291 posts categorized "Court Cases" Feed

Federal Reserve Enforcement Action Against Banking Executives

Last month, the Federal Reserve Board (FRB) announced several notable enforcement actions. A February 5th press release discussed a:

"Consent Notice of Suspension and Prohibition against Fred Daibes, former Chairman of Mariner's Bancorp, Edgewater, New Jersey, for perpetuating a fraudulent loan scheme, according to a federal indictment."

The order against Daibes described the violations:

"... on October 30, 2018, a federal grand jury in the United States District Court for the District of New Jersey charged [Diabes] and an accomplice by indictment with one count conspiracy to misapply bank funds and to make false entries to deceive a financial institution and the FDIC, five counts of misapplying bank funds, six counts of making false entries to decide a financial institution and the FDIC, and one count of causing reliance on a false document to influence the FDIC... During the relevant time period, Mariner’s was subject to federal banking regulations that placed limits on the amount of money that the Bank could lend to a single borrower... the Indictment charges that in about January 2008 to December 2013, Daibes and others orchestrated a nominee loan scheme designed to circumvent the Lending Limits by ensuring that millions of dollars in loans made by the Bank (the “Nominee Loans”) flowed from the nominees to Daibes, while concealing Daibes’ beneficial interests in those loans from both the Bank and the FDIC. Daibes recruited nominees to make materially false and misleading statements and material omissions..."

The FRB and the U.S. Federal Deposit Insurance Corporation (FDIC) are two of several federal agencies which oversee and regulate the banking industry within the United States. The order bars Daibes from working within the banking industry.

Then, a February 7th FRB press release discussed a:

"Consent Prohibition against Alison Keefe, former employee of SunTrust Bank, Atlanta, Georgia, for violating bank overdraft policies for her own benefit."

The order against Keefe described the violations:

"... between September 2017 and May 2018, while employed as the manager of the Bank’s Hilltop Branch in Virginia Beach, Virginia, Keefe repeatedly overdrew her personal checking account at the Bank and instructed Bank staff, without authorization and contrary to Bank policies, to honor the overdrafts... Keefe’s misconduct described above constituted unsafe or unsound banking practices and demonstrated a reckless disregard for the safety and soundness of the Bank..."

Keefe was fired by the bank on July 12, 2018, and has repaid the bank. The order bars Keefe from working within the banking industry.

A February 21st press release discussed the agency's enforcement action against a former manager at J.P. Morgan Chase bank. The FRB:

"... permanently barred from the banking industry Timothy Fletcher, a former managing director at a non-bank subsidiary of J.P. Morgan Chase & Co. Fletcher consented to the prohibition, which includes allegations that he improperly administered a referral hiring program at the firm by offering internships and other employment opportunities to individuals referred by foreign officials, clients, and prospective clients in order to obtain improper business advantages for the firm. The FRB is also requiring Fletcher to cooperate in any pending or prospective enforcement action against other individuals who are or were affiliated with the firm. The firm was previously fined $61.9 million by the Board relating to this program. In addition, the Department of Justice and the Securities and Exchange Commission have also fined the firm."

The $61.9 million fine was levied against J.P. Morgan Chase in November, 2016. Back then, the FRB found that the bank:

"... did not have adequate enterprise-wide controls to ensure that referred candidates were appropriately vetted and hired in accordance with applicable anti-bribery laws and firm policies. The Federal Reserve's order requires J.P. Morgan Chase to enhance the effectiveness of senior management oversight and controls relating to the firm's referral hiring practices and anti-bribery policies. The Federal Reserve is also requiring the firm to cooperate in its investigation of the individuals..."

Last month's order against Fletcher described the violations:

"... from at least 2008 until 2013 [Fletcher] engaged in unsafe and unsound practices, breaches of fiduciary duty, and violations of law related to his involvement in the Firm’s referral hiring program for the Asia-Pacific region investment bank, whereby candidates who were referred, directly or indirectly, by foreign government officials and existing or prospective commercial clients were offered internships, training, and other employment opportunities in order to obtain improper business advantages for the Firm... the Firm’s internal policies prohibited Firm employees from giving anything of value, including the offer of internships or training, to certain individuals, including relatives of public officials and relatives and associates of non-government corporate representatives, in order to obtain improper business advantages for the Firm..."

Kudos to the FRB for its enforcement action. Executives must suffer direct consequences for wrongdoing. After reading this, one wonders why direct consequences are not applied against executives within the social media industry. The behaviors there do just as much damage; and cross borders, too. What are your opinions?


Large Natural Gas Producer to Pay West Virginia Plaintiffs $53.5 Million to Settle Royalty Dispute

[Editor's note: today's guest post by ProPublica discusses business practices within the energy industry. It is reprinted with permission.]

By Kate Mishkin and Ken Ward Jr., The Charleston Gazette-Mail

The second-largest natural gas producer in West Virginia will pay $53.5 million to settle a lawsuit that alleged the company was cheating thousands of state residents and businesses by shorting them on gas royalty payments, according to terms of the deal unsealed in court this week.

EQT Corporation logo Pittsburgh-based EQT Corp. agreed to pay the money to end a federal class-action lawsuit, brought on behalf of about 9,000 people, which alleged that EQT wrongly deducted a variety of unacceptable charges from peoples’ royalty checks.

The deal is the latest in a series of settlements in cases that accused natural gas companies of engaging in such maneuvers to pocket a larger share of the profits from the boom in natural gas production in West Virginia.

This lawsuit was among the royalty cases highlighted last year in a joint examination by the Charleston Gazette-Mail and ProPublica that showed how West Virginia’s natural gas producers avoid paying royalties promised to thousands of residents and businesses. The plaintiffs said EQT was improperly deducting transporting and processing costs from their royalty payments. EQT said its royalty payment calculations were correct and fair.

A trial was scheduled to begin in November but was canceled after the parties reached the tentative settlement. Details of the settlement were unsealed earlier this month.

Under the settlement agreement, EQT Production Co. will pay the $53.5 million into a settlement fund. The company will also stop deducting those post-production costs from royalty payments.

“This was an opportunity to turn over a new leaf in our relationship with our West Virginia leaseholders and this mutually beneficial agreement demonstrates our renewed commitment to the state of West Virginia,” EQT’s CEO, Robert McNally, said in a prepared statement.

EQT is working to earn the trust of West Virginians and community leaders, he said.

Marvin Masters, the lead lawyer for the plaintiffs, called the settlement “encouraging” after six years of litigation. (Masters is among a group of investors who bought the Charleston Gazette-Mail last year.)

Funds will be distributed to people who leased the rights to natural gas beneath their land in West Virginia to EQT between Dec. 8, 2009, and Dec. 31, 2017. EQT will also pay up to $2 million in administrative fees to distribute the settlement.

Settlement payments will be calculated based on such factors as the amount of gas produced and sold from each well, as well as how much was deducted from royalty payments. The number of people who submit claims could also affect settlement payments. Each member of the class that submits a claim will receive a minimum payment of at least $200. The settlement allows lawyers to collect up to one-third of the settlement, or roughly $18 million, subject to approval from the court.

The settlement is pending before U.S. District Judge John Preston Bailey in the Northern District of West Virginia. The judge gave it preliminary approval on February 11th, which begins a process for public notice of the terms and a fairness hearing July 11 in Wheeling, West Virginia. Payments would not be made until that process is complete.

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Ex-IBM Executive Says She Was Told Not to Disclose Names of Employees Over Age 50 Who’d Been Laid Off

[Editor's note: today's guest blog post, by reporters at ProPublica, explores employment and hiring practices within the workplace. Part of a series, it is reprinted with permission.]

IBM logo By Peter Gosselin, ProPublica

In sworn testimony filed recently as part of a class-action lawsuit against IBM, a former executive says she was ordered not to comply with a federal agency’s request that the company disclose the names of employees over 50 who’d been laid off from her business unit.

Catherine A. Rodgers, a vice president who was then IBM’s senior executive in Nevada, cited the order among several practices she said prompted her to warn IBM superiors the company was leaving itself open to allegations of age discrimination. She claims she was fired in 2017 because of her warnings.

Company spokesman Edward Barbini labeled Rodgers’ claims related to potential age discrimination “false,” adding that the reasons for her firing were “wholly unrelated to her allegations.”

Rodgers’ affidavit was filed Jan. 17 as part of a lawsuit in federal district court in New York. The suit cites a March 2018 ProPublica story that IBM engaged in a strategy designed to, in the words of one internal company document, “correct seniority mix” by flouting or outflanking U.S. anti-age discrimination laws to force out tens of thousands of older workers in the five years through 2017 alone.

Rodgers said in an interview Sunday that IBM “appears to be engaged in a concerted and disproportionate targeting of older workers.” She said that if the company releases the ages of those laid off, something required by federal law and that IBM did until 2014, “the facts will speak for themselves.”

“IBM is a data company. Release the data,” she said.

Rodgers is not a plaintiff in the New York case but intends to become one, said Shannon Liss-Riordan, the attorney for the employees.

IBM has not yet responded to Rodgers’ affidavit in the class-action suit. But in a filing in a separate age-bias lawsuit in federal district court in Austin, Texas, where a laid-off IBM sales executive introduced the document to bolster his case, lawyers for the company termed the order for Rodgers not to disclose the layoffs of older workers from her business unit “unremarkable.”

They said that the U.S. Department of Labor sought the names of the workers so it could determine whether they qualified for federal Trade Adjustment Assistance, or TAA, which provides jobless benefits and re-training to those who lose their jobs because of foreign competition. They said that company executives concluded that only one of about 10 workers whose names Rodgers had sought to provide qualified.

In its reporting, ProPublica found that IBM has gone to considerable lengths to avoid reporting its layoff numbers by, among other things, limiting its involvement in government programs that might require disclosure. Although the company has laid off tens of thousands of U.S. workers in recent years and shipped many jobs overseas, it sought and won TAA aid for just three during the past decade, government records show.

Company lawyers in the Texas case said that Rodgers, 62 at the time of her firing and a 39-year veteran of IBM, was let go in July 2017 because of "gross misconduct."

Rodgers said that she received “excellent” job performance reviews for decades before questioning IBM’s practices toward older workers. She rejected the misconduct charge as unfounded.

Legal action against IBM over its treatment of older workers appears to be growing. In addition to the suits in New York and Texas, cases are also underway in California, New Jersey and North Carolina.

Liss-Riordan, who has represented workers against a series of tech giants including Amazon, Google and Uber, has added 41 plaintiffs to the original three in the New York case and is asking the judge to require that IBM notify all U.S. workers whom it has laid off since July 2017 of the suit and of their option to challenge the company.

One complicating factor is that IBM requires departing employees who want to receive severance pay to sign a document waiving their right to take the company to court and limiting them to private, individual arbitration. Studies show this process rarely results in decisions that favor workers. To date, neither plaintiffs’ lawyers nor the government has challenged the legality of IBM’s waiver document.

Many ex-employees also don’t act within the 300-day federal statute of limitations for bringing a case. Of about 500 ex-employees who Liss-Riordan said contacted her since she filed the New York case last September, only 100 had timely claims and, of these, only about 40 had not signed the waivers and so were eligible to join the lawsuit. She said she’s filed arbitration cases for the other 60.

At key points, Rodgers’ account of IBM’s practices is similar to those reported by ProPublica. Among the parallels:

  • Rodgers said that all layoffs in her business unit were of older workers and that younger workers were unaffected. (ProPublica estimated that about 60 percent of the company’s U.S. layoffs from 2014 through 2017 were workers age 40 and above.)
  • She said that she and other managers were told to encourage workers flagged for layoff to use IBM’s internal hiring system to find other jobs in the company even as upper management erected insurmountable barriers to their being hired for these jobs.
  • Rodgers said the company reversed a decades long practice of encouraging employees to work from home and ordered many to begin reporting to a few “hub” offices around the country, a change she said appeared designed to prompt people to quit. She said that in one case an employee agreed to relocate to Connecticut only to be told to relocate again to North Carolina.

Barbini, the IBM spokesman, didn’t comment on individual elements of Rodgers’ allegations. Last year, he did not address a 10-page summary of ProPublica’s findings, but issued a statement that read in part, “We are proud of our company and our employees’ ability to reinvent themselves era after era, while always complying with the law.”

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Walgreens To Pay About $2 Million To Massachusetts To Settle Multiple Price Abuse Allegations. Other Settlement Payments Exceed $200 Million

Walgreens logo The Office of the Attorney General of the Commonwealth of Massachusetts announced two settlement agreements with Walgreens, a national pharmacy chain. Walgreens has agreed to pay about $2 million to settle multiple allegations of pricing abuses. According to the announcement:

"Under the first settlement, Walgreens will pay $774,486 to resolve allegations that it submitted claims to MassHealth in which it reported prices for certain prescription drugs at levels that were higher than what Walgreens actually charged, resulting in fraudulent overpayments."

