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Senators Grill Dr. Oz on Medicaid Cuts and Medicare Changes

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Senators Grill Dr. Oz on Medicaid Cuts and Medicare Changes

In a hearing on Friday, senators pressed Dr. Mehmet Oz, the TV celebrity nominated to head Medicare and Medicaid, on Republican-led proposals that would significantly affect the health care coverage for nearly half of all Americans.

At his confirmation hearing before the Senate Finance Committee, Dr. Oz bantered with senators in a friendly atmosphere, joking about basketball and allegiances to college teams. He largely escaped tough questions from either side of the aisle, displaying his on-air charm as he deflected Democrats’ most pointed concerns about potentially radical changes in health coverage for not only those 65 and older but also for poor children.

Many senators seemed distracted by the fierce debate over the Republicans’ budget deal to avert a government shutdown, and they dashed in and out of Dr. Oz’s hearing. But he is poised to sail through the Senate for confirmation as the next administrator of the Centers for Medicare and Medicaid Services, an agency with $1.5 trillion in spending.

Senator Elizabeth Warren, Democrat of Massachusetts, made a big deal of his financial conflicts before the hearing. But at the session, she did not press him on those issues. Instead, she focused on his views about whether private Medicare plans are overcharging the government, an area where she and Dr. Oz seemed to agree on the need to tackle potential fraud and waste.

Throughout the hearing, he displayed a facile knowledge of a variety of relevant agency issues, although he repeatedly reverted to stock answers that he would need to study the topic at hand more.

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Several lawmakers, mainly Democrats, tried to force Dr. Oz to express his views on the Trump administration’s goals to cut back on health care costs and agency budgets, but he repeatedly sidestepped those minefields.

“It is our patriotic duty to be healthy,” he told senators. “It costs a lot of money to take care of sick people who are sick because of lifestyle choices.”

This refrain is in line with the Make America Healthy Again movement championed by Robert F. Kennedy Jr., the new secretary of the Department of Health and Human Services, and Dr. Oz’s soon-to-be boss if he is confirmed.

Introductory remarks from Senator Ron Wyden, Democrat of Oregon, held out an initial promise of some challenging questions. He accused Dr. Oz of dodging almost $500,000 in Social Security and Medicare taxes in recent years by using a tax exemption related to limited partnerships, something Democrats concluded after reviewing Dr. Oz’s tax returns. But there were no follow up questions on it.

Mr. Wyden also raised the specter that he was going to grill Dr. Oz on his connection to TZ Insurance Solutions, a for-profit company that sells Medicare Advantage plans to older Americans. Dr. Oz has been a relentless promoter of these private plans, which have been criticized by lawmakers and regulators for systemic overbilling and denying patients care, on his show and YouTube channel.

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Dr. Oz, 64, is also a registered broker for TZ Insurance in states across the country, according to a recent investigation into his finances by The New York Times. Again, Mr. Wyden flagged the issue and did not follow up.

Despite concerns by Democrats that Dr. Oz would most likely roll back some of the rules meant to rein in the plans, he instead committed to strong oversight. He acknowledged that some of the brokers now selling these plans were “churning policies,” switching people from one plan to another, regardless of whether the change in coverage benefited them.

“Part of this is just recognizing there’s a new sheriff in town,” Dr. Oz said. “We actually have to go after places and areas where we’re not managing the American people’s money well.”

Several times in the hearing, Dr. Oz addressed bipartisan concerns over whether Medicare Advantage plans are overpaid. In response to questions from a fellow physician, Senator Bill Cassidy, Republican of Louisiana, Dr. Oz mentioned a study suggesting the federal government spends more on the private alternative to Medicare than the government-run program. “It’s upside down,” he said.

“We should examine whether some of the money should be reimbursed to the American people,” Dr. Oz said.

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He also expressed interest in solving some of the bipartisan concern over insurers’ use of prior authorization for approving medical procedures by reducing the number of services that would be subject to review.

