Department of Industrial Relations

Industrial Medical Council Public Meeting

Holiday Inn, LAX

Thursday, Dec 13, 2001

Members present:

Barry Halote, PhD. Richard Pitts, D.O.

Robert Larsen, M.D., MPH Patricia Sinnott, PT, MPH

Marvin Lipton, M.D. Richard Sommer, M.Phil., J.D.

Maria Mayoral, M.D. Paul E. Wakim, D.O.

Ira Monosson, M.D. Gayle Walsh, D.C.

Steven Nagelberg, M.D. Benjamin Yang, C.A. OMD

Jonathan Ng, M.D., J.D

Members absent:

Glenn Ocker, DPM, MS

Michael Roback, M.D

Lawrence Tain, D.C.

1. The meeting was called to order by Co-Chair Dr. Richard Pitts.

    1. Consent Agenda

a. Adoption of the Minutes and Notice of Actions: Dr. Pitts asked for a motion on the Draft Minutes and Notice of Action of the November 15, 2001 IMC meeting. Some editorial changes were made.

Action: The Consent Agenda was approved unanimously.

b. Executive Medical Director's Report:

Dr. D. Allan MacKenzie indicated that his EMD report stands as written and stated that all of the IMC Mandates were up to date.

He also announced that Dr. Ira Monosson has been reappointed by the Speaker of the Assembly, Robert Hertzberg, as an IMC Council Member effective January 2, 2002 through December 31, 2005. He will be sworn in at the January 2002 meeting.

He then proceeded to give a report of the Council's accomplishments for the Y2001. In the first quarter, the main activity was the fulfillment of AB776, the mandate that directed the Council to develop a 12-hour Med/Legal Report Writing Course (MLRWC). The Staff produced a

4-hour video tape for the purposes of distant learning and then developed and administered an 8-hour live MLRWC session course which was presented in the Northern and Southern California.

Secondly, IMC and CPS Staff reviewed the foundational elements of the QME Competency Exam. What began as an effort to help unsuccessful QME exam candidates identify their areas of weakness escalated into a total makeover of the whole exam process.

The third major endeavor of the Council was the task of supplying the Administrative Director with the research material from which he will promulgate the next Official Medical Fee Schedules. These research projects have been a major undertaking and should be completed by Q2 of Y2002.

c. DWC Report:

Mr. Richard Gannon, Administrative Director, DWC, reiterated his appreciation and thanks to the Industrial Medical Council for work done for the Fee Schedules. He reported that DWC's intent regarding the ground rules is to utilize CPT language whenever it is possible to leave out California's non-specific CPT language unless it is absolutely necessary. He asked for comments from the interested public. DWC is soliciting input for those situations where additional ground rules are necessary. He sought input from the public and from the Council Members who were involved with the Fee Schedules. All of these comments would go into a draft revision of the fee schedules.

3. Education Committee Report and Recommendations for Action:

Dr. Gayle Walsh reported that the Education Committee was not able to meet this morning. Accordingly her comments on continuing education were based on the IMC Staff review of materials submitted. Dr. Walsh recommended approval of renewals of the following four providers for continuing education: (1) David O' Brian, a distance learning program–tapes and written materials; (2) Livingstone-Lopez Consulting, also a distance learning program; (3) Saint Francis Memorial Hospital – A program to be presented in February 2002, and (4) North Bay Workers' Compensation Association – a program presented last November, 2001, a retroactive renewal.

Dr. Walsh: Motion: To approve the renewals of the above four providers for continuing education.

It was seconded.

Action: Motion passes.

Dr. Walsh also reported that the Committee will continue their work on audits, a review of the postcards sent in by the continuing education providers, and a survey if the Staff received the

rosters from the providers. The Committee will put some information out for next month's meeting.

4. Urinary Incontinence Work Group:

Dr. Paul Wakim reported that they would have a descriptive term for the urinary incontinence document. He said that the IMC wishes to advise every body that this document is simply an educational document and recommended its approval by the Council.

Dr. Wakim: Motion: To accept the "Urinary Incontinence Educational Document".

It was seconded.

Action: Motion passes.

5. Search Committee Report:

Dr. Walsh reported that the contract with Cooperative Personnel Services (CPS) has been approved. CPS had already started working on the candidate profile and will be contacting individuals to try to ascertain the qualities and requirements for this job. CPS asked each Council Member to think about what issues and challenges the IMC will be facing in the near future and longer.

Dr. Walsh asked the Council to think hard about what the Council should be doing now and over the next year two–three years. Also, what problems and issues the Council should take on and in what areas we need to improve. This is the best opportunity for us unite and strengthen the Council and to re-define ourselves again. She stated that the Council is a blend of old timers and new blood and this is the good time to re-energize ourselves and to take on the many challenges and thus make a difference.