"Under the second settlement, Walgreens will pay $1,437,366 to resolve allegations that from January 2006 through December 2017, rather than dispensing the quantity of insulin called for by a patient’s prescription, Walgreens exceeded the prescription amount and falsified information on claims submitted for reimbursement to MassHealth, including the quantity of insulin and/or days’ supply dispensed."

Both settlements arose from whistle-blower activity. MassHealth is the state's healthcare program based upon a state law passed in 2006 to provide health insurance to all Commonwealth residents. The law was amended in 2008 and 2010 to make it consistent with the federal Affordable Care Act.

Massachusetts Attorney General (AG) Maura Healey said:

"Walgreens repeatedly failed to provide MassHealth with accurate information regarding its dispensing and billing practices, resulting in overpayment to the company at taxpayers’ expense... We will continue to investigate cases of fraud and take action to protect the integrity of MassHealth."

In a separate case, Walgreen's will pay $1 million to the state of Arkansas to settle allegations of Medicaid fraud. Last month, the New York State Attorney General announced that New York State, other states, and the federal government reached:

"... an agreement in principle with Walgreens to settle allegations that Walgreens violated the False Claims Act by billing Medicaid at rates higher than its usual and customary (U&C) rates for certain prescription drugs... Walgreens will pay the states and federal government $60 million, all of which is attributable to the states’ Medicaid programs... The national federal and state civil settlement will resolve allegations relating to Walgreens’ discount drug program, known as the Prescription Savings Club (PSC). The investigation revealed that Walgreens submitted claims to the states’ Medicaid programs in which it identified U&C prices for certain prescription drugs sold through the PSC program that were higher than what Walgreens actually charged for those drugs... This is the second false claims act settlement reached with Walgreens today. On January 22, 2019, AG James announced that Walgreens is to pay New York over $6.5 million as part of a $209.2 million settlement with the federal government and other states, resolving allegations that Walgreens knowingly engaged in fraudulent conduct when it dispensed insulin pens..."

States involved in the settlement include New York, California, Illinois, Indiana, Michigan and Ohio. Kudos to all Attorneys General and their staffs for protecting patients against corporate greed.


Companies Want Your Location Data. Recent Examples: The Weather Channel And Burger King

Weather Channel logo It is easy to find examples where companies use mobile apps to collect consumers' real-time GPS location data, so they can archive and resell that information later for additional profits. First, ExpressVPN reported:

"The city of Los Angeles is suing the Weather Company, a subsidiary of IBM, for secretly mining and selling user location data with the extremely popular Weather Channel App. Stating that the app unfairly manipulates users into enabling their location settings for more accurate weather reports, the lawsuit affirms that the app collects and then sells this data to third-party companies... Citing a recent investigation by The New York Times that revealed more than 75 companies silently collecting location data (if you haven’t seen it yet, it’s worth a read), the lawsuit is basing its case on California’s Unfair Competition Law... the California Consumer Privacy Act, which is set to go into effect in 2020, would make it harder for companies to blindly profit off customer data... This lawsuit hopes to fine the Weather Company up to $2,500 for each violation of the Unfair Competition Law. With more than 200 million downloads and a reported 45+ million users..."

Long-term readers remember that a data breach in 2007 at IBM Inc. prompted this blog. It's not only internet service providers which collect consumers' location data. Advertisers, retailers, and data brokers want it, too.

Burger King logo Second, Burger King ran last month a national "Whopper Detour" promotion which offered customers a once-cent Whopper burger if they went near a competitor's store. News 5, the ABC News affiliate in Cleveland, reported:

"If you download the Burger King mobile app and drive to a McDonald’s store, you can get the penny burger until December 12, 2018, according to the fast-food chain. You must be within 600 feet of a McDonald's to claim your discount, and no, McDonald's will not serve you a Whopper — you'll have to order the sandwich in the Burger King app, then head to the nearest participating Burger King location to pick it up. More information about the deal can be found on the app on Apple and Android devices."

Next, the relevant portions from Burger King's privacy policy for its mobile apps (emphasis added):

"We collect information you give us when you use the Services. For example, when you visit one of our restaurants, visit one of our websites or use one of our Services, create an account with us, buy a stored-value card in-restaurant or online, participate in a survey or promotion, or take advantage of our in-restaurant Wi-Fi service, we may ask for information such as your name, e-mail address, year of birth, gender, street address, or mobile phone number so that we can provide Services to you. We may collect payment information, such as your credit card number, security code and expiration date... We also may collect information about the products you buy, including where and how frequently you buy them... we may collect information about your use of the Services. For example, we may collect: 1) Device information - such as your hardware model, IP address, other unique device identifiers, operating system version, and settings of the device you use to access the Services; 2) Usage information - such as information about the Services you use, the time and duration of your use of the Services and other information about your interaction with content offered through a Service, and any information stored in cookies and similar technologies that we have set on your device; and 3) Location information - such as your computer’s IP address, your mobile device’s GPS signal or information about nearby WiFi access points and cell towers that may be transmitted to us..."

So, for the low, low price of one hamburger, participants in this promotion gave RBI, the parent company which owns Burger King, perpetual access to their real-time location data. And, since RBI knows when, where, and how long its customers visit competitors' fast-food stores, it also knows similar details about everywhere else you go -- including school, work, doctors, hospitals, and more. Sweet deal for RBI. A poor deal for consumers.

Expect to see more corporate promotions like this, which privacy advocates call "surveillance capitalism."

Consumers' real-time location data is very valuable. Don't give it away for free. If you decide to share it, demand a fair, ongoing payment in exchange. Read privacy and terms-of-use policies before downloading mobile apps, so you don't get abused or taken. Opinions? Thoughts?


Pennsylvania Ruling May Help Plaintiffs in Class Action Lawsuits About Data Breaches

An article in the Lexology site by attorneys at Thompson Coburn LLP provides an important update about class-action lawsuits in Pennsylvania regarding data breaches and data security:

"One of the most insurmountable barriers for security breach class action plaintiffs has been the ability to show concrete damages. In order to bring a lawsuit, fundamentally, plaintiffs must have standing to sue. In federal court, this standing to sue is governed by Article III of the U.S. Constitution. The U.S. Supreme Court has articulated standing to sue as requiring (1) injury in fact, (2) fairly traceable to the defendant’s conduct, (3) that is likely redressed by a favorable decision... Proving a concrete and particularized injury therefore becomes difficult for plaintiffs... since it often becomes an individualized analysis of harms. Many state courts follow similar standing requirements as those articulated by the federal courts..."

The case involved a class-action lawsuit by employees against their employer, the University of Pittsburgh Medical Center (UPMC). The suit alleged that the sensitive personal and financial information for 62,000 current and former employees had been stolen, and that:

"... UPMC breached an implied contract and was negligent by failing to implement adequate security measures to safeguard information relating to employees."

The claims were dismissed by a trial court. The employees appealed that decision, and the appellate court agreed with the trial court's decision. The good news:

"... the Pennsylvania Supreme Court concluded the lower courts erred in determining UPMC did not owe a duty to safeguard the employees’ personal information and that the economic loss doctrine barred the negligence claim... While the Pennsylvania decision affects only Pennsylvania for the time being, anyone that collects or stores personal information should be aware that this could signal a new tide for security breach plaintiffs..."


Oath To Pay Almost $5 Million To Settle Charges By New York AG Regarding Children's Privacy Violations

Oath Inc. logo Barbara D. Underwood, the Attorney General (AG) for New York State, announced last week a settlement with Oath, Inc. for violating the Children’s Online Privacy Protection Act (COPPA). Oath Inc. is a wholly-owned subsidiary of Verizon Communications. Until June 2017, Oath was known as AOL Inc. ("AOL"). The announcement stated:

"The Attorney General’s Office found that AOL conducted billions of auctions for ad space on hundreds of websites the company knew were directed to children under the age of 13. Through these auctions, AOL collected, used, and disclosed personal information from the websites’ users in violation of COPPA, enabling advertisers to track and serve targeted ads to young children. The company has agreed to adopt comprehensive reforms to protect children from improper tracking and pay a record $4.95 million in penalties..."

The United States Congress enacted COPPA in 1998 to protect the safety and privacy of young children online. As many parents know, young children don't understand complicated legal documents such as terms-of-use and privacy policies. COPPA prohibits operators of certain websites from collecting, using, or disclosing personal information (e.g., first and last name, e-mail address) of children under the age of 13 without first obtaining parental consent.

The definition of "personal information" was revised in 2013 to include persistent identifiers that can be used to recognize a user over time and across websites, such as the ID found in a web browser cookie or an Internet Protocol (“IP”) address. The revision effectively prohibits covered operators from using cookies, IP addresses, and other persistent identifiers to track users across websites for most advertising purposes on COPPA-covered websites.

The announcement by AG Underwood explained the alleged violations in detail. Despite policies to the contrary:

"... AOL nevertheless used its display ad exchange to conduct billions of auctions for ad space on websites that it knew to be directed to children under the age of 13 and subject to COPPA. AOL obtained this knowledge in two ways. First, several AOL clients provided notice to AOL that their websites were subject to COPPA. These clients identified more than a dozen COPPA-covered websites to AOL. AOL conducted at least 1.3 billion auctions of display ad space from these websites. Second, AOL itself determined that certain websites were directed to children under the age of 13 when it conducted a review of the content and privacy policies of client websites. Through these reviews, AOL identified hundreds of additional websites that were subject to COPPA. AOL conducted at least 750 million auctions of display ad space from these websites."

AG Underwood said in a statement:

"COPPA is meant to protect young children from being tracked and targeted by advertisers online. AOL flagrantly violated the law – and children’s privacy – and will now pay the largest-ever penalty under COPPA. My office remains committed to protecting children online and will continue to hold accountable those who violate the law."

A check at press time of both the press and "company values" sections of Oath's site failed to find any mentions of the settlement. TechCrunch reported on December 4th:

"We reached out to Oath with a number of questions about this privacy failure. But a spokesman did not engage with any of them directly — emailing a short statement instead, in which it writes: "We are pleased to see this matter resolved and remain wholly committed to protecting children’s privacy online." The spokesman also did not confirm nor dispute the contents of the New York Times report."

Hmmm. Almost a week has passed since AG Underwood's December 4th announcement. You'd think that Oath management would have released a statement by now. Maybe Oath isn't as committed to children's online privacy as they claim. Something for parents to note.

The National Law Review provided some context:

"...in 2016, the New York AG concluded a two-year investigation into the tracking practices of four online publishers for alleged COPPA violations... As recently as September of this year, the New Mexico AG filed a lawsuit for alleged COPPA violations against a children's game app company, Tiny Lab Productions, and the online ad companies that work within Tiny Lab's, including those run by Google and Twitter... The Federal Trade Commission (FTC) continues to vigorously enforce COPPA, closing out investigations of alleged COPPA violations against smart toy manufacturer VTech and online talent search company Explore Talent... there have been a total of 28 enforcement proceedings since the COPPA rule was issued in 2000."

You can read about many of these actions in this blog, and how COPPA was strengthened in 2013.

So, the COPPA law works well and it is being vigorously enforced. Kudos to AG Underwood, her staff, and other states' AGs for taking these actions. What are your opinions about the AOL/Oath settlement?


Yahoo Agrees To $50 Million Payment To Settle 2013 Breach

Fortune magazine reported that Yahoo:

"... has agreed to pay a $50 million settlement to roughly 200 million people affected by the email service’s 2013 data breach... Up to 3 billion accounts had their emails and other personal information stolen in the hacking, but the settlement filed late Monday only applies to an estimated 1 billion accounts, held by 200 million people in the United States and Israel between 2012 and 2016... A hearing to approve this proposed end to the two-year lawsuit will be held in California on Nov. 29. If approved, the affected account holders will be emailed a notice."


Aetna To Pay More Than $17 Million To Resolve 2 Privacy Breaches

Aetna logo Aetna inked settlement agreements with several states, including New Jersey, to resolve disclosures of sensitive patient information. According to an announcement by the Attorney General for New Jersey, the settlement agreements resolve:

"... a multi-state investigation focused on two separate privacy breaches by Aetna that occurred in 2017 – one involving a mailing that potentially revealed information about addressees’ HIV/AIDS status, the other involving a mailing that potentially revealed individuals’ involvement in a study of patients with atrial fibrillation (or AFib)..."

Connecticut, Washington, and the District of Columbia joined with New Jersey for both the  investigation and settlement agreements. The multi-state investigation found:

"... that Aetna inadvertently disclosed HIV/AIDS-related information about thousands of individuals across the U.S. – including approximately 647 New Jersey residents – through a third-party mailing on July 28, 2017. The envelopes used in the mailing had an over-sized, transparent glassine address window, which revealed not only the recipients’ names and addresses, but also text that included the words “HIV Medications"... The second breach occurred in September 2017 and involved a mailing sent to 1,600 individuals concerning a study of patients with AFib. The envelopes for the mailing included the name and logo for the study – IMPACT AFib – which could have been interpreted as indicating that the addressee had an AFib diagnosis... Aetna not only violated the federal Health Insurance Portability and Accountability Act (HIPAA), but also state laws pertaining to the protected health information of individuals in general, and of persons with AIDS or HIV infection in particular..."

