent.

The investigation also revealed that several patients who were enrolled in the program did not have a drug problem, and many of their drug tests were fabricated to ensure continued and unnecessary treatment. New Beginnings employees enticed adult Medi-Cal beneficiaries to enroll in the organization’s drug counseling program by offering cigarettes, food, and assistance with Section 8 housing qualification.

The majority of treatment and group notes were stored on computers, which made it easy to cut and paste and change the names of the clients. Counselors were instructed to occasionally create a “crisis,” which meant a dirty drug test or a situation that warranted a client’s continued drug treatment.

Additionally, investigators determined that some counselors were ordered to enter treatment records for 120 clients when only 40 clients were actually receiving treatment. The average client had four treatment group activities per month, but counselors were pushed to increase the documentation to 20 activities per month.

The six individuals arrested today on charges of felony grand theft and filing false Medi-Cal claims include:
• Tatyana Yakovenko, 35, of Beverly Hills,
• Natalya Zvereva, 34, of Sherman Oaks,
• Carlos Villanueva, 38, of Pico Rivera,
• Aleksey Lisitsa, 27, of Los Angeles,
• Jodee A. Wallace, 41, of Granada Hills; and,
• Romalis Conway, 29, of Los Angeles

Earlier this month, Brown announced his office recovered more than $209 million and secured 139 criminal convictions by aggressively investigating and prosecuting Medi-Cal fraud cases in 2009. Brown also reported that in 2009, his Bureau of Medi-Cal Fraud and Elder Abuse returned more than $12 million to victims of elder abuse and secured 47 criminal convictions in elder abuse cases.

Copies of the felony complaint and arrest warrant affidavits are attached.

Los Angeles—In an ongoing crackdown on prescription-drug fraud and abuse, Attorney General Edmund G. Brown Jr. today announced that his office is investigating an “illegal and massive prescription-drug ring” linked to the actor Corey Haim.

An unauthorized prescription under the former child star’s name was found during an ongoing investigation of fraudulent prescription-drug pads ordered from a vendor in San Diego.

“Corey Haim’s death is yet another tragedy linked to the growing problem of prescription-drug abuse,” Attorney General Brown said. “This problem is increasingly linked to criminal organizations, like the illegal and massive prescription-drug ring under investigation. It’s a serious public health problem.”

The prescription-drug ring under investigation operates by ordering prescription-drug pads from authorized vendors using stolen doctor identities. The pads are then either sold on the street to prescription-drug addicts or to individuals who are paid to fill the prescription and then sell the drugs on the underground market. The doctor whose name is printed on the form is usually unaware that his or her identity has been stolen for this purpose.

The investigation has thus far uncovered more than 4,500 to 5,000 fraudulent prescriptions linked to the fraud ring in Southern California.

The San Diego Regional Pharmaceutical Narcotic Enforcement Team (RxNET) is conducting the investigation. RxNET is a cooperative effort of the California Department of Justice, Bureau of Narcotic Enforcement; Department of Health Care Services and Immigration and Customs Enforcement. RxNET also works in conjunction with other state, federal and local law enforcement agencies.

Prescription-drug abuse is a growing problem. Brown’s office has investigated and filed charges in more than 200 cases—against both physicians who have abused their trust and patients who go from doctor to doctor in search of drugs.

In February 2009, Brown filed charges against Dr. Lisa Barden of Rancho Cucamonga, who stole the identities of her patients to obtain highly addictive painkillers. The San Bernardino County District Attorney is prosecuting the case.

In April 2009, Brown’s office arrested five college-age individuals who conspired to fraudulently obtain thousands of prescription drugs. The San Diego County District Attorney is now prosecuting the case.

In addition to costing the state millions of dollars each year, prescription-drug abuse can have serious public safety consequences, as many of the top abusers hold down regular jobs including truck drivers, transit operators and medical practitioners.

California is at the forefront of technology that makes it more difficult for criminals to operate prescription-drug rings. Brown’s office has introduced significant technology upgrades to the state’s prescription-monitoring program, known as CURES, by creating an accessible, online database. The database is a critical tool in assisting law enforcement in investigating these types of crimes.

For more information on the California Department of Justice Bureau of Narcotic Enforcement and California’s prescription-drug monitoring system visit: http://ag.ca.gov/bne/CURES.php.