Democrats seemed most frustrated by Dr. Oz’s stance toward Medicaid, the state-federal program that covers 72 million low-income Americans. “All my colleagues want to know, are you going to cut Medicaid?” asked Senator Maria Cantwell, Democrat of Washington.

But Dr. Oz, who has not spoken much about the program he would also oversee as head of the agency, did not answer directly. He said he did not know the details of the Republican budget discussions, in which lawmakers are looking at hundreds of billions of dollars in cuts that could result in people’s loss of coverage as it became more difficult to enroll and states had to shoulder more of the burden.

When questioned by Senator Raphael Warnock, Democrat of Georgia, about Republican efforts to add burdensome monthly paperwork for some people to show they should get benefits, Dr. Oz said he favored the work requirements that Republicans want to limit eligibility. But he agreed with the senator about making sure people who should be eligible for Medicaid were not cut off.

There were other subjects senators seemed to veer away from. For instance, Dr. Oz has made tens of millions of dollars over the years promoting dietary supplements, often without any mention of his financial interest. He has been paid by numerous medical and health firms for showcasing their products. Many of those companies would be affected by any decisions he would make as the administrator for the Centers for Medicare and Medicaid Services, and many already benefit from agency funding.

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Senator Maggie Hassan, Democrat of New Hampshire, asked him to put a dollar figure on exactly what he has made from promoting supplements on his daytime TV show. He said he was not paid anything. He started to explain that Sony Pictures distributed the show, and that it was the entity paid by these companies (which in turn paid him), but he was cut off. Ultimately, Ms. Hassan was unable to extract anything meaningful from him and moved on.

In the hearing, Mr. Wyden pressed Dr. Oz about the access granted to Elon Musk’s so-called Department of Government Efficiency to Americans’ private medical information. Mr. Wyden raised concerns about the need to protect people’s privacy given the department’s potential ability to view personal health and medical data. Despite his repeated questions, he said, the Trump administration had so far not addressed those concerns. Surprisingly, Dr. Oz said he had no discussions with the administration about what Mr. Musk’s team was doing as it inspected agency information, but he promised to “address what is going on.”

The measles outbreak in Texas and New Mexico has heightened concerns and leveled significant criticism at the response by Mr. Kennedy and the Trump administration. Senator Ben Ray Luján, Democrat of New Mexico, asked Dr. Oz whether he believed the measles vaccine was safe. Dr. Oz said he did, but when the senator followed up by asking whether it was effective, Dr. Oz stepped back and said that judging individual vaccines and their recommendations for use would not be under his purview but under that of the Centers for Disease Control and Prevention.

“My job, if confirmed, is to make sure we pay for those vaccines,” he said.

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Landmark downtown apartment tower faces foreclosure

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Landmark downtown apartment tower faces foreclosure

A landmarked downtown Los Angeles apartment building designed by famed Los Angeles architect John Parkinson is on the market as its owners face foreclosure.

Residences in the Metropolitan, a 10-story tower built in 1913, are nearly filled with tenants but its ground floor retail spaces on Broadway and 5th Street are unoccupied, as are other street-level stores in downtown’s Historic Core.

The historic building was once considered one of the best in the city and is owned by the Fallas family, which operated a chain of value-priced clothing stores based in Gardena including one called Fallas Paredes in the Metropolitan.

Fallas-Paredes at 449 S. Broadway, Los Angeles, CA 90013.

(Google Maps)

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Around 2011, Michael Fallas, who once worked in family’s downtown store as a stock boy, converted the upstairs floors from offices to apartments while continuing to operate Fallas Paredes. The store closed more than five years ago in the wake of a 2018 filing by its parent company for Chapter 11 bankruptcy protection.

Earlier this month in state Superior Court, a special servicer representing Fallas’ lender asked for a judicial foreclosure of the property, alleging that Fallas had stopped making payments on a $32 million loan dating to 2017. After leasing the property for years, Fallas bought the building in the 1990s.