A class-action lawsuit filed on behalf of affected HIV/AIDS patients has been settled, pending approval from a federal court, which requires Aetna to pay about $17 million to resolve allegations. Terms of the multi-state settlement agreement require Aetna to pay a $365,211.59 civil penalty to New Jersey, and:

  • Implement policy, processes, and employee training reforms to both better protect persons' protected health information, and ensure mailings maintain persons' privacy; and
  • Hire an independent consultant to evaluate and report on its privacy protection practices, and to monitor its compliance with the terms of the settlement agreements.

CVS Health logo In December of last year, CVS Health and Aetna announced a merger agreement where CVS Health acquired Aetna for about $69 billion. Last week, CVS Health announced an expansion of its board of directors to include the addition of three directors from its Aetna unit. At press time, neither company's website mentioned the multi-state settlement agreement.


FTC: How You Should Handle Robocalls. 4 Companies Settle Regarding Privacy Shield Claims

First, it seems that the number of robocalls has increased during the past two years. Some automated calls are English. Some are in other languages. All try to trick consumers into sending money or disclosing sensitive financial and payment information. Advice from the U.S. Federal Trade Commission (FTC):

Second, the FTC announced a settlement agreement with four companies:

"In separate complaints, the FTC alleges that IDmission, LLC, mResource LLC (doing business as Loop Works, LLC), SmartStart Employment Screening, Inc., and VenPath, Inc. falsely claimed to be certified under the EU-U.S. Privacy Shield, which establishes a process to allow companies to transfer consumer data from European Union countries to the United States in compliance with EU law... The Department of Commerce administers the Privacy Shield framework, while the FTC enforces the promises companies make when joining the framework."

According to the lawsuits, IDmission, a cloud-based services firm, applied in 2017 for Privacy Shield certification with the U.S. Department of Commerce but never completed the necessary steps to be certified under the program. The other three companies each obtained Privacy Shield certification in 2016 but allowed their certifications to lapse. VenPath is a data analytics firm. SmartStart offers employment and background screening services. mResource provides talent management and recruitment services.

Terms of the settlement agreements prohibit all four companies from misrepresenting their participation in any privacy or data security program sponsored by the government. Also:

"... VenPath and SmartStart must also continue to apply the Privacy Shield protections to personal information they collected while participating in the program, protect it by another means authorized by the Privacy Shield framework, or return or delete the information within 10 days of the order."


Uber To Pay $148 Million To Settle Lawsuits And Coverup From Its 2016 Data Breach

Uber logo California-based Uber Technologies, Inc. has agreed to pay $148 million to settle lawsuits by several states' attorneys general regarding the ride-sharing service's massive data breach in 2016 where hackers stole information about 57 million Uber customers and drivers worldwide, including 600,000 U.S. driver's license numbers. The breach problems were compounded by allegations that Uber paid the hackers $100,000 for their silence, and by the company's failure to notify both state agencies and affected consumers about the breach.

Josh Shapiro, the Attorney General (AG) for the State of Pennsylvania, announced on the Wednesday the settlement agreement including a coalition of 51 state AGs:

"In November 2016, Uber learned that hackers had gained access to some personal information Uber maintains about its drivers, including drivers’ license information for about 600,000 drivers nationwide. Instead of reporting the breach to law enforcement and impacted individuals, Uber tracked down the hackers and obtained assurances that the hackers deleted the information – and made payments to ensure their silence... Since some of the compromised information – specifically driver’s license numbers – is considered personally identifiable information (PII), Uber was required to notify impacted individuals under the Pennsylvania Breach of Personal Information Notification Act. However, Uber failed to report the breach until November 2017."

13,500 Uber drivers in Pennsylvania were affected by the breach. Pennsylvania's share of the total payment is $5.7 million. Each Uber driver in Pennsylvania will receive $100.

48 states have data breach notification laws requiring various levels of notifications to both state officials and affected consumers, who need notice in order to take action to protect themselves and their sensitive personal and payment information.

Massachusetts' share of the total payment is $7.1 million, of which $6.5 million will be distributed to the Commonwealth’s General fund and $600,000 will be used to assist consumers and businesses. Massachusetts AG Maura Healey said:

"Uber failed to immediately report this data breach and tried to pay hush money to hackers. This settlement should be a lesson to other businesses that consumers have a right to know when their personal information has been compromised."

California's share of the total payment is $26 million. California AG  Xavier Becerra said:

"Uber’s decision to cover up this breach was a blatant violation of the public’s trust. The company failed to safeguard user data and notify authorities when it was exposed. Consistent with its corporate culture at the time, Uber swept the breach under the rug in deliberate disregard of the law. Companies in California and throughout the nation are entrusted with customers’ valuable private information. This settlement broadcasts to all of them that we will hold them accountable to protect their data."

San Francisco District Attorney George Gascon said:

"We wholeheartedly support innovative business models, but new ways of engaging in business cannot come at the expense of public safety or consumer privacy. This settlement today demonstrates what happens when all of us in law enforcement work together. My office will continue to collaborate closely with the Attorney General to protect consumers both in San Francisco, and the rest of California."

Terms of the settlement agreement require Uber and its executives to:

"1. Implement and maintain robust data security practices.
2. Comply with state laws in connection with its collection, maintenance, and safeguarding of personal information, as well as reporting of data security incidents.
3. Accurately and honestly represent data security and privacy practices to better ensure transparency in how the company’s driver and customer information is safeguarded.
4. Develop, implement, and maintain a comprehensive information security program with an executive officer who advises key executive staff and Uber’s Board of Directors.
5. Report any data security incidents to states on a quarterly basis for two years.
6. Maintain a Corporate Integrity Program that includes a hotline to report misconduct, quarterly reports to the board, implementation of privacy principles, and an annual code of conduct training".

Uber and its executives have a long history of sketchy behavior including the 'Greyball' worldwide program by executives to thwart code enforcement inspections by governments, dozens of employees fired or investigated for sexual harassment, a lawsuit describing how the company's mobile app allegedly scammed both riders and drivers, and privacy abuses with the 'God View' tool.

This breach settlement is another reminder that Uber and its executives deserve close monitoring and supervision.


Amid Accusations of Age Bias, IBM Winds Down a Push for Millennial Workers

[Editor's note: today's post, by reporters at ProPublica, updates a prior post about corporate hiring. A data breach in 2007 at IBM resulted in the creation of this blog. Today's post is reprinted with permission.]

By Peter Gosselin and Ariana Tobin, ProPublica

IBM logo Faced with a mounting pile of lawsuits accusing it of age discrimination — the latest, a class action, was filed this week in federal district court in New York — tech giant IBM appears to be winding down its Millennial Corps, an internal network of young employees that’s been cited in several legal complaints as evidence of the company’s bias toward younger workers.

ProPublica reported in March that IBM, which had annual revenue of $79 billion in 2017, had ousted an estimated 20,000 U.S. employees ages 40 or older in the past five years, in some instances using money saved from the departures to hire young replacements to, in the words of an internal company document, “correct seniority mix.”

IBM deployed several strategies to attract younger workers, establishing a digital platform catering to millennials, a blog called “The Millennial Experience,” a Twitter account, @IBMillennial, as well as creating the Millennial Corps, whose members company executives pledged to consult about major business moves. The Corps was featured in a 2016 FastCompany piece titled “These Millennials Have Become the Top Decision Makers at IBM.”

But company sources said this week that the internal millennial platform has had almost no entries in recent months and the only posting on the blog dates from at least a year ago. There have been no recent tweets from @IBMillennial. At least one of the Millennial Corps founders quoted in the FastCompany story about the network has left the company, as have several of those listed as Millennial Corps “ambassadors” on the internal platform.

An IBM spokesman did not respond to questions on the status of the Millennial Corps.

The class action was filed Monday on behalf of three former IBM employees who say the company discriminated against them based on their age by ousting them from their jobs and refusing to hire them for other slots. The complaint cites ProPublica’s article extensively in accusing IBM of “systematically laying off older employees in order to build a younger workforce.” The suit was filed by Boston lawyer Shannon Liss-Riordan, who has represented workers against such tech behemoths as Amazon, Google and Uber.

IBM responded to the filing by saying it has done nothing wrong in retooling its workforce to meet the challenges of an evolving tech landscape.

“Changes in our workforce are about skills, not age,” company spokesman Edward Barbini said in a statement. “In fact, since 2010 there is no difference in the age of our U.S. workforce.”

This week’s class action suit follows lawsuits filed against IBM on behalf of individuals in California, Georgia and Texas, as well as a nationwide investigation of age bias at the company by the U.S. Equal Employment Opportunity Commission, which administers the nation’s workplace anti-discrimination laws.

The Texas case, filed by 60-year-old former sales executive Jonathan Langley, accuses the company of laying him off after 24 years because of his age. In court papers, he said IBM “devoted countless millions of dollars to its effort to rebrand as a hip, Millennial-centric tech company” by, among other things, establishing the Millennial Corps.

An IBM spokesman has said the company will defend the Langley case vigorously and complies with all applicable laws.

The new class-action complaint is somewhat narrower than it at first appears, a reflection of complexities in the laws against age discrimination and legal protections IBM has erected for itself.

At the moment, the complaint seeks the right to represent older ex-IBM employees in just two states, California and North Carolina. Ex-employees in other states would have to sign up, or affirmatively opt in, to be covered. Liss-Riordan said in an email that individuals from other could be added to the class if other plaintiffs emerge.

In addition, the class action filed this week only seeks to represent ex-IBM employees who did not sign the company’s separation agreement when they were ousted.

ProPublica reported in March that IBM regularly denies older workers being laid off information that federal law says they’re entitled to in order to decide whether they have been victims of age bias. It does so by making severance pay contingent on departing employees signing separation agreements in which they give up their right to sue, and can then only pursue age claims through secret, individual arbitration.

Even with these limits on potential plaintiffs, experts on employment said the legal actions could have a substantial effect on IBM.

“If a judge approves class-action status, or any of the age-discrimination lawsuits filed against IBM recently proceed, the company is going to face a costly fight defending its treatment of older workers,” said Jeffrey Young, an Augusta, Maine, lawyer who has successfully sued major employers for age bias but isn’t representing any of the plaintiffs in the IBM cases.

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Verizon Throttled Mobile Services Of First Responders Fighting California Wildfires

Verizon logo Fighting fires is difficult, dangerous work. Recently, that was made worse by an internet service provider (ISP). Ars Technica reported:

"Verizon Wireless' throttling of a fire department that uses its data services has been submitted as evidence in a lawsuit that seeks to reinstate federal net neutrality rules. "County Fire has experienced throttling by its ISP, Verizon," Santa Clara County Fire Chief Anthony Bowden wrote in a declaration. "This throttling has had a significant impact on our ability to provide emergency services. Verizon imposed these limitations despite being informed that throttling was actively impeding County Fire's ability to provide crisis-response and essential emergency services." Bowden's declaration was submitted in an addendum to a brief filed by 22 state attorneys general, the District of Columbia, Santa Clara County, Santa Clara County Central Fire Protection District, and the California Public Utilities Commission. The government agencies are seeking to overturn the recent repeal of net neutrality rules in a lawsuit they filed against the Federal Communications Commission in the US Court of Appeals for the District of Columbia Circuit."

Reportedly, Verizon replied with a statement that the throttling, "was a customer service error." Huh? This is how Verizon treats first-responders? This is how an ISP treats first-responders during a major emergency and natural disaster? The wildfires have claimed 12 deaths, destroyed at least 1,200 homes, and wiped out the state's emergency fund. Smoke from the massive wildfires has caused extensive pollution and health warnings in Northwest areas including Portland, Oregon and Seattle, Washington. The thick smoke could be seen from space.

Ars Technica reported in an August 21 update:

"Santa Clara County disputed Verizon's characterization of the problem in a press release last night. "Verizon's throttling has everything to do with net neutrality—it shows that the ISPs will act in their economic interests, even at the expense of public safety," County Counsel James Williams said on behalf of the county and fire department. "That is exactly what the Trump Administration's repeal of net neutrality allows and encourages." "

In 2017, President Trump appointed Ajit Pai, a former Verizon attorney, as Chairman of the U.S. Federal Communications Commission. Under Pai's leadership, the FCC revoked both online privacy and net neutrality protections for consumers. This gave ISPs the freedom to do as they want online while consumers lost two key freedoms: a) the freedom to control the data describing their activities online (which are collected and shared with others by ISPs), and b) freedom to use the internet bandwidth purchased as they choose.