For doctors and other authorized healthcare and prescription-drug providers, visit www.ag.ca.gov for more information on CURES.

Sacramento—Attorney General Edmund G. Brown Jr. today announced that last year, his office recovered more than $209 million in “hard-earned taxpayer dollars” and secured 139 criminal convictions by aggressively investigating and prosecuting Medi-Cal fraud cases.

Brown also reported that in 2009, his Bureau of Medi-Cal Fraud and Elder Abuse returned more than $12 million to victims of elder abuse and secured 47 criminal convictions in elder abuse cases.

“In these tough budget times, the state can’t afford to lose millions in hard-earned taxpayer dollars from people who try to cheat and steal from the system,” Brown said. “Thanks to the tireless work of DOJ investigators, we protected our most vulnerable citizens and recovered critical public health dollars.”

Brown’s Bureau of Medi-Cal Fraud and Elder Abuse (BMFEA) investigates and prosecutes those who cheat taxpayers out of millions of dollars each year and divert scarce healthcare resources from the needy. The Bureau also protects patients in nursing homes and other long-term care facilities from abuse and neglect.

Combined, Brown recovered more than $221 million in Medi-Cal fraud and elder abuse cases. The amount recovered last year is more than six times the BMFEA’s $33.1 million operating budget. This represents a recovery of $36 for every $1 expended from the state's general funds.

The recoveries stem from restitution obtained in Medi-Cal fraud, elder abuse, and patient fund cases. Patient fund cases occur when a disabled person's finances are being controlled by a trustee who steals from the patient's trust account. Annually, the BMFEA conducts more than 1,500 investigations.

Medi-Cal Fraud

Last year’s $209 million recovery stemmed from civil lawsuits Brown’s office filed against companies and individuals that billed the state’s Medi-Cal fund for unnecessary services or for services that were never performed.

In one such case filed in October 2009, Brown’s office arrested the former manager of a Mount Shasta-based medical clinic after she billed Medi-Cal $2.2 million for services never performed. Denise Fairhurst, 57, of Redding, filed false Medi-Cal claims with the state to help cover the medical clinic’s operations and management costs. In addition, she used $33,492 of the funds to pay personal credit card bills. Fairhurst is scheduled to be sentenced on March 24 in Siskiyou County Superior Court.

Some of the fraud is perpetrated by criminal fraud rings. In May 2009, Brown filed criminal charges against six individuals who paid healthy seniors to be admitted into a hospice for the terminally ill and then billed state healthcare programs more than $1 million for procedures never performed. Some of the individuals used the proceeds of the scheme to purchase expensive cars, designer clothing, and luxury homes. Four of the defendants have pled guilty, and the state has recovered the $1 million.

A number of Medi-Cal fraud cases are institutional. In December 2009, Brown reached a $21.3 million settlement with pharmaceutical giant Schering-Plough Corporation, resolving allegations the company deliberately inflated the price of Albuterol and other drugs, overcharging Medi-Cal millions of dollars in pharmacy reimbursement.

Most of the funds recovered go back into the state’s Medi-Cal fund, which provides medical payments for nearly 20 percent of California’s children, lower income individuals and families, the elderly and disabled.

Elder Abuse

Although elder abuse can take many forms, the majority of cases involve abuses at California’s skilled nursing facilities. Brown’s office uses its civil, administrative and criminal enforcement powers to bring poorly performing care facilities into compliance with federal and state laws.

A few elder abuse cases Brown’s office prosecuted include:
• Mary Louise Wilson, who was sentenced to nineteen years and four months in prison for setting multiple fires at Southern California nursing homes, including the beds of elderly patients who were unable to get out of bed without assistance;
• Pamela Ott, who was charged with eight felony counts of elder abuse in September 2009 for allowing staff to forcibly administer psychotropic medications to patients for their own convenience, rather than for their patients' therapeutic interests; and,
• Leander Jackson, who was sentenced to three years, eight months in prison for identity theft and grand theft for operating several unlicensed skilled nursing facilities and neglecting to provide the proper care to the residents. Jackson used the identities of the patients to obtain cash loans and car leases.

A copy of the BMFEA Annual Report is attached.

Los Angeles—Attorney General Edmund G. Brown Jr. today announced that his office has secured an agreement with Santa Fe Natural Tobacco Company, Inc., the manufacturer of American Spirit tobacco products, that requires the company to clearly disclose that its organic tobacco is “no safer or healthier” than other tobacco products.