Fallas didn’t respond to requests for comment.

The location of the Metropolitan where the buildings stands was hailed in a Times story in 1912, saying “it is regarded by many realty men as the most valuable piece of real estate in Los Angeles.”

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The building today is recognized as a city historic-cultural monument because “Broadway became the commercial center of the Southland, a title it retained until well after World War II,” with its development, the city said. One of the architects who designed the Metropolitan in the Beaux-Arts style was John Parkinson, who is credited with designing such well-known local structures as City Hall, the Los Angeles Memorial Coliseum and Union Station.

Notable tenants in the Metropolitan have included the Los Angeles Public Library, Owl Drug Co., variety store J.J. Newberry and real estate company Janns Investment Co., which sold the land where UCLA is built and developed Westwood Village, among other Los Angeles neighborhoods.

In recent years, the buildings around the Metropolitan have struggled to keep retail tenants after a spurt of residential conversions of historic buildings starting in the early 2000s brought commerce to the neighborhood. Many downtown businesses have struggled since the pandemic reduced occupancy in offices downtown and reduced the flow of visitors.

“The lack of bodies on the street is generally hurting downtown, and that’s one of the reasons that has building has problems,” said downtown real estate broker Hal Bastian, who lives in the Historic Core.

There are close to 1,000 residential units in historic buildings at the intersection of Broadway and 5th Street, Bastian said, but all the ground floor stores are closed. Drug stores there suffered substantial losses from shoplifting he said, and now, “our challenge on Broadway is leasing.”

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The 88 apartments in the Metropolitan are 91% rented, according to a listing for the property by the Zacuto Group, which also touts its roof deck with pool, fitness center and barbecue grills. No sale price is set.

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January 2025 wildfire victims seek tougher penalties against State Farm over claims handling

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January 2025 wildfire victims seek tougher penalties against State Farm over claims handling

A fire survivors’ group announced Thursday it was seeking tougher penalties against State Farm over its handling of January 2025 wildfire claims.

The Every Fire Survivor’s Network said it was petitioning to join a state enforcement action announced this year against the company to make sure the case results in meaningful changes at California’s largest home insurer.

“We’re seeking a systematic review of all their claims and penalties calibrated to the actual scale of the harm — and we’re seeking the payouts that families are owed,” said Joy Chen, executive director of the group, at a Pacific Palisades news conference joined by victims of the fires.

The Department of Insurance in May filed an administrative action against State Farm General — the subsidiary of the giant Bloomington, Ill., insurer that handles California home insurance — after completing a “market conduct” exam.

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The Jan. 7, 2025, fire damaged or destroyed more than 18,000 structures and killed 31 people.

State Farm has received more January 2025 claims than any other insurer — more than 13,700 auto and homeowners claims as of May 4, with payouts totaling $5.7 billion, according to the company.

The market conduct exam looked at 220 sample claims filed by the victims and found 398 violations of state law in about half of them.

Among other alleged violations, it found that the company failed in numerous cases to pursue a “thorough, fair and objective investigation” into claims, failed to come to “prompt, fair, and equitable settlements” and made settlement offers that were “unreasonably low.”

In announcing the action, Insurance Commissioner Ricardo Lara called the company’s claims handling “unacceptable” and said his department was taking “decisive action to hold them accountable.”

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The state is seeking a “cease and desist” order to stop the insurer from engaging in unfair or deceptive practices.

It also has threatened to suspend State Farm’s license over the alleged violations, which each carry a penalty of up to $5,000 — or twice that figure if found to be willful. That could amount to a penalty of $2 million or more.

The threat to actually suspend State Farm’s license and its authority to write policies has been viewed skeptically by some, given its roughly 20% market share of the state’s home insurance market.

The company, which had an opportunity to include its responses in the exam report, denied fault in some cases and admitted fault in others. It often blamed problems on individual adjusters and denied systemic issues with its claims handling.