If an ISP will throttle and abuse first-responders, think of what it will do it regular consumers. What are your opinions?


Besieged Facebook Says New Ad Limits Aren’t Response to Lawsuits

[Editor's note: today's guest post, by reporters at ProPublica, is the latest in a series monitoring Facebook's attempts to clean up its advertising systems and tools. It is reprinted with permission.]

By Ariana Tobin and Jeremy B. Merrill, ProPublica

Facebook logo Facebook’s move to eliminate 5,000 options that enable advertisers on its platform to limit their audiences is unrelated to lawsuits accusing it of fostering housing and employment discrimination, the company said Wednesday.

“We’ve been building these tools for a long time and collecting input from different outside groups,” Facebook spokesman Joe Osborne told ProPublica.

Tuesday’s blog post announcing the elimination of categories that the company has described as “sensitive personal attributes” came four days after the Department of Justice joined a lawsuit brought by fair housing groups against Facebook in federal court in New York City. The suit contends that advertisers could use Facebook’s options to prevent racial and religious minorities and other protected groups from seeing housing ads.

Raising the prospect of tighter regulation, the Justice Department said that the Communications Decency Act of 1996, which gives immunity to internet companies from liability for content on their platforms, did not apply to Facebook’s advertising portal. Facebook has repeatedly cited the act in legal proceedings in claiming immunity from anti-discrimination law. Congress restricted the law’s scope in March by making internet companies more liable for ads and posts related to child sex-trafficking.

Around the same time the Justice Department intervened in the lawsuit, the Department of Housing and Urban Development (HUD) filed a formal complaint against Facebook, signaling that it had found enough evidence during an initial investigation to raise the possibility of legal action against the social media giant for housing discrimination. Facebook has said that its policies strictly prohibit discrimination, that over the past year it has strengthened its systems to protect against misuse, and that it will work with HUD to address the concerns.

“The Fair Housing Act prohibits housing discrimination including those who might limit or deny housing options with a click of a mouse,” Anna María Farías, HUD’s assistant secretary for fair housing and equal opportunity, said in a statement accompanying the complaint. “When Facebook uses the vast amount of personal data it collects to help advertisers to discriminate, it’s the same as slamming the door in someone’s face.”

Regulators in at least one state are also scrutinizing Facebook. Last month, the state of Washington imposed legally binding compliance requirements on the company, barring it from offering advertisers the option of excluding protected groups from seeing ads about housing, credit, employment, insurance or “public accommodations of any kind.”

Advertising is the primary source of revenue for the social media giant, which is under siege on several fronts. A recent study and media coverage have highlighted how hate speech and false rumors on Facebook have spurred anti-refugee discrimination in Germany and violence against minority ethnic groups such as the Rohingya in Myanmar. This week, Facebook said it had found evidence of Russian and Iranian efforts to influence elections in the U.S. and around the world through fake accounts and targeted advertising. It also said it had suspended more than 400 apps “due to concerns around the developers who built them or how the information people chose to share with the app may have been used.”

Facebook declined to identify most of the 5,000 options being removed, saying that the information might help bad actors game the system. It did say that the categories could enable advertisers to exclude racial and religious minorities, and it provided four examples that it deleted: “Native American culture,” “Passover,” “Evangelicalism” and “Buddhism.” It said the changes will be completed next month.

According to Facebook, these categories have not been widely used by advertisers to discriminate, and their removal is intended to be proactive. In some cases, advertisers legitimately use these categories to reach key audiences. According to targeting data from ads submitted to ProPublica’s Political Ad Collector project, Jewish groups used the “Passover” category to promote Jewish cultural events, and the Michael J. Fox Foundation used it to find people of Ashkenazi Jewish ancestry for medical research on Parkinson’s disease.

Facebook is not limiting advertisers’ options for narrowing audiences by age or sex. The company has defended age-based targeting in employment ads as beneficial for employers and job seekers. Advertisers may also still target or exclude by ZIP code — which critics have described as “digital red-lining” but Facebook says is standard industry practice.

A pending suit in federal court in San Francisco alleges that, by allowing employers to target audiences by age, Facebook is enabling employment discrimination against older job applicants. Peter Romer-Friedman, a lawyer representing the plaintiffs in that case, said that Facebook’s removal of the 5,000 options “is a modest step in the right direction.” But allowing employers to sift job seekers by age, he added, “shows what Facebook cares about: its bottom line. There is real money in age-restricted discrimination.”

Senators Bob Casey of Pennsylvania and Susan Collins of Maine have asked Facebook for more information on what steps it is taking to prevent age discrimination on the site.

The issue of discriminatory advertising on Facebook arose in October 2016 when ProPublica revealed that advertisers on the platform could narrow their audiences by excluding so-called “ethnic affinity” categories such as African-Americans and Spanish-speaking Hispanics. At the time, Facebook promised to build a system to flag and reject such ads. However, a year later, we bought dozens of rental housing ads that excluded protected categories. They were approved within seconds. So were ads that excluded older job seekers, as well as ads aimed at anti-Semitic categories such as “Jew hater.”

The removal of the 5,000 options isn’t Facebook’s first change to its advertising portal in response to such criticism. Last November, it added a self-certification option, which asks housing advertisers to check a box agreeing that their advertisement is not discriminatory. The company also plans to require advertisers to read educational material on the site about ethical practices.

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Federal Reserve Board Fined Citigroup For Mishandling Residential Mortgages

Citibank logo The Federal Reserve Board (FRB) announced on Friday that it had fined Citigroup $8.6 million for the "improper execution of residential mortgage-related documents" in a subsidiary. The announcement explained:

"The $8.6 million penalty addresses the deficient execution and notarization of certain mortgage-related affidavits prepared by a subsidiary, CitiFinancial. The improper practices occurred in 2015 and were corrected. CitiFinancial exited the mortgage servicing business in 2017.

Also on Friday, the Board announced the termination of an enforcement action from 2011 against Citigroup and CitiFinancial related to residential mortgage loan servicing. The termination of this action was based on evidence of sustainable improvements."

In 2014, Citigroup paid $7 billion to settle allegations by the Department of Justice (DOJ) and several states attorneys general (AGs) that the bank mislead investors about toxic mortgage-backed securities. So, sloppy or shoddy handling of mortgage paperwork  will get a bank fined. Good. There must be consequences when consumers are abused.

Earlier this month, Wells Fargo admitted to software bugs in its systems which led to the bank accidentally foreclosing on residential homeowners it shouldn't have. 400 homeowners lost their homes. Untold consumers' credit ratings wrecked. That sounds like shabby mortgage paperwork handling, too -- definitely worth a larger fine. What do you think?


How the Case for Voter Fraud Was Tested — and Utterly Failed

[Editor's note: today's blog post, by reporters at ProPublica, explores the results of a trial in Kansas about the state's voter-ID laws and claims of voter fraud. It is reprinted with permission.]

By Jessica Huseman, ProPublica

In the end, the decision seemed inevitable. After a seven-day trial in Kansas City federal court in March, in which Kansas Secretary of State Kris Kobach needed to be tutored on basic trial procedure by the judge and was found in contempt for his “willful failure” to obey a ruling, even he knew his chances were slim. Kobach told The Kansas City Star at the time that he expected the judge would rule against him (though he expressed optimism in his chances on appeal).

Sure enough, federal Judge Julie Robinson overturned the law that Kobach was defending as lead counsel for the state, dealing him an unalloyed defeat. The statute, championed by Kobach and signed into law in 2013, required Kansans to present proof of citizenship in order to register to vote. The American Civil Liberties Union sued, contending that the law violated the National Voter Registration Act (AKA the “motor voter” law), which was designed to make it easy to register.

The trial had a significance that extends far beyond the Jayhawk state. One of the fundamental questions in the debate over alleged voter fraud — whether a substantial number of non-citizens are in fact registering to vote — was one of two issues to be determined in the Kansas proceedings. (The second was whether there was a less burdensome solution than what Kansas had adopted.) That made the trial a telling opportunity to remove the voter fraud claims from the charged, and largely proof-free, realms of political campaigns and cable news shoutfests and examine them under the exacting strictures of the rules of evidence.

That’s precisely what occurred and according to Robinson, an appointee of George W. Bush, the proof that voter fraud is widespread was utterly lacking. As the judge put it, “the court finds no credible evidence that a substantial number of non-citizens registered to vote” even under the previous law, which Kobach had claimed was weak.

For Kobach, the trial should’ve been a moment of glory. He’s been arguing for a decade that voter fraud is a national calamity. Much of his career has been built on this issue, along with his fervent opposition to illegal immigration. (His claim is that unlawful immigrants are precisely the ones voting illegally.) Kobach, who also co-chaired the Trump administration’s short-lived commission on voter fraud, is perhaps the individual most identified with the cause of sniffing out and eradicating phony voter registration. He’s got a gilded resume, with degrees from Harvard University, Yale Law School and the University of Oxford, and is seen as both the intellect behind the cause and its prime advocate. Kobach has written voter laws in other jurisdictions and defended them in court. If anybody ever had time to marshal facts and arguments before a trial, it was Kobach.

But things didn’t go well for him in the Kansas City courtroom, as Robinson’s opinion made clear. Kobach’s strongest evidence of non-citizen registration was anemic at best: Over a 20-year period, fewer than 40 non-citizens had attempted to register in one Kansas county that had 130,000 voters. Most of those 40 improper registrations were the result of mistakes or confusion rather than intentional attempts to mislead, and only five of the 40 managed to cast a vote.

One of Kobach’s own experts even rebutted arguments made by both Kobach and President Donald Trump. The expert testified that a handful of improper registrations could not be extrapolated to conclude that 2.8 million fraudulent votes — roughly, the gap between Hillary Clinton and Trump in the popular vote tally — had been cast in the 2016 presidential election. Testimony from a second key expert for Kobach also fizzled.

As the judge’s opinion noted, Kobach insisted the meager instances of cheating revealed at trial are just “the tip of the iceberg.” As she explained, “This trial was his opportunity to produce credible evidence of that iceberg, but he failed to do so.” Dismissing the testimony by Kobach’s witnesses as unpersuasive, Robinson drew what she called “the more obvious conclusion that there is no iceberg; only an icicle largely created by confusion and administrative error.”

By the time the trial was over, Kobach, a charismatic 52-year-old whose broad shoulders and imposing height make him resemble an aging quarterback, seemed to have shrunk inside his chair at the defense table.

But despite his defeat, Kobach’s causes — restricting immigration and tightening voting requirements — seem to be enjoying favorable tides elsewhere. Recent press accounts noted Kobach’s role in restoring a question about citizenship, abandoned since 1950, to U.S. Census forms for 2020. And the Supreme Court ruled on June 11 that the state of Ohio can purge voters from its rolls when they fail to vote even a single time and don’t return a mailing verifying their address, a provision that means more voters will need to re-register and prove their eligibility again.

For his own part, Kobach is now a candidate for governor of Kansas, running neck and neck with the incumbent in polls for the Republican primary on Aug. 7. It’s not clear whether the verdict will affect his chances — or whether it will lead him and others to quietly retreat from claims of voter fraud. But the judge’s opinion and expert interviews reveal that Kobach effectively put the concept of mass voter fraud to the test — and the evidence crumbled.

Perhaps it was an omen. Before Kobach could enter the courtroom inside the Robert J. Dole U.S. Courthouse each day, he had to pass through a hallway whose walls featured a celebratory display entitled “Americans by Choice: The Story of Immigration and Citizenship in Kansas.” Photographs of people who’d been sworn in as citizens in that very courthouse were superimposed on the translucent window shades.

Public interest in the trial was high. The seating area quickly filled to capacity on the first day of trial on the frigid morning of March 6. The jury box was opened to spectators; it wouldn’t be needed, as this was a bench trial. Those who couldn’t squeeze in were sent to a lower floor, where a live feed had been prepared in a spillover room.

From the moment the trial opened, Kobach and his co-counsels in the Kansas secretary of state’s office, Sue Becker and Garrett Roe, stumbled over the most basic trial procedures. Their mistakes antagonized the judge. “Evidence 101,” Robinson snapped, only minutes into the day, after Kobach’s team attempted to improperly introduce evidence. “I’m not going to do it.”

Matters didn’t improve for Kobach from there.

Throughout the trial, his team’s repeated mishaps and botched cross examinations cost hours of the court’s time. Robinson was repeatedly forced to step into the role of law professor, guiding Kobach, Becker and Roe through courtroom procedure. “Do you know how to do the next step, if that’s what you’re going to do?” the judge asked Becker at one point, as she helped her through the steps of impeaching a witness. “We’re going to follow the rules of evidence here.”

Becker often seemed nervous. She took her bright red glasses off and on. At times she burst into nervous chuckles after a misstep. She laughed at witnesses, skirmished with the judge and even taunted the lawyers for the ACLU. “I can’t wait to ask my questions on Monday!” she shouted at the end of the first week, jabbing a finger in the direction of Dale Ho, the lead attorney for the plaintiffs. Ho rolled his eyes.

