The History of CSIMS
In 1980, the workers’ compensation insurance industry sponsored a comprehensive reform bill, Senate Bill 375, by the Chair of the Senate Labor and Industrial Relations Committee, Bill Greene (D-Los Angeles). Among other changes, the bill proposed to abolish the recognition of cumulative injuries in California and to mandate that medical-legal reports could only be written by state employee physicians. Although the applicants’ attorneys strongly opposed the bill, the medical community initially remained silent and the bill passed the Senate.
While awaiting a hearing in the Assembly, a small group of concerned physicians in Los Angeles approached the statewide medical association, urging it to oppose SB 375. Unfortunately, the association’s workers’ compensation committee was chaired by the medical director of the State Compensation Insurance Fund and he liked the bill. The physicians then turned to another association that was the western states affiliate of the American Occupational Medical Association. That organization was composed primarily of company doctors who didn’t treat and they also liked SB 375.
With no place to turn, nine physicians convened an organizing committee and created the California Society of Industrial Medicine and Surgery or CSIMS. On several occasions, they went to Sacramento to lobby the Assembly Finance, Insurance and Commerce Committee. Through their efforts, and those of the California Applicants’ Attorneys Association, they managed to defeat the bill in committee, much to the chagrin of the sponsors. CSIMS became the mouse that roared.
The founding members soon realized that merely defeating SB 375 was not CSIMS’ only mission. They understood that private physicians practicing occupational medicine would continue to need a voice and representation in Sacramento because the traditional medical societies were silent.
In early 1981, CSIMS contacted Carl Brakensiek, General Counsel of the Assembly Finance, Insurance and Commerce Committee, who had written an extensive analysis highly critical of SB 375. After several meetings, Brakensiek resigned from the Assembly and became CSIMS’ Director of Governmental Relations. A few months later, he assumed the title of Executive Vice President when he took over the management as well as the lobbying on behalf of the association.
For more than 40 years, CSIMS has continued to represent physicians and their patients in the workers’ compensation arena. CSIMS negotiated the first medical-legal fee schedule; obtained a 26% increase in the treatment fee schedule; helped design the QME system; and played an active role in various workers’ compensation reform efforts over the years. CSIMS is regularly consulted for input and advice by the Legislature and the Department of Industrial Relations on policy matters.
CSIMS also became active in the training of occupational physicians, providing top tier educational programs long before they were mandated for QMEs. CSIMS was among the first approved providers of continuing education for our Physician’s & Providers to obtain Continuing Medical Education (CME) credits, Continuing Education (CE) credits and Qualified Medical Evaluator (QME) credits).
CSIMS has a long and illustrious history of supporting good workers’ compensation legislation and opposing bad proposals. CSIMS actively participates in administrative proceedings before the Division of Workers’ Compensation, the Workers’ Compensation Appeals Board, the Commission on Health and Safety and Workers’ Compensation, the Medical Board of California, and the Board of Chiropractic Examiners, to name a few.
In the past, we cosponsored a program with the Medical Unit of the Division of Workers’ Compensation to explain and promote the utilization review hierarchy of evidence regulations. Over the years, we have provided medical lecturers for the Conference of California Workers’ Compensation Judges and the DWC Educational Conference. We successfully petitioned the Insurance Commissioner to adopt regulations requiring insurance companies to separate medical management costs – bill review, utilization review, MPN management fees, etc. – from payments for direct patient care.
More recently, we were involved in the development of the new formulary legislation. We have been actively involved with the RAND study of the medical and medical-legal aspects of workers’ compensation. Finally, CSIMS was alo the co-sponsor of Assembly Bill 1542 which proposes to restore recognition of neuropsychologist QMEs.
Over the past year and a half, CSIMS has been battling the changes being put forth by the DWC for the Med-Legal Fee Schedule (MLFS). This battle is not yet over as CSIMS continues to be at the forefront with our “EMERGENCY WEBINARS” presented by our Leadership and our Advocacy Committee. The battles for Cost of Living Adjustment (COLA), improved Managed Provider Network (MPN) directives, Utilization Review (UR) and Independent Medical Review (IMR) are now being promulgated.
Throughout its long career, CSIMS has remained committed to its Core Values:
- Helping people get their lives back together
- Delivering the best, cost-effective, quality care available
- Serving with integrity, objectivity, honesty, and independence
- Providing cutting edge Education, aggressive Advocacy and sharing the pearls of the Business of Medicine in the Workers Compensation arena
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