Attorneys general from 32 other states and the District of Columbia signed onto today’s agreement.

“Stamping an organic label on tobacco products is ultimately a distinction without a difference—organic or not, cigarettes are bad for your health,” Brown said. “Today’s settlement with Santa Fe Natural Tobacco Company ensures that all future advertisements make it clear that organic tobacco is no safer or healthier.”

Today’s agreement follows Brown’s contention that Santa Fe Natural Tobacco Company may have misled consumers in advertising its “organic” or “100% organic” Natural American Spirit cigarettes and roll-your-own tobacco and pouches, leading consumers to believe these products were less harmful than other tobacco products. There is currently no competent or reliable scientific evidence to support this conclusion.

Under the terms of the agreement, all advertisements will clearly and prominently feature the following warnings:

• For Natural American Spirit organic cigarettes: “Organic tobacco does NOT mean safer cigarettes.”
• For Natural American Spirit organic roll-your-own or pouch tobacco: “Organic tobacco does NOT mean safer tobacco.”

Santa Fe Natural Tobacco Company has until April 1, 2010 to meet these requirements in the placement of future advertising. All tobacco retailers selling these products must be contacted and instructed to dispose of old advertisements that do not feature these disclosures once updated advertisements and point of sale materials are received.

Organic tobacco is certified under the U.S. Department of Agriculture’s National Organic Program. To receive organic certification, tobacco farmers have to follow a strict, labor-intensive growing regimen. Certified organic tobacco is grown without the use of pesticides and fertilizers prohibited under the program.

Thirty-two other attorneys general signed onto Brown’s agreement today from the following states: Arizona, Arkansas, Colorado, Connecticut, Delaware, Georgia, Hawaii, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Montana, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Tennessee, South Dakota, Vermont, Washington, West Virginia and Wisconsin. Additionally, the attorney general of the District of Columbia signed onto the agreement.

Brown’s agreement with Santa Fe Natural Tobacco Company, Inc. is attached.

Los Angeles—Attorney General Edmund G. Brown Jr., who has an ongoing investigation into possibly illegal practices by some California health insurers, today subpoenaed financial records and other documents from California’s seven largest health insurance companies.

“We have been looking at these companies for a number of months and are very concerned that some of them are unjustly raising premiums and denying payment of legitimate claims,” Brown said. “Not only are the rate increases devastating to Californians strapped by the economy, but in some cases, they are possibly illegal.”

“Our best attorneys are going to get to the bottom of this, and where we find violations of California’s unfair business laws, we intend to stop them,” Brown added.

Brown subpoenaed records from Aetna Health, Anthem Blue Cross, CIGNA, Health Net, Blue Shield of California, Kaiser Permanente and PacifiCare. Today’s subpoenas cover pay-for-service health plans, which are health plans that reimburse doctors and hospitals for services performed instead of a health maintenance organization (HMO) approach. Brown revealed that his office served subpoenas to those same companies last month regarding their managed care plans, known as HMOs.

Brown said the insurance companies have 30 days to hand over their financial and other records.

Brown began an official inquiry last September into HMO practices of reviewing and paying insurance claims submitted by doctors, hospitals and other medical providers. The investigation was prompted by reports that California’s five largest health insurance providers were denying insurance claims at rates of up to 39.6 percent.

Recently, Anthem Blue Cross announced to its members that it planned to hike premium rates by as much as 39 percent. Brown’s investigation will probe whether the other health plans are planning similar rate hikes and will consider whether Anthem’s steep rate increases for individual California consumers are fair under California law.

The investigation will include an examination of how much the plans are spending on health care versus non-healthcare costs such as marketing, administration and profits. The plans have been asked to provide detailed information on how they spend policy-holders’ premiums and how they review claims and decide whether and how much to pay the doctor or hospital for the service.

The investigation also will examine:
• Member and medical provider complaints against the health plans describing payment delays, reduced payments and denials of payment claims, and the health plans responses to those complaints;
• How health plans determine doctor and hospital rankings and whether those rankings mislead customers on quality;
• Whether the health plans intend to raise premiums, and, if so, whether the plans disclosed the amount and frequency of the premium increases at the time of enrollment;
• Whether the health plans offer alternative policies to members when they increase premiums and whether the plans may deny enrollment in the alternative policies based on preexisting conditions.