Roe was gentler — deferential, even. He often admitted he didn’t know what step came next, asking the judge for help. “I don’t — I don’t know if this one is objectionable. I hope it’s not,” he offered at one point, as he prepared to ask a question following a torrent of sustained objections. “I’ll let you know,” an attorney for the plaintiffs responded, to a wave of giggles in the courtroom. On the final day of trial, as Becker engaged in yet another dispute with the judge, Roe slapped a binder to his forehead and audibly whispered, “Stop talking. Stop talking.”

Kobach’s cross examinations were smoother and better organized, but he regularly attempted to introduce exhibits — for example, updated state statistics that he had failed to provide the ACLU in advance to vet — that Robinson ruled were inadmissible. As the trial wore on, she became increasingly irritated. She implored Kobach to “please read” the rules on which she based her rulings, saying his team had repeated these errors “ad nauseum.”

Kobach seemed unruffled. Instead of heeding her advice, he’d proffer the evidence for the record, a practice that allows the evidence to be preserved for appeal even if the trial judge refuses to admit it. Over the course of the trial, Kobach and his team would do this nearly a dozen times.

Eventually, Robinson got fed up. She asked Kobach to justify his use of proffers. Kobach, seemingly alarmed, grabbed a copy of the Federal Rules of Civil Procedure — to which he had attached a growing number of Post-it notes — and quickly flipped through it, trying to find the relevant rule.

The judge tried to help. “It’s Rule 26, of course, that’s been the basis for my rulings,” she told Kobach. “I think it would be helpful if you would just articulate under what provision of Rule 26 you think this is permissible.” Kobach seemed to play for time, asking clarifying questions rather than articulating a rationale. Finally, the judge offered mercy: a 15-minute break. Kobach’s team rushed from the courtroom.

It wasn’t enough to save him. In her opinion, Robinson described “a pattern and practice by Defendant [Kobach] of flaunting disclosure and discovery rules.” As she put it, “it is not clear to the Court whether Defendant repeatedly failed to meet his disclosure obligations intentionally or due to his unfamiliarity with the federal rules.” She ordered Kobach to attend the equivalent of after-school tutoring: six hours of extra legal education on the rules of civil procedure or the rules of evidence (and to present the court with a certificate of completion).

It’s always a bad idea for a lawyer to try the patience of a judge — and that’s doubly true during a bench trial, when the judge will decide not only the law, but also the facts. Kobach repeatedly annoyed Robinson with his procedural mistakes. But that was nothing next to what the judge viewed as Kobach’s intentional bad faith.

This view emerged in writing right after the trial — that’s when Robinson issued her ruling finding Kobach in contempt — but before the verdict. And the conduct that inspired the contempt finding had persisted over several years. Robinson concluded that Kobach had intentionally failed to follow a ruling she issued in 2016 that ordered him to restore the privileges of 17,000 suspended Kansas voters.

In her contempt ruling, the judge cited Kobach’s “history of noncompliance” with the order and characterized his explanations for not abiding by it as “nonsensical” and “disingenuous.” She wrote that she was “troubled” by Kobach’s “failure to take responsibility for violating this Court’s orders, and for failing to ensure compliance over an issue that he explicitly represented to the Court had been accomplished.” Robinson ordered Kobach to pay the ACLU’s legal fees for the contempt proceeding.

That contempt ruling was actually the second time Kobach was singled out for punishment in the case. Before the trial, a federal magistrate judge deputized to oversee the discovery portion of the suit fined him $1,000 for making “patently misleading representations” about a voting fraud document Kobach had prepared for Trump. Kobach paid the fine with a state credit card.

More than any procedural bumbling, the collapse of Kobach’s case traced back to the disintegration of a single witness.

The witness was Jesse Richman, a political scientist from Old Dominion University, who has written studies on voter fraud. For this trial, Richman was paid $5,000 by the taxpayers of Kansas to measure non-citizen registration in the state. Richman was the man who had to deliver the goods for Kobach.

With his gray-flecked beard and mustache, Richman looked the part of an academic, albeit one who seemed a bit too tall for his suit and who showed his discomfort in a series of awkward, sudden movements on the witness stand. At moments, Richman’s testimony turned combative, devolving into something resembling an episode of The Jerry Springer Show. By the time he left the stand, Richman had testified for more than five punishing hours. He’d bickered with the ACLU’s lawyer, raised his voice as he defended his studies and repeatedly sparred with the judge.

“Wait, wait, wait!” shouted Robinson at one point, silencing a verbal free-for-all that had erupted among Richman, the ACLU’s Ho, and Kobach, who were all speaking at the same time. “Especially you,” she said, turning her stare to Richman. “You are not here to be an advocate. You are not here to trash the plaintiff. And you are not here to argue with me.”

Richman had played a small but significant part in the 2016 presidential campaign. Trump and others had cited his work to claim that illegal votes had robbed Trump of the popular vote. At an October 2016 rally in Wisconsin, the candidate cited Richman’s work to bolster his predictions that the election would be rigged. “You don’t read about this, right?” Trump told the crowd, before reading from an op-ed Richman had written for The Washington Post: “‘We find that this participation was large enough to plausibly account for Democratic victories in various close elections.’ Okay? All right?”

Richman’s 2014 study of non-citizen registration used data from the Cooperative Congressional Election Study — an online survey of more than 32,000 people. Of those, fewer than 40 individuals indicated they were non-citizens registered to vote. Based on that sample, Richman concluded that up to 2.8 million illegal votes had been cast in 2008 by non-citizens. In fact, he put the illegal votes at somewhere between 38,000 and 2.8 million — a preposterously large range — and then Trump and others simply used the highest figure.

Academics pilloried Richman’s conclusions. Two hundred political scientists signed an open letter criticizing the study, saying it should “not be cited or used in any debate over fraudulent voting.” Harvard’s Stephen Ansolabehere, who administered the CCES, published his own peer-reviewed paper lambasting Richman’s work. Indeed, by the time Trump read Richman’s article onstage in 2016, The Washington Post had already appended a note to the op-ed linking to three rebuttals and a peer-reviewed study debunking the research.

None of that discouraged Kobach or Trump from repeating Richman’s conclusions. They then went a few steps further. They took the top end of the range for the 2008 election, assumed that it applied to the 2016 election, too, and further assumed that all of the fraudulent ballots had been cast for Clinton.

Some of those statements found their way into the courtroom, when Ho pressed play on a video shot by The Kansas City Star on Nov. 30, 2016. Kobach had met with Trump 10 days earlier and had brought with him a paper decrying non-citizen registration and voter fraud. Two days later, Trump tweeted that he would have won the popular vote if not for “millions of people who voted illegally.”

On the courtroom’s televisions, Kobach appeared, saying Trump’s tweet was “absolutely correct.” Without naming Richman, Kobach referred to his study: The number of non-citizens who said they’d voted in 2008 was far larger than the popular vote margin, Kobach said on the video. The same number likely voted again in 2016.

In the courtroom, Ho asked Richman if he believed his research supported such a claim. Richman stammered. He repeatedly looked at Kobach, seemingly searching for a way out. Ho persisted and finally, Richman gave his answer: “I do not believe my study provides strong support for that notion.”

To estimate the number of non-citizens voting in Kansas, Richman had used the same methodology he employed in his much-criticized 2014 study. Using samples as small as a single voter, he’d produced surveys with wildly different estimates of non-citizen registration in the state. The multiple iterations confused everyone in the courtroom.

“For the record, how many different data sources have you provided?” Robinson interjected in the middle of one Richman answer. “You provide a range of, like, zero to 18,000 or more.”

“I sense the frustration,” Richman responded, before offering a winding explanation of the multiple data sources and surveys he’d used to arrive at a half-dozen different estimates. Robinson cut him off. “Maybe we need to stop here,” she said.

“Your honor, let me finish answering your question,” he said.

“No, no. I’m done,” she responded, as he continued to protest. “No. Dr. Richman, I’m done.”

To refute Richman’s numbers, the ACLU called on Harvard’s Ansolabehere, whose data Richman had relied on in the past. Ansolabehere testified that Richman’s sample sizes were so small that it was just as possible that there were no non-citizens registered to vote in Kansas as 18,000. “There’s just a great deal of uncertainty with these estimates,” he said.

Ho asked if it would be accurate to say that Richman’s data “shows a rate of non-citizen registration in Kansas that is not statistically distinct from zero?”

“Correct.”

The judge was harsher than Ansolabehere in her description of Richman’s testimony. In her opinion, Robinson unloaded a fusillade of dismissive adjectives, calling Richman’s conclusions “confusing, inconsistent and methodologically flawed,” and adding that they were “credibly dismantled” by Ansolabehere. She labeled elements of Richman’s testimony “disingenuous” and “misleading,” and stated that she gave his research “no weight” in her decision.

One of the paradoxes of Kobach is that he has become a star in circles that focus on illegal immigration and voting fraud despite poor results in the courtroom. By ProPublica’s count, Kobach chalked up a 2–6 won-lost record in federal cases in which he was played a major role, and which reached a final disposition before the Kansas case.

Those results occurred when Kobach was an attorney for the legal arm of the Federation for American Immigration Reform from 2004 to 2011, when he became secretary of state in Kansas. In his FAIR role (in which he continued to moonlight till about 2014), Kobach traveled to places like Fremont, Nebraska, Hazleton, Pennsylvania, Farmers Branch, Texas, and Valley Park, Missouri, to help local governments write laws that attempted to hamper illegal immigration, and then defend them in court. Kobach won in Nebraska, but lost in Texas and Pennsylvania, and only a watered down version of the law remains in Missouri.

The best-known law that Kobach helped shape before joining the Kansas government in 2011 was Arizona’s “show me your papers” law. That statute allowed police to demand citizenship documents for any reason from anyone they thought might be in the country illegally. After it passed, the state paid Kobach $300 an hour to train law enforcement on how to legally arrest suspected illegal immigrants. The Supreme Court gutted key provisions of the law in 2012.

Kobach also struggled in two forays into political campaigning. In 2004, he lost a race for Congress. He also drew criticism for his stint as an informal adviser to Mitt Romney’s 2012 presidential campaign. Kobach was the man responsible for Romney’s much-maligned proposal that illegal immigrants “self-deport,” one reason Romney attracted little support among Latinos. Romney disavowed Kobach even before the campaign was over, telling media outlets that he was a “supporter,” not an adviser.

Trump’s election meant Kobach’s positions on immigration would be welcome in the White House. Kobach lobbied for, but didn’t receive, an appointment as Secretary of Homeland Security. He was, however, placed in charge of the voter fraud commission, a pet project of Trump’s. Facing a raft of lawsuits and bad publicity, the commission was disbanded little more than six months after it formally launched.

Back at home, Kobach expanded his power as secretary of state. Boasting of his experience as a law professor and scholar, Kobach convinced the state legislature to give him the authority to prosecute election crimes himself, a power wielded by no other secretary of state. In that role, he has obtained nine guilty pleas against individuals for election-related misdemeanors. Only one of those who pleaded guilty, as it happens, was a non-citizen.

He also persuaded Kansas’ attorney general to allow Kobach to represent the state in the trial of Kansas’ voting law. Kobach argued it was a bargain. As he told The Wichita Eagle at the time, “The advantage is the state gets an experienced appellate litigator who is a specialist in this field and in constitutional law for the cost the state is already paying, which is my salary.”

Kobach fared no better in the second main area of the Kansas City trial than he had in the first. This part explored whether there is a less burdensome way of identifying non-citizens than forcing everyone to show proof of citizenship upon registration. Judge Robinson would conclude that there were many alternatives that were less intrusive.

In his opening, Ho of the ACLU spotlighted a potentially less intrusive approach. Why not use the Department of Homeland Security’s Systematic Alien Verification for Entitlements System list, and compare the names on it to the Kansas voter rolls? That, Ho argued, could efficiently suss out illegal registrations.

Kobach told the judge that simply wasn’t feasible. The list, he explained, doesn’t contain all non-citizens in the country illegally — it contains only non-citizens legally present and those here illegally who register in some way with the federal government. Plus, he told Robinson, in order to really match the SAVE list against a voter roll, both datasets would have to contain alien registration numbers, the identifier given to non-citizens living in the U.S. “Those are things that a voter registration system doesn’t have,” he said. “So, the SAVE system does not work.”

But Kobach had made the opposite argument when he headed the voter fraud commission. There, he’d repeatedly advocated the use of the SAVE database. Appearing on Fox News in May 2017, shortly after the commission was established, Kobach said, “The Department of Homeland Security knows of the millions of aliens who are in the United States legally and that data that’s never been bounced against the state’s voter rolls to see whether these people are registered.” He said the federal databases “can be very valuable.”