Today, we are electing officers and Dr. Walsh asked each of the Members to give direction as to where we want to be and what we expect from them, to ask for commitment in promoting this Council before the work comp. community and to offer assistance in getting the work of the Council done. This will be a year of transition and challenges. Thus far, the Council has met every challenge placed before them and she stated, she is sure that we are going to meet those challenges in the future as long as we continue to work all together.

6. Fee Schedule Committee Report:

Mr. Richard Sommer reported that the Lewin Group is here is do another presentation. He announced that there was a letter from Mr. Gannon, requesting input from the public on ground rule issues for the fee schedule. Mr. Sommer reminded everybody that it is important to talk about where they were, where they are and where they are going. He also said that there are three

studies: Study No. 1 – Looking at updating the relative value scale with the RBRVS; Study No. 2 – Looking at whether there is a difference in the physician work between workers' comp. and non- workers' comp., and Study No. 3 – Looking at the difference between the practice expense in workers' comp. and non-workers' comp. Studies two and three are integrated closely because they deal with the difference between workers' compensation and other reimbursement systems.

Mr. Sommer said that there are four phases of the first study in terms of creating a new fee schedule. Phase one getting the study approved, up and running, and getting the reports back. Phase two is beginning the process of dealing with ground rules issues. Phase three is thinking and debating the issues. Phase four is the rulemaking process. We are still in phase two in that we received the results from the study and are beginning the process of opening up dialogue and ground rules discussions. There is plenty of time for people to get their comments in regarding this process of transitioning to an RBRVS system.


a. Timeline for the OMFS Revision - Presented by Susan McKenzie, M.D.

(A two-page handout is attached to these minutes of the meeting)

b. California Workers' Compensation RBRVS Study

Presented by Allen Dobson, Ph.D. - The Lewin Group

II. Discussion Part:

The members of the public and the Council Members participated in the discussion part of the presentation.

The Council meeting closed for closed session. The meeting resumed at 12:00.

7. Discipline Committee Report:

Dr. Pitts announced that after deliberation, the Council voted to adopt the Stipulation on Dr. Jeffrey Holmes case. The Council also voted to accept the recommendation of the Disciplinary Committee to revoke Dr. Fethi Shami's QME status based on the fact that he does not have his license anymore.

8. Election of Officers:

Dr. Marvin Lipton stated that because of the Executive Medical Director's leaving the IMC, it is important for the Council to recognize the importance of stability.

After the Council nominated and voted for the IMC Executive Officers for the Y2002, Dr. Lipton announced the results: Dr. Richard Pitts and Dr. Steven Nagelberg as co-chairman's; Dr. Lawrence Tain as vice chairman and Ms. Patsi Sinnott as the secretary.

9. Announcements:

Dr. Pitts announced that the January 2002 meeting would be a video-conferenced public meeting in San Francisco and Los Angeles.

Mr. Sommer suggested that it would be nicer to have couple more people to be in the executive so as to have education and sharing responsibilities. He said he would love to have some of the newer Council Members to be up for next year election

Meeting adjourned at 12:30 p.m.


Thursday, December 13, 2001

IMC Staff presents:

Annadesa Gregorio Allan MacKenzie, M.D., Exec.Med.Dir.

Milagros Diadula Susan McKenzie, M.D.

James Fisher, Esq. Anne Searcy, M.D

David Kizer, Esq Larry Williams

Gerry Evans


DIR/DWC Staff present:

Richard Gannon, Adm. Director, DWC

Jackie Schauer, Esq.

Members of the public present:

Rea Crane, CWCI Brenda Ramirez, State Comp. Ins. Fund

Linda Cotrin, CCA Diane Przepiorski, CA Ortho. Assoc.

Philipp M. Lippe, M.D., CANS Frank Navarro, CMA

Jan Nguyen, CCn Peggy Sugarman, CA Appl. Atty's Assoc.

Jennifer Orosz, HNC Software Robert Lenzini, VQ. Ortho Care

Doug Hikawa, Priority Compnet Michael Vo, Lien On Me, Inc.

Colleen Dinunzio, EOS Managed Care Serv., Inc. Elizabeth Hagen, CorVel

Carolyn O'Brian OES Dave O' Brian

Joe Solancho, CARE Solutions Rose Piper Ladroix, USH Works

Wayne Whalen, D.C., CCA Vern Goldschmit, CAAA

Sharon Ibarra, U.S. Health Works Bradford Brooks,VQ OrthoCare