Brown’s investigation will look for violations of law, including California’s Unfair Competition Law (Business & Professions Code section 17200) and False Advertising Law (Business & Professions Code section 17500.) These laws prohibit “any unlawful, unfair or fraudulent business act or practice” and the use of “false or misleading statements” to the public.

The attorney general is authorized to prosecute violations of the Unfair Competition Law criminally or file a civil law enforcement action to obtain an injunction forcing the company to stop the business practices, restitution of money to affected consumers and civil penalties beyond those available to private parties.

San Diego—Attorney General Edmund G. Brown Jr. today announced that Mary Louise Wilson, 54, of San Diego, has been sentenced to 19 years and 4 months in prison for attempting to “kill or seriously injure” nursing home residents by setting fires in the homes.

Today’s sentence marks the longest prison term that anyone convicted by the Attorney General’s Office has received in an elder abuse case.

“These fires were no accident. This woman meant to kill or seriously injure dozens of disabled people,” Brown said. “Residents of nursing homes are particularly vulnerable, so today’s sentence is an important victory in our fight against elder abuse in California communities.”

Brown’s Bureau of Medi-Cal Fraud and Elder Abuse (BMFEA) was created in 1978 to uncover Medi-Cal fraud and to combat the abuse and neglect of patients in nursing homes and other long-term care facilities. Since Brown took office, BMFEA has secured 217 criminal convictions and has collected more than $1.1 million in restitution and reimbursement.

In August 2009, Brown’s office, along with the National City Fire Department and the El Cajon Police Department, began an investigation into a series of fires set in nursing homes in the San Diego area.

The first incident occurred in January 2009 at El Dorado Care Center in El Cajon. Wilson, a resident of the facility, had been placed in a room with two other women. Neither of her two roommates was able to get in or out of bed without nursing assistance, and one of the women was attached to an oxygen tank.

In the middle of the night, Wilson set fire to the bed of one of her roommates while she was sleeping. A nurse heard the smoke alarm and used a fire extinguisher to put out the fire before anyone was hurt.

Four months later, Wilson, who was able to manage in a more independent environment, was transferred to Golden Paradise Senior Living, an assisted living center in National City.

Soon after being transferred, Wilson set fires in the second-floor trash chute, the first-floor dumpster and the second-floor library. She also threw burning materials down the trash chute. National City Fire Department firefighters and the building’s sprinkler system put out the fires before anyone was hurt.

Investigators from Brown’s office identified Wilson as a suspect by linking the fires at the two facilities. In October, she was charged with the crimes and pled guilty on January 5, 2010 to:

• Two counts of attempted murder;
• Three counts of arson;
• Two counts of attempted arson;
• One count of assault with a deadly weapon for threatening a resident with a knife; and
• One count of making a criminal threat with a deadly or dangerous weapon.

In addition to today’s court victory, BMFEA has investigated and prosecuted several other notable elder abuse cases in the past year. Late last year in Sacramento, Maria Elna Flora pleaded guilty to 12 counts of grand theft and burglary for stealing $435,100 from retirees to fund a daily gambling habit.

In September 2009, Brown filed charges against Pamela Ott, a Kern Valley Hospital administrator, for allowing staff to forcibly administer psychotropic medications to patients to sedate them for the staff’s convenience. The case is pending in Kern County Superior Court.

Wilson’s booking photo and a copy of the complaint are attached.

Oakland—Attorney General Edmund G. Brown Jr. today sued Florida-based electronic-cigarette retailer Smoking Everywhere to prevent the company from targeting minors and making “misleading and irresponsible” claims that electronic cigarettes are a safe alternative to smoking.

“Smoking Everywhere launched a misleading and irresponsible advertising campaign targeting minors and claiming that electronic cigarettes do not contain harmful chemicals,” Brown said. “We are asking the Court to take these cigarettes off the market until the company has proven the products are safe.”

Electronic cigarettes, or e-cigarettes, are battery-operated devices with nicotine cartridges designed to look and feel like conventional cigarettes. Instead of actual smoke, e-cigarettes produce a vapor from the nicotine cartridge that is inhaled by the user. Smoking Everywhere, one of the largest e-cigarette retailers in the United States, claims in its advertisements that the e-cigarettes have no carcinogens, no tar, no second-hand smoke, and are therefore safe and healthy.