A month later, as chief of the voting fraud commission, Kobach took steps to compare state information to the SAVE database. He sent a letter to all 50 secretaries of state requesting their voter rolls. Bipartisan outrage ensued. Democrats feared he would use the rolls to encourage states to purge legitimately registered voters. Republicans labelled the request federal overreach.

At trial, Kobach’s main expert on this point was Hans von Spakovsky, another member of the voter fraud commission. He, too, had been eager in commission meetings to match state voter rolls to the SAVE database.

But like Kobach, von Spakovsky took a different tack at trial. He testified that this database was unusable by elections offices. “In your experience and expertise as an election administrator and one who studies elections,” Kobach asked, “is [the alien registration number] a practical or even possible thing for a state to do in its voter registration database?” Von Spakovsky answered, “No, it is not.”

Von Spakovsky and Kobach have been friends for more than a decade. They worked together at the Department of Justice under George W. Bush. Kobach focused on immigration issues — helping create a database to register visitors to the U.S. from countries associated with terrorism — while von Spakovsky specialized in voting issues; he had opposed the renewal of the Voting Rights Act.

Von Spakovsky’s history as a local elections administrator in Fairfax County, Va., qualified him as an expert on voting fraud. Between 2010 and 2012, while serving as vice chairman of the county’s three-member electoral board, he’d examined the voter rolls and found what he said were 300 registered non-citizens. He’d pressed for action against them, but none came. Von Spakovsky later joined the Heritage Foundation, where he remains today, generating research that underpins the arguments of those who claim mass voter fraud.

Like Richman, von Spakovsky seemed nervous on the stand, albeit not combative. He wore wire-rimmed glasses and a severe, immovable expression. Immigration is a not-so-distant feature of his family history: His parents — Russian and German immigrants — met in a refugee camp in American-occupied Germany after World War II before moving to the U.S.

Von Spakovsky had the task of testifying about what was intended to be a key piece of evidence for Kobach’s case: a spreadsheet of 38 non-citizens who had registered to vote, or attempted to register, in a 20-year period in Sedgwick County, Kansas.

But the 38 non-citizens turned out to be something less than an electoral crime wave. For starters, some of the 38 had informed Sedgwick County that they were non-citizens. One woman had sent her registration postcard back to the county with an explanation that it was a “mistake” and that she was not a citizen. Another listed an alien registration number — which tellingly begins with an “A” — instead of a Social Security number on the voter registration form. The county registered her anyway.

When von Spakovsky took the stand, he had to contend with questions that suggested he had cherry-picked his data. (The judge would find he had.) In his expert report, von Spakovsky had referenced a 2005 report by the Government Accountability Office that polled federal courts to see how many non-citizens had been excused from jury duty for being non-citizens — a sign of fraud, because jurors are selected from voter rolls. The GAO report mentioned eight courts. Only one said it had a meaningful number of jury candidates who claimed to be non-citizens: “between 1 and 3 percent” had been dismissed on these grounds. This was the only court von Spakovsky mentioned in his expert report.

His report also cited a 2012 TV news segment from an NBC station in Fort Myers, Fla. Reporters claimed to have discovered more than 100 non-citizens on the local voter roll.

“Now, you know, Mr. von Spakovsky, don’t you, that after this NBC report there was a follow-up by the same NBC station that determined that at least 35 of those 100 individuals had documentation to prove they were, in fact, United States citizens. Correct?” Ho asked. “I am aware of that now, yes,” von Spakovsky replied.

That correction had been online since 2012 and Ho had asked von Spakovsky the same question almost two years before in a deposition before the trial. But von Spakovsky never corrected his expert report.

Under Ho’s questioning, von Spakovsky also acknowledged a false assertion he made in 2011. In a nationally syndicated column for McClatchy, von Spakovsky claimed a tight race in Missouri had been decided by the illegal votes of 50 Somali nationals. A month before the column was published, a Missouri state judge ruled that no such thing had happened.

On the stand, von Spakovsky claimed he had no knowledge of the ruling when he published the piece. He conceded that he never retracted the assertion.

Kobach, who watched the exchange without objection, had repeatedly made the same claim — even after the judge ruled it was false. In 2011, Kobach wrote a series of columns using the example as proof of the need for voter ID, publishing them in outlets ranging from the Topeka Capital-Journal to the Wall Street Journal and the Washington Post. In 2012, he made the claim in an article published in the Syracuse Law Review. In 2013, he wrote an op-ed for the Kansas City Star with the same example: “The election was stolen when Rizzo received about 50 votes illegally cast by citizens of Somalia.” None of those articles have ever been corrected.

Ultimately, Robinson would lacerate von Spakovsky’s testimony, much as she had Richman’s. Von Spakovsky’s statements, the judge wrote, were “premised on several misleading and unsupported examples” and included “false assertions.” As she put it, “His generalized opinions about the rates of noncitizen registration were likewise based on misleading evidence, and largely based on his preconceived beliefs about this issue, which has led to his aggressive public advocacy of stricter proof of citizenship laws.”

There was one other wobbly leg holding up the argument that voter fraud is rampant: the very meaning of the word “fraud.”

Kobach’s case, and the broader claim, rely on an extremely generous definition. Legal definitions of fraud require a person to knowingly be deceptive. But both Kobach and von Spakovsky characterized illegal ballots as “fraud” regardless of the intention of the voter.

Indeed, the nine convictions Kobach has obtained in Kansas are almost entirely made up of individuals who didn’t realize they were doing something wrong. For example, there were older voters who didn’t understand the restrictions and voted in multiple places they owned property. There was also a college student who’d forgotten she’d filled out an absentee ballot in her home state before voting months later in Kansas. (She voted for Trump both times.)

Late in the trial, the ACLU presented Lorraine Minnite, a professor at Rutgers who has written extensively about voter fraud, as a rebuttal witness. Her book, “The Myth of Voter Fraud,” concluded that almost all instances of illegal votes can be chalked up to misunderstandings and administrative error.

Kobach sent his co-counsel, Garrett Roe, to cross-examine her. “It’s your view that what matters is the voter’s knowledge that his or her action is unlawful?” Roe asked. “In a definition of fraud, yes,” said Minnite. Roe pressed her about this for several questions, seemingly surprised that she wouldn’t refer to all illegal voting as fraud.

Minnite stopped him. “The word ‘fraud’ has meaning, and that meaning is that there’s intent behind it. And that’s actually what Kansas laws are with respect to illegal voting,” she said. “You keep saying my definition” she said, putting finger quotes around “my.” “But, you know, it’s not like it’s a freak definition.”

Kobach had explored a similar line of inquiry with von Spakovsky, asking him if the list of 38 non-citizens he’d reviewed could be absolved of “fraud” because they may have lacked intent.

“No,” von Spakovsky replied, “I think any time a non-citizen registers, any time a non-citizen votes, they are — whether intentionally or by accident, I mean — they are defrauding legitimate citizens from a fair election.”

After Kobach concluded his questions, the judge began her own examination of von Spakovsky.

“I think it’s fair to say there’s a pretty good distinction in terms of how the two of you define fraud,” the judge said, explaining that Minnite focused on intent, while she understood von Spakovsky’s definition to include any time someone who wasn’t supposed to vote did so, regardless of reason. “Would that be a fair characterization?” she asked.

“Yes ma’am,” von Spakovsky replied.

The judge asked whether a greater number of legitimate voters would be barred from casting ballots under the law than fraudulent votes prevented. In that scenario, she asked, “Would that not also be defrauding the electoral process?” Von Spakovsky danced around the answer, asserting that one would need to answer that question in the context of the registration requirements, which he deemed reasonable.

The judge cut him off. “Well that doesn’t really answer my question,” she said, saying that she found it contradictory that he wanted to consider context when examining the burden of registration requirements, but not when examining the circumstances in which fraud was committed.

“When you’re talking about … non-citizen voting, you don’t want to consider that in context of whether that person made a mistake, whether a DMV person convinced them they should vote,” she said. Von Spakovsky allowed that not every improper voter should be prosecuted, but insisted that “each ballot they cast takes away the vote of and dilutes the vote of actual citizens who are voting. And that’s —”

The judge interrupted again. “So, the thousands of actual citizens that should be able to vote but who are not because of the system, because of this law, that’s not diluting the vote and that’s not impairing the integrity of the electoral process, I take it?” she said.

Von Spakovsky didn’t engage with the hypothetical. He simply didn’t believe it was happening. “I don’t believe that this requirement prevents individuals who are eligible to register and vote from doing so.” Later, on the stand, he’d tell Ho he couldn’t think of a single law in the country that he felt negatively impacted anyone’s ability to register or vote.

Robinson, in the end, strongly disagreed. As she wrote in her opinion, “the Court finds that the burden imposed on Kansans by this law outweighs the state’s interest in preventing noncitizen voter fraud, keeping accurate voter rolls, and maintaining confidence in elections. The burden is not just on a ‘few voters,’ but on tens of thousands of voters, many of whom were disenfranchised” by Kobach’s law. The law, she concluded, was a bigger problem than the one it set out to solve, acting as a “deterrent to registration and voting for substantially more eligible Kansans than it has prevented ineligible voters from registering to vote.”

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The DIY Revolution: Consumers Alter Or Build Items Previously Not Possible. Is It A Good Thing?

Recent advances in technology allow consumers to alter, customize, or build locally items previously not possible. These items are often referred to as Do-It-Yourself (DIY) products. You've probably heard DIY used in home repair and renovation projects on television. DIY now happens in some unexpected areas. Today's blog post highlights two areas.

DIY Glucose Monitors

Earlier this year, CNet described the bag an eight-year-old patient carries with her everywhere daily:

"... It houses a Dexcom glucose monitor and a pack of glucose tablets, which work in conjunction with the sensor attached to her arm and the insulin pump plugged into her stomach. The final item in her bag was an iPhone 5S. It's unusual for such a young child to have a smartphone. But Ruby's iPhone, which connects via Bluetooth to her Dexcom monitor, allowing [her mother] to read it remotely, illustrates the way technology has transformed the management of diabetes from an entirely manual process -- pricking fingers to measure blood sugar, writing down numbers in a notebook, calculating insulin doses and injecting it -- to a semi-automatic one..."

Some people have access to these new technologies, but many don't. Others want more connectivity and better capabilities. So, some creative "hacking" has resulted:

"There are people who are unwilling to wait, and who embrace unorthodox methods. (You can find them on Twitter via the hashtag #WeAreNotWaiting.) The Nightscout Foundation, an online diabetes community, figured out a workaround for the Pebble Watch. Groups such as Nightscout, Tidepool and OpenAPS are developing open-source fixes for diabetes that give major medical tech companies a run for their money... One major gripe of many tech-enabled diabetes patients is that the two devices they wear at all times -- the monitor and the pump -- don't talk to each other... diabetes will never be a hands-off disease to manage, but an artificial pancreas is basically as close as it gets. The FDA approved the first artificial pancreas -- the Medtronic 670G -- in October 2017. But thanks to a little DIY spirit, people have had them for years."

CNet shared the experience of another tech-enabled patient:

"Take Dana Lewis, founder of the open-source artificial pancreas system, or OpenAPS. Lewis started hacking her glucose monitor to increase the volume of the alarm so that it would wake her in the night. From there, Lewis tinkered with her equipment until she created a closed-loop system, which she's refined over time in terms of both hardware and algorithms that enable faster distribution of insulin. It has massively reduced the "cognitive burden" on her everyday life... JDRF, one of the biggest global diabetes research charities, said in October that it was backing the open-source community by launching an initiative to encourage rival manufacturers like Dexcom and Medtronic to open their protocols and make their devices interoperable."

Convenience and affordability are huge drivers. As you might have guessed, there are risks:

"Hacking a glucose monitor is not without risk -- inaccurate readings, failed alarms or the wrong dose of insulin distributed by the pump could have fatal consequences... Lewis and the OpenAPS community encourage people to embrace the build-your-own-pancreas method rather than waiting for the tech to become available and affordable."

Are DIY glucose monitors a good thing? Some patients think so as a way to achieve convenient and affordable healthcare solutions. That might lead you to conclude anything DIY is an improvement. Right? Keep reading.

DIY Guns

Got a 3-D printer? If so, then you can print your own DIY gun. How did this happen? How did the USA get to here? Wired explained:

"Five years ago, 25-year-old radical libertarian Cody Wilson stood on a remote central Texas gun range and pulled the trigger on the world’s first fully 3-D-printed gun... he drove back to Austin and uploaded the blueprints for the pistol to his website, Defcad.com... In the days after that first test-firing, his gun was downloaded more than 100,000 times. Wilson made the decision to go all in on the project, dropping out of law school at the University of Texas, as if to confirm his belief that technology supersedes law..."

