Arizona Gov. Fife Symington has signed legislation that blocks most of the provisions of Proposition 200, a ballot initiative passed last fall that had legalized the use of marijuana, heroin and other illegal drugs for medical purposes. The legislation requires Food and Drug Administration approval of any drugs dispensed in the state for medical purposes. Voters in Arizona passed Proposition 200 last November, while a similar initiative was approved in California. Few physicians have prescribed marijuana or other controlled substances to patients since the initiatives passed (Feb. 17, p. 68). Both the American Medical Association and the Clinton administration oppose using marijuana for medical purposes, although the National Institutes of Health has been commissioned to perform a study on its effectiveness in relieving pain and other symptoms in AIDS, glaucoma and cancer patients. Supporters of the Arizona initiative said they would sue to block the new state law, calling it unconstitutional.
Negotiations between the American Association of Retired Persons and nine HMOs it selected to serve its members have hit a snag. Four HMOs are "not comfortable with the independent marketing organization we are proposing," said Tom Otwell, AARP spokesman. The plans say the AARP's program would be duplicative and confusing to enrollees. Otwell identified the objecting plans as Humana, Fallon Community Health Plan, Kaiser Permanente and Group Health Cooperative of Puget Sound. They were among the plans that received the AARP's blessing last fall to market their insurance products to the group's 5.7 million members (Dec. 2, 1996, p. 4). Because of objections raised by the plans and, reportedly, by HCFA, the AARP is rethinking the way HMOs will make royalty payments to the AARP in exchange for the association's coveted endorsement. The AARP had proposed a royalty payment of $20 per enrollee. HCFA, according to published reports, views the royalty payment as a possible violation of the federal anti-kickback statutes, which bar any form of remuneration to induce the referral of Medicare or Medicaid patients. HCFA officials declined comment. The AARP is considering proposing that royalty payments instead be based on the number of AARP members in a given market.
The city of Berkeley, Calif., and Alta Bates Medical Center have settled litigation regarding the hospital's recently expanded obstetrics unit. Under the terms of the agreement, which was approved last month by the Berkeley City Council, Alta Bates will be able to immediately use the new delivery rooms, maternity operating room and recovery room. In exchange, the 507-bed hospital has agreed to retroactively file for a modification to its master-plan permit and submit its expansion plans to the city for review. The hospital opened the expanded obstetrics ward one day after the council's approval. In February, the city sued the hospital, claiming the $1.4 million renovation was performed in violation of zoning laws and would increase traffic into the already congested area (April 7, p. 82). The city also asserted Alta Bates had violated a 1983 consent decree that requires it to notify neighbors of any changes that might alter traffic patterns and increase noise. Hospital officials claimed interior modifications were not subject to the city's jurisdiction and that traffic had actually been reduced since the consent decree was signed. If the city determines the expansion increases traffic and noise, Alta Bates has the option of relocating some services off-site or providing alternative transportation for its employees.
The 9th U.S. Circuit Court of Appeals in San Francisco granted a request by opponents of Oregon's physician-assisted suicide law to delay implementation of the law until it is reviewed by the U.S. Supreme Court. The appeals court ruled in February that a lawsuit by physicians and a terminally ill patient was premature and said enforcement would pose no immediate threat to the rights of the physicians or the patient who filed the suit (Feb. 17, p. 2). The law was approved by Oregon voters in 1994 but has been blocked by the court challenge. The law sets conditions under which physicians may assist terminally ill patients in suicide. Meanwhile, Oregonians might get another opportunity to vote on the issue of assisted suicide. A House subcommittee recently approved a measure to hold another referendum.