However, the U.S. Food and Drug Administration (FDA) has determined that electronic cigarettes contain a variety of dangerous chemicals, including nicotine, carcinogens such as nitrosamines and, in at least one case, diethylene glycol, commonly known as antifreeze.

Today’s lawsuit seeks to prevent the company from selling its products until there is evidence to substantiate its claims that they are safe. The lawsuit will also require the products to display the state-mandated Proposition 65 warnings of ingredients known to cause cancer or reproductive harm and seeks to prevent the company from making false and misleading claims and promoting the products to minors.

In one advertisement targeted to minors, Smoking Everywhere featured a video with radio show host Howard Stern claiming, “kids love ‘em.” The products feature flavors that appeal to youth, including strawberry, chocolate, mint, banana and cookies-and-cream.

Other ads claim that electronic cigarettes can help people quit smoking. To be advertised as a smoking-cessation device, a product must be approved by the FDA for that purpose. In fact, none of Smoking Everywhere’s products have been approved by the FDA.

The American Cancer Society, the American Heart Association, the American Lung Association, the Campaign for Tobacco Free Kids and other groups have expressed serious concerns about the safety of electronic cigarettes and urged that they be removed from the market until proof of their safety has been established.

A copy of the complaint is attached.

Sacramento – Attorney General Edmund G. Brown Jr. announced today a $21.3 million settlement with Schering-Plough Corporation, resolving allegations the company “deliberately inflated” the price of Albuterol and other drugs, causing California’s Medicaid (Medi-Cal) program to overpay millions of dollars in pharmacy reimbursement.

Albuterol is a widely prescribed generic drug, delivered through inhalers, nebulizers and masks, and used to treat asthma and other breathing problems.

“With healthcare costs spiraling out of control, it’s unconscionable that a Fortune 500 pharmaceutical company deliberately inflated its drug prices to cheat California’s public healthcare system out of millions of dollars,” said Brown. “This is a company that made more than $12 billion in profits last year, yet still raided the pockets of California taxpayers.”

Today’s settlement stems from a lawsuit filed by a whistleblower against several pharmaceutical companies accused of Medicaid fraud. The case is still proceeding against Dey, Inc., Mylan Pharmaceuticals, Inc., Sandoz, Inc. and their parent companies. Schering-Plough recently merged with Merck, and is now known as Merck & Co.

California’s $21.3 million agreement is one of three settlements negotiated with Schering-Plough, collectively totaling $69 million, over falsely inflated drug prices. The three lawsuits were originally filed by a whistleblower, Ven-A-Care of the Florida Keys, Inc., on behalf of California, Florida and the federal government. Schering-Plough also reached settlements with Florida and the federal government, the latter for approximately $44.5 million.

The settlement resolves allegations that Warrick Pharmaceuticals, a subsidiary of Schering-Plough, deliberately inflated the Average Wholesale Prices (AWPs) it reported to California for Albuterol. Medi-Cal sets the reimbursement rates for pharmacies for many of the drugs dispensed to Medi-Cal patients based on the AWPs reported by drug manufacturers.

California pharmacies dispensed Albuterol to patients and were then reimbursed by Medi-Cal. By reporting falsely inflated AWPs, some drug manufacturers caused Medi-Cal to overpay millions of dollars in pharmacy reimbursement. Medi-Cal is funded on a roughly 50% - 50% basis by the federal government and the State of California.

Reporting fraudulent AWPs is a violation of the California False Claims Act. The Attorney General’s Office investigated the claims, and in 2005, intervened in the lawsuit with its own complaint, currently being litigated in federal court in Boston. The California Department of Health Care Services, which is responsible for administering Medi-Cal, will receive $20.1 million, and the Attorney General’s False Claims Fund will receive just over $1.2 million.

The Attorney General’s False Claims Fund is used for the ongoing investigation and prosecution of false claims, including Medi-Cal fraud claims. Today’s settlement was negotiated by the Attorney General’s Bureau of Medi-Cal Fraud and Elder Abuse. The Bureau of Medi-Cal Fraud and Elder Abuse investigates and prosecutes claims of Medi-Cal civil and criminal fraud, as well as allegations of elder abuse, such as physical assaults or financial theft.

The settlement agreement is attached.