The law intervened. Wilson stopped, took down his site, and then pursued a legal remedy:

"Two months ago, the Department of Justice quietly offered Wilson a settlement to end a lawsuit he and a group of co-plaintiffs have pursued since 2015 against the United States government. Wilson and his team of lawyers focused their legal argument on a free speech claim: They pointed out that by forbidding Wilson from posting his 3-D-printable data, the State Department was not only violating his right to bear arms but his right to freely share information. By blurring the line between a gun and a digital file, Wilson had also successfully blurred the lines between the Second Amendment and the First."

So, now you... anybody with an internet connection and a 3-D printer (and a computer-controlled milling machine for some advanced parts)... can produce their own DIY gun. No registration required. No licenses nor permits. No training required. And, that's anyone anywhere in the world.

Oh, there's more:

"The Department of Justice's surprising settlement, confirmed in court documents earlier this month, essentially surrenders to that argument. It promises to change the export control rules surrounding any firearm below .50 caliber—with a few exceptions like fully automatic weapons and rare gun designs that use caseless ammunition—and move their regulation to the Commerce Department, which won't try to police technical data about the guns posted on the public internet. In the meantime, it gives Wilson a unique license to publish data about those weapons anywhere he chooses."

As you might have guessed, Wilson is re-launching his website, but this time with blueprints for more DIY weaponry besides pistols: AR-15 rifles and semi-automatic weaponry. So, it will be easier for people to skirt federal and state gun laws. Is that a good thing?

You probably have some thoughts and concerns. I do. There are plenty of issues and questions. Are DIY products a good thing? Who is liable? How should laws be upgraded? How can society facilitate one set of DIY products and not the other? What related issues do you see? Any other notable DIY products?


New Jersey to Suspend Prominent Psychologist for Failing to Protect Patient Privacy

[Editor's note: today's guest blog post, by reporters at ProPublica, explores privacy issues within the healthcare industry. The post is reprinted with permission.]

By Charles Ornstein, ProPublica

A prominent New Jersey psychologist is facing the suspension of his license after state officials concluded that he failed to keep details of mental health diagnoses and treatments confidential when he sued his patients over unpaid bills.

The state Board of Psychological Examiners last month upheld a decision by an administrative law judge that the psychologist, Barry Helfmann, “did not take reasonable measures to protect the confidentiality of his patients’ protected health information,” Lisa Coryell, a spokeswoman for the state attorney general’s office, said in an e-mail.

The administrative law judge recommended that Helfmann pay a fine and a share of the investigative costs. The board went further, ordering that Helfmann’s license be suspended for two years, Coryell wrote. During the first year, he will not be able to practice; during the second, he can practice, but only under supervision. Helfmann also will have to pay a $10,000 civil penalty, take an ethics course and reimburse the state for some of its investigative costs. The suspension is scheduled to begin in September.

New Jersey began to investigate Helfmann after a ProPublica article published in The New York Times in December 2015 that described the lawsuits and the information they contained. The allegations involved Helfmann’s patients as well as those of his colleagues at Short Hills Associates in Clinical Psychology, a New Jersey practice where he has been the managing partner.

Helfmann is a leader in his field, serving as president of the American Group Psychotherapy Association, and as a past president of the New Jersey Psychological Association.

ProPublica identified 24 court cases filed by Short Hills Associates from 2010 to 2014 over unpaid bills in which patients’ names, diagnoses and treatments were listed in documents. The defendants included lawyers, business people and a manager at a nonprofit. In cases involving patients who were minors, the lawsuits included children’s names and diagnoses.

The information was subsequently redacted from court records after a patient counter-sued Helfmann and his partners, the psychology group and the practice’s debt collection lawyers. The patient’s lawsuit was settled.

Helfmann has denied wrongdoing, saying his former debt collection lawyers were responsible for attaching patients’ information to the lawsuits. His current lawyer, Scott Piekarsky, said he intends to file an immediate appeal before the discipline takes effect.

"The discipline imposed is ‘so disproportionate as to be shocking to one’s sense of fairness’ under New Jersey case law," Piekarsky said in a statement.

Piekarsky also noted that the administrative law judge who heard the case found no need for any license suspension and raised questions about the credibility of the patient who sued Helfmann. "We feel this is a political decision due to Dr. Helfmann’s aggressive stance" in litigation, he said.

Helfmann sued the state of New Jersey and Joan Gelber, a senior deputy attorney general, claiming that he was not provided due process and equal protection under the law. He and Short Hills Associates sued his prior debt collection firm for legal malpractice. Those cases have been dismissed, though Helfmann has appealed.

Helfmann and Short Hills Associates also are suing the patient who sued him, as well as the man’s lawyer, claiming the patient and lawyer violated a confidential settlement agreement by talking to a ProPublica reporter and sharing information with a lawyer for the New Jersey attorney general’s office without providing advance notice. In court pleadings, the patient and his lawyer maintain that they did not breach the agreement. Helfmann brought all three of these lawsuits in state court in Union County.

Throughout his career, Helfmann has been an advocate for patient privacy, helping to push a state law limiting the information an insurance company can seek from a psychologist to determine the medical necessity of treatment. He also was a plaintiff in a lawsuit against two insurance companies and a New Jersey state commission, accusing them of requiring psychologists to turn over their treatment notes in order to get paid.

"It is apparent that upholding the ethical standards of his profession was very important to him," Carol Cohen, the administrative law judge, wrote. "Having said that, it appears that in the case of the information released to his attorney and eventually put into court papers, the respondent did not use due diligence in being sure that confidential information was not released and his patients were protected."

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Supreme Court Ruling Requires Government To Obtain Search Warrants To Collect Users' Location Data

On Friday, the Supreme Court of the United States (SCOTUS) issued a decision which requires the government to obtain warrants in order to collect information from wireless carriers such as geo-location data. 9to5Mac reported that the court case resulted from:

"... a 2010 case of armed robberies in Detroit in which prosecutors used data from wireless carriers to make a conviction. In this case, lawyers had access to about 13,000 location data points. The sticking point has been whether access and use of data like this violates the Fourth Amendment. Apple, along with Google and Facebook had previously submitted a brief to the Supreme Court arguing for privacy protection..."

The Fourth Amendment in the U.S. Constitution states:

"The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no warrants shall issue, but upon probable cause, supported by oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized."

The New York Times reported:

"The 5-to-4 ruling will protect "deeply revealing" records associated with 400 million devices, the chief justice wrote. It did not matter, he wrote, that the records were in the hands of a third party. That aspect of the ruling was a significant break from earlier decisions. The Constitution must take account of vast technological changes, Chief Justice Roberts wrote, noting that digital data can provide a comprehensive, detailed — and intrusive — overview of private affairs that would have been impossible to imagine not long ago. The decision made exceptions for emergencies like bomb threats and child abductions..."

Background regarding the Fourth Amendment:

"In a pair of recent decisions, the Supreme Court expressed discomfort with allowing unlimited government access to digital data. In United States v. Jones, it limited the ability of the police to use GPS devices to track suspects’ movements. And in Riley v. California, it required a warrant to search cellphones. Chief Justice Roberts wrote that both decisions supported the result in the new case.

The Supreme court's decision also discussed historical use of the "third-party doctrine" by law enforcement:

"In 1979, for instance, in Smith v. Maryland, the Supreme Court ruled that a robbery suspect had no reasonable expectation that his right to privacy extended to the numbers dialed from his landline phone. The court reasoned that the suspect had voluntarily turned over that information to a third party: the phone company. Relying on the Smith decision’s “third-party doctrine,” federal appeals courts have said that government investigators seeking data from cellphone companies showing users’ movements do not require a warrant. But Chief Justice Roberts wrote that the doctrine is of limited use in the digital age. “While the third-party doctrine applies to telephone numbers and bank records, it is not clear whether its logic extends to the qualitatively different category of cell-site records,” he wrote."

The ruling also covered the Stored Communications Act, which requires:

"... prosecutors to go to court to obtain tracking data, but the showing they must make under the law is not probable cause, the standard for a warrant. Instead, they must demonstrate only that there were “specific and articulable facts showing that there are reasonable grounds to believe” that the records sought “are relevant and material to an ongoing criminal investigation.” That was insufficient, the court ruled. But Chief Justice Roberts emphasized the limits of the decision. It did not address real-time cell tower data, he wrote, “or call into question conventional surveillance techniques and tools, such as security cameras.” "

What else this Supreme Court decision might mean:

"The decision thus has implications for all kinds of personal information held by third parties, including email and text messages, internet searches, and bank and credit card records. But Chief Justice Roberts said the ruling had limits. "We hold only that a warrant is required in the rare case where the suspect has a legitimate privacy interest in records held by a third party," the chief justice wrote. The court’s four more liberal members — Justices Ruth Bader Ginsburg, Stephen G. Breyer, Sonia Sotomayor and Elena Kagan — joined his opinion."

Dissenting opinions by conservative Justices cited restrictions on law enforcement's abilities and further litigation. Breitbart News focused upon divisions within the Supreme Court and dissenting Justices' opinions, rather than a comprehensive explanation of the majority's opinion and law. Some conservatives say that President Trump will have an opportunity to appoint two Supreme Court Justices.

Albert Gidari, the Consulting Director of Privacy at the Stanford Law Center for Internet and Society, discussed the Court's ruling:

"What a Difference a Week Makes. The government sought seven days of records from the carrier; it got two days. The Court held that seven days or more was a search and required a warrant. So can the government just ask for 6 days with a subpoena or court order under the Stored Communications Act? Here’s what Justice Roberts said in footnote 3: “[W]e need not decide whether there is a limited period for which the Government may obtain an individual’s historical CSLI free from Fourth Amendment scrutiny, and if so, how long that period might be. It is sufficient for our purposes today to hold that accessing seven days of CSLI constitutes a Fourth Amendment search.” You can bet that will be litigated in the coming years, but the real question is what will mobile carriers do in the meantime... Where You Walk and Perhaps Your Mere Presence in Public Spaces Can Be Private. The Court said this clearly: “A person does not surrender all Fourth Amendment protection by venturing into the public sphere. To the contrary, “what [one] seeks to preserve as private, even in an area accessible to the public, may be constitutionally protected.”” This is the most important part of the Opinion in my view. It’s potential impact is much broader than the location record at issue in the case..."

Mr. Gidari's essay explored several more issues:

  • Does the Decision Really Make a Difference to Law Enforcement?
  • Are All Business Records in the Hands of Third Parties Now Protected?
  • Does It Matter Whether You Voluntarily Give the Data to a Third Party?

And:

Most people carry their smartphones with them 24/7 and everywhere they go. Hence, the geo-location data trail contains unique and very personal movements: where and whom you visit, how often and long you visit, who else (e.g., their smartphones) is nearby, and what you do (e.g., calls, mobile apps) at certain locations. The Supreme Court, or at least a majority of its Justices, seem to recognize and value this.

What are your opinions of the Supreme Court ruling?


Why Your Health Insurer Doesn’t Care About Your Big Bills

[Editor's note: today's guest post, by the reporters at ProPublica, discusses pricing and insurance problems within the healthcare industry, and a resource most consumers probably are unaware of. It is reprinted with permission.]

By Marshall Allen, ProPublica

Michael Frank ran his finger down his medical bill, studying the charges and pausing in disbelief. The numbers didn’t make sense.

His recovery from a partial hip replacement had been difficult. He’d iced and elevated his leg for weeks. He’d pushed his 49-year-old body, limping and wincing, through more than a dozen physical therapy sessions.

NYU Langone Health logo The last thing he needed was a botched bill.

His December 2015 surgery to replace the ball in his left hip joint at NYU Langone Medical Center in New York City had been routine. One night in the hospital and no complications.

Aetna Inc. logoHe was even supposed to get a deal on the cost. His insurance company, Aetna, had negotiated an in-network “member rate” for him. That’s the discounted price insured patients get in return for paying their premiums every month.

But Frank was startled to see that Aetna had agreed to pay NYU Langone $70,000. That’s more than three times the Medicare rate for the surgery and more than double the estimate of what other insurance companies would pay for such a procedure, according to a nonprofit that tracks prices.

Fuming, Frank reached for the phone. He couldn’t see how NYU Langone could justify these fees. And what was Aetna doing? As his insurer, wasn’t its duty to represent him, its “member”? So why had it agreed to pay a grossly inflated rate, one that stuck him with a $7,088 bill for his portion?

Frank wouldn’t be the first to wonder. The United States spends more per person on health care than any other country. A lot more. As a country, by many measures, we are not getting our money’s worth. Tens of millions remain uninsured. And millions are in financial peril: About 1 in 5 is currently being pursued by a collection agency over medical debt. Health care costs repeatedly top the list of consumers’ financial concerns.

Experts frequently blame this on the high prices charged by doctors and hospitals. But less scrutinized is the role insurance companies — the middlemen between patients and those providers — play in boosting our health care tab. Widely perceived as fierce guardians of health care dollars, insurers, in many cases, aren’t. In fact, they often agree to pay high prices, then, one way or another, pass those high prices on to patients — all while raking in healthy profits.

