1. The meeting was called to order by Co-Chair Dr. Richard
2. Consent Agenda:
Adoption of the Minutes and Notice of Actions: Dr.
Pitts asked for a motion on the Draft Minutes and Notice of Action of the
September 19, 2002 IMC meeting. Dr. Walsh proposed minor changes/corrections
to the Minutes:
Action: The Consent Agenda was approved unanimously.
Executive Medical Director's Report: Dr.
Susan McKenzie indicated that her EMD report stands as written.
Legislative Report:Nothing added to what is in the packet.
Administrative Director Richard Gannon was not able to
attend, so Ms. Jackie Schauer gave the report. DWC is facing budget reductions
as previously discussed. In an effort to meet these reductions, they are going
to hold an open meeting in November to discuss which projects should be given
the highest priority. They are accepting comments for 15 days on the draft of
Regulation Section 9785. They are also going to
post on the web proposed ground rules for the upcoming Fee Schedule revision
and will hold a public meeting in the future.
3. Education Committee Report:
Dr. Gayle Walsh reported that the Committee reviewed and
recommended approval of an application for reaccredidation as a provider for
continuing education by the Insurance Education Association (IEA) for three
programs: Cost of Words-Medical Reports in the Workers' Compensation System-a
distance learning program; From Medicine to Psychology-Approaches to Patients
with Multiple Problems, and the Workers' Compensation for the Medical
Dr. Walsh: Motion: That the Council approve the
renewal application of the above provider for continuing education courses.
The motion was seconded.
Action: Motion passed unanimously.
Dr. Walsh said that the Committee is committed to revising
the Regulations, as it does not have a major revision for several years. They
reviewed areas that she thinks need to be revised. The IMC Staff will collate
these suggestions so that they can be discussed at an hour-long committee
meeting in November.
On Foot and Ankle Guidelines, Dr. Glenn Ocker mentioned
several typographical errors in the document that was sent in the packet. The
errors were corrected in the draft of the Guidelines that was available on the
table at the meeting. The public did not submit any suggestions.
Dr. Ocker: Motion: that the Council accept the
corrected Foot and Ankle Guidelines and then be sent to the Office of
Administrative Law (OAL) for approval. The motion was seconded.
Action: Motion passed unanimously.
4. Fee Schedule Committee Report:
Dr. Susan McKenzie reported that the Committee met this
morning and talked about some changes made on the last presentation of the
Practice Expense Study. The Lewin Group issued a draft report of the RBRVS
Study, copies of which was distributed to the public present today. This RBRVS
report is a report of the initial impact analysis done almost a year ago. It
discusses the methodology for the study. The Lewin Group
will remodel that impact analysis and will incorporate any
proposed changes to the fee schedules in the future. The numbers in this
initial RBRVS report will change.
Dr. McKenzie also recapped what the Council has done on the
entire RBRVS project to date. In 1998, they had public discussions about the
revisions for the 1999 fee schedule. During these discussions and revisions,
the community encountered a number of problems in updating relative values and
discussed replacing the relative value scale. So in 1999, the IMC initiated an
educational study that was done by UCLA headed by Gerald Kominski, Ph.D. So
the Council moved on from that and hired the Lewin Group through an RFP. The
Lewin Group did an initial impact analysis, the results of which you received
today. At the same time, the Council decided to undertake two studies of
Evaluation and Management codes to determine whether or not there is a
difference between physician work and practice expenses in the workers'
compensation setting and the non workers' compensation setting. The studies
were undertaken by the Lewin Group, a premier health care consulting group in
this field. The study methodology was rigorous and both studies showed that
there was a difference.
Dr. McKenzie said that the Lewin group would come back when
they do the final model that will incorporate these studies in the rule
5. Overview of the Work of the NIH Advisory Council for
Complementary & Alternative Medicine:
Dr. Pitts introduced Dr. Benjamin Yang who was recently
appointed by the President to the NIH National Center for Complementary and
Alternative Medicine. Dr. Yang gave an overview of the Council, their funding,
budget and mandates. They fund research that is carried out around the world
on nontraditional medicine. The budget for 2002 is $104 million and for 2003
will be $113 million. Dr. Yang also announced their telephone number -
1-888-644-6226 and their website www.ncam.nih.gov
for those who are interested.
The Council meeting closed for discussion on disciplinary
6. Discipline Committee Report:
When the meeting opened again, the Council announced that the settlements
on Dr. Michael Uzelac, DDS and of Dr. Margaret Howell, DC were accepted. The
accusation on Dr. Robert Glover, DC was tabled until the next meeting.
Dr. Pitts announced that the next month's meeting
November 21, 2002 would be in South San Francisco and the December meeting
will be on December 12, 2002 in Los Angeles.
8. Meeting adjourned at 1:30 p.m.
9. AD Hoc Committee on Education Statements - Fibromyalgia:
Council Members and most of the guests stayed for the
discussion on Fibromyalgia. Dr. Paul Wakim and Dr. Ira Monosson are
co-chairmans of this Committee.