The petition filed by the wildfire survivor’s group criticizes the sample size of the market conduct exam as too small to capture all the alleged deficiencies in State Farm’s claims handling, which it claims are a “general business practice” of the company.

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The group is seeking to conduct discovery, cross examine witnesses, present testimony from fire victims and bring more that 1,600 firsthand policyholder statements regarding State Farm’s practices into evidence, according to the petition.

It also wants State Farm to reopen cases in which claimants were paid too little, and it is seeking to participate in settlement discussions in order to increase any penalty State Farm would pay.

It calculated that a $2-million penalty would amount to a minute fraction of the assets of the State Farm Group.

“I submit to you that doesn’t defer bad conduct, it just allows you to continue to do it,” said Michelle Meyers, an attorney for Every Fire Survivor’s Network, at the news conference.

Consumer Watchdog, which has been a harsh critic of State Farm, also is providing legal support for victims’ effort.

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Sevag Sarkissian, a spokesperson for State Farm, said the company was aware of the petition.

“We recognize that many wildfire survivors, including those that are State Farm General policyholders, continue to face difficult recovery challenges,” he said. “Our focus remains on helping customers recover.”

Michael Soller, a spokesperson for Lara, said the department is “acting with urgency to assist wildfire survivors in their ongoing recovery by investigating formal complaints filed by survivors and conducting the expedited market conduct exam that led to this enforcement action.”

He added that the department’s position is the state’s Administrative Procedure Act does not contemplate the commissioner or department staff authorizing intervention requests in the case.

He said that would be a hearing officer’s or administrative law judge’s decision when one is assigned to the case.

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Meyers acknowledged the request was novel but said her reading of the law is that Lara can make the decision because no judge is yet assigned.

In response to the criticism, State Farm pledged earlier this year to improve its claims handling, including by providing single points of contact and improved communication so there are “fewer handoffs, fewer repeated explanations, and seamless support.”

It also named a new vice president of customer relations for State Farm General.

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Uber, California lawyers say deal reached to avert dueling ballot initiative showdown

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Uber, California lawyers say deal reached to avert dueling ballot initiative showdown

The state’s trial attorneys and Uber say they have reached a last-minute deal to scrap their dueling ballot measures and avert what was gearing up to be one of most expensive battles of the November election.

The deal, which comes a day after both measures qualified for the November ballot, has Uber agreeing to bulk up safety measures, while the trial attorneys will limit how much they can claim for lien-based medical treatment of victims who get in Uber or Lyft accidents, according to spokespeople for both sides of the campaign.

“Both sides agree: Californians deserve a system that’s safe, fair, and accountable,” read a joint statement from Uber and the Consumer Attorneys of California, a powerful attorney trade group. “This agreement protects patients from unnecessary treatment or getting overcharged, ensures access to medical care and legal representation, and strengthens safety measures.”

The agreement, finalized Thursday, means the ride-share giant will kill its ballot measure to cap how much attorneys can earn in vehicle collision cases and limit medical damages to rates based on insurance. Uber has argued that the costs for medical treatment done on a lien, which allows doctors to get paid from a cut of the plaintiff’s payout, far exceed what it would cost if the victim had used their own insurance.

In return, the Consumer Attorneys of California will cancel its competing ballot measure that sought to increase legal liability for ride-share companies if a passenger is sexually assaulted by a driver. The measure followed an investigation by the New York Times into sexual assault by drivers.

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Both sides had poured tens of millions into the campaigns, plastering billboards across Los Angeles.

Lawyers claimed the fight had turned existential with the measure threatening to decimate the profit margin of many personal injury cases and leave drivers with small or thorny cases unable to find an attorney willing to take their case.

Spokespeople say the deal is predicated on their agreement being codified into a bill within the next week. Otherwise, they said, each side will move forward with its ballot measure.

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