ProPublica and NPR are examining the bewildering, sometimes enraging ways the health insurance industry works, by taking an inside look at the games, deals and incentives that often result in higher costs, delays in care or denials of treatment. The misunderstood relationship between insurers and hospitals is a good place to start.

Today, about half of Americans get their health care benefits through their employers, who rely on insurance companies to manage the plans, restrain costs and get them fair deals.

But as Frank eventually discovered, once he’d signed on for surgery, a secretive system of pre-cut deals came into play that had little to do with charging him a reasonable fee.

After Aetna approved the in-network payment of $70,882 (not including the fees of the surgeon and anesthesiologist), Frank’s coinsurance required him to pay the hospital 10 percent of the total.

When Frank called NYU Langone to question the charges, the hospital punted him to Aetna, which told him it paid the bill according to its negotiated rates. Neither Aetna nor the hospital would answer his questions about the charges.

Frank found himself in a standoff familiar to many patients. The hospital and insurance company had agreed on a price and he was required to help pay it. It’s a three-party transaction in which only two of the parties know how the totals are tallied.

Frank could have paid the bill and gotten on with his life. But he was outraged by what his insurance company agreed to pay. “As bad as NYU is,” Frank said, “Aetna is equally culpable because Aetna’s job was to be the checks and balances and to be my advocate.”

And he also knew that Aetna and NYU Langone hadn’t double-teamed an ordinary patient. In fact, if you imagined the perfect person to take on insurance companies and hospitals, it might be Frank.

For three decades, Frank has worked for insurance companies like Aetna, helping to assess how much people should pay in monthly premiums. He is a former president of the Actuarial Society of Greater New York and has taught actuarial science at Columbia University. He teaches courses for insurance regulators and has even served as an expert witness for insurance companies.

The hospital and insurance company may have expected him to shut up and pay. But Frank wasn’t going away.

Patients fund the entire health care industry through taxes, insurance premiums and cash payments. Even the portion paid by employers comes out of an employee’s compensation. Yet when the health care industry refers to “payers,” it means insurance companies or government programs like Medicare.

Patients who want to know what they’ll be paying — let alone shop around for the best deal — usually don’t have a chance. Before Frank’s hip operation he asked NYU Langone for an estimate. It told him to call Aetna, which referred him back to the hospital. He never did get a price.

Imagine if other industries treated customers this way. The price of a flight from New York to Los Angeles would be a mystery until after the trip. Or, while digesting a burger, you’d learn it cost 50 bucks.

A decade ago, the opacity of prices was perhaps less pressing because medical expenses were more manageable. But now patients pay more and more for monthly premiums, and then, when they use services, they pay higher co-pays, deductibles and coinsurance rates.

Employers are equally captive to the rising prices. They fund benefits for more than 150 million Americans and see health care expenses eating up more and more of their budgets.

Richard Master, the founder and CEO of MCS Industries Inc. in Easton, Pennsylvania, offered to share his numbers. By most measures MCS is doing well. Its picture frames and decorative mirrors are sold at Walmart, Target and other stores and, Master said, the company brings in more than $200 million a year.

But the cost of health care is a growing burden for MCS and its 170 employees. A decade ago, Master said, an MCS family policy cost $1,000 a month with no deductible. Now it’s more than $2,000 a month with a $6,000 deductible. MCS covers 75 percent of the premium and the entire deductible. Those rising costs eat into every employee’s take-home pay.

Economist Priyanka Anand of George Mason University said employers nationwide are passing rising health care costs on to their workers by asking them to absorb a larger share of higher premiums. Anand studied Bureau of Labor Statistics data and found that every time health care costs rose by a dollar, an employee’s overall compensation got cut by 52 cents.

Master said his company hops between insurance providers every few years to find the best benefits at the lowest cost. But he still can’t get a breakdown to understand what he’s actually paying for.

“You pay for everything, but you can’t see what you pay for,” he said.

Master is a CEO. If he can’t get answers from the insurance industry, what chance did Frank have?

Frank’s hospital bill and Aetna’s “explanation of benefits” arrived at his home in Port Chester, New York, about a month after his operation. Loaded with an off-putting array of jargon and numbers, the documents were a natural playing field for an actuary like Frank.

Under the words, “DETAIL BILL,” Frank saw that NYU Langone’s total charges were more than $117,000, but that was the sticker price, and those are notoriously inflated. Insurance companies negotiate an in-network rate for their members. But in Frank’s case at least, the “deal” still cost $70,882.

With a practiced eye, Frank scanned the billing codes hospitals use to get paid and immediately saw red flags: There were charges for physical therapy sessions that never took place, and drugs he never received. One line stood out — the cost of the implant and related supplies. Aetna said NYU Langone paid a “member rate” of $26,068 for “supply/implants.” But Frank didn’t see how that could be accurate. He called and emailed Smith & Nephew, the maker of his implant, until a representative told him the hospital would have paid about $1,500. His NYU Langone surgeon confirmed the amount, Frank said. The device company and surgeon did not respond to ProPublica’s requests for comment.

Frank then called and wrote Aetna multiple times, sure it would want to know about the problems. “I believe that I am a victim of excessive billing,” he wrote. He asked Aetna for copies of what NYU Langone submitted so he could review it for accuracy, stressing he wanted “to understand all costs.”

Aetna reviewed the charges and payments twice — both times standing by its decision to pay the bills. The payment was appropriate based on the details of the insurance plan, Aetna wrote.

Frank also repeatedly called and wrote NYU Langone to contest the bill. In its written reply, the hospital didn’t explain the charges. It simply noted that they “are consistent with the hospital’s pricing methodology.”

Increasingly frustrated, Frank drew on his decades of experience to essentially serve as an expert witness on his own case. He gathered every piece of relevant information to understand what happened, documenting what Medicare, the government’s insurance program for the disabled and people over age 65, would have paid for a partial hip replacement at NYU Langone — about $20,491 — and what FAIR Health, a New York nonprofit that publishes pricing benchmarks, estimated as the in-network price of the entire surgery, including the surgeon fees — $29,162.

He guesses he spent about 300 hours meticulously detailing his battle plan in two inches-thick binders with bills, medical records and correspondence.

ProPublica sent the Medicare and FAIR Health estimates to Aetna and asked why they had paid so much more. The insurance company declined an interview and said in an emailed statement that it works with hospitals, including NYU Langone, to negotiate the “best rates” for members. The charges for Frank's procedure were correct given his coverage, the billed services and the Aetna contract with NYU Langone, the insurer wrote.

NYU Langone also declined ProPublica’s interview request. The hospital said in an emailed statement it billed Frank according to the contract Aetna had negotiated on his behalf. Aetna, it wrote, confirmed the bills were correct.

After seven months, NYU Langone turned Frank’s $7,088 bill over to a debt collector, putting his credit rating at risk. “They upped the ante,” he said.

Frank sent a new flurry of letters to Aetna and to the debt collector and complained to the New York State Department of Financial Services, the insurance regulator, and to the New York State Office of the Attorney General. He even posted his story on LinkedIn.

But no one came to the rescue. A year after he got the first bills, NYU Langone sued him for the unpaid sum. He would have to argue his case before a judge.

You’d think that health insurers would make money, in part, by reducing how much they spend.

Turns out, insurers don’t have to decrease spending to make money. They just have to accurately predict how much the people they insure will cost. That way they can set premiums to cover those costs — adding about 20 percent to for their administration and profit. If they’re right, they make money. If they’re wrong, they lose money. But, they aren’t too worried if they guess wrong. They can usually cover losses by raising rates the following year.

Frank suspects he got dinged for costing Aetna too much with his surgery. The company raised the rates on his small group policy — the plan just includes him and his partner — by 18.75 percent the following year.

The Affordable Care Act kept profit margins in check by requiring companies to use at least 80 percent of the premiums for medical care. That’s good in theory but it actually contributes to rising health care costs. If the insurance company has accurately built high costs into the premium, it can make more money. Here’s how: Let’s say administrative expenses eat up about 17 percent of each premium dollar and around 3 percent is profit. Making a 3 percent profit is better if the company spends more.

It’s like if a mom told her son he could have 3 percent of a bowl of ice cream. A clever child would say, “Make it a bigger bowl.”

Wonks call this a “perverse incentive.”

“These insurers and providers have a symbiotic relationship,” said Wendell Potter, who left a career as a public relations executive in the insurance industry to become an author and patient advocate. “There’s not a great deal of incentive on the part of any players to bring the costs down.”

Insurance companies may also accept high prices because often they aren’t always the ones footing the bill. Nowadays about 60 percent of the employer benefits are “self-funded.” That means the employer pays the bills. The insurers simply manage the benefits, processing claims and giving employers access to their provider networks. These management deals are often a large, and lucrative, part of a company’s business. Aetna, for example, insured 8 million people in 2017, but provided administrative services only to considerably more — 14 million.

To woo the self-funded plans, insurers need a strong network of medical providers. A brand-name system like NYU Langone can demand — and get — the highest payments, said Manuel Jimenez, a longtime negotiator for insurers including Aetna. “They tend to be very aggressive in their negotiations.”

On the flip side, insurers can dictate the terms to the smaller hospitals, Jimenez said. The little guys, “get the short end of the stick,” he said. That’s why they often merge with the bigger hospital chains, he said, so they can also increase their rates.

Other types of horse-trading can also come into play, experts say. Insurance companies may agree to pay higher prices for some services in exchange for lower rates on others.

Patients, of course, don’t know how the behind-the-scenes haggling affects what they pay. By keeping costs and deals secret, hospitals and insurers dodge questions about their profits, said Dr. John Freedman, a Massachusetts health care consultant. Cases like Frank’s “happen every day in every town across America. Only a few of them come up for scrutiny.”

In response, a Tennessee company is trying to expose the prices and steer patients to the best deals. Healthcare Bluebook aims to save money for both employers who self-pay, and their workers. Bluebook used payment information from self-funded employers to build a searchable online pricing database that shows the low-, medium- and high-priced facilities for certain common procedures, like MRIs. The company, which launched in 2008, now has more than 4,500 companies paying for its services. Patients can get a $50 bonus for choosing the best deal.

Bluebook doesn’t have price information for Frank’s operation — a partial hip replacement. But its price range in the New York City area for a full hip replacement is from $28,000 to $77,000, including doctor fees. Its “fair price” for these services tops out at about two-thirds of what Aetna agreed to pay on Frank’s behalf.

Frank, who worked with mainstream insurers, didn’t know about Bluebook. If he had used its data, he would have seen that there were facilities that were both high quality and offered a fair price near his home, including Holy Name Medical Center in Teaneck, New Jersey, and Greenwich Hospital in Connecticut. NYU Langone is one of Bluebook’s highest-priced, high-quality hospitals in the area for hip replacements. Others on Bluebook’s pricey list include Montefiore New Rochelle Hospital in New Rochelle, New York, and Hospital for Special Surgery in Manhattan.

ProPublica contacted Hospital for Special Surgery to see if it would provide a price for a partial hip replacement for a patient with an Aetna small-group plan like Frank’s. The hospital declined, citing its confidentiality agreements with insurance companies.

Frank arrived at the Manhattan courthouse on April 2 wearing a suit and fidgeted in his seat while he waited for his hearing to begin. He had never been sued for anything, he said. He and his attorney, Gabriel Nugent, made quiet conversation while they waited for the judge.

In the back of the courtroom, NYU Langone’s attorney, Anton Mikofsky, agreed to talk about the lawsuit. The case is simple, he said. “The guy doesn’t understand how to read a bill.”

The high price of the operation made sense because NYU Langone has to pay its staff, Mikofsky said. It also must battle with insurance companies who are trying to keep costs down, he said. “Hospitals all over the country are struggling,” he said.

“Aetna reviewed it twice,” Mikofsky added. “Didn’t the operation go well? He should feel blessed.”

When the hearing started, the judge gave each side about a minute to make its case, then pushed them to settle.

Mikofsky told the judge Aetna found nothing wrong with the billing and had already taken care of most of the charges. The hospital’s position was clear. Frank owed $7,088.

Nugent argued that the charges had not been justified and Frank felt he owed about $1,500.

The lawyers eventually agreed that Frank would pay $4,000 to settle the case.

Frank said later that he felt compelled to settle because going to trial and losing carried too many risks. He could have been hit with legal fees and interest. It would have also hurt his credit at a time he needs to take out college loans for his kids.

After the hearing, Nugent said a technicality might have doomed their case. New York defendants routinely lose in court if they have not contested a bill in writing within 30 days, he said. Frank had contested the bill over the phone with NYU Langone, and in writing within 30 days with Aetna. But he did not dispute it in writing to the hospital within 30 days.

Frank paid the $4,000, but held on to his outrage. “The system,” he said, “is stacked against the consumer.”

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