News in brief - June 27, 2011

Arizona governor sues over medical marijuana law

Arizona officials led by Gov. Jan Brewer have sued the Justice Dept., seeking to block a state law permitting the use of marijuana for medical purposes.

The lawsuit, filed May 27, asks a federal judge to clarify whether compliance with the Arizona law violates federal drug laws.

In a statement, Brewer said she is concerned that state employees and others expected to administer the medical marijuana program will be at risk for federal prosecution. The governor noted that the drug is still a controlled substance and that federal laws against drug usage may preempt state law.

The American Civil Liberties Union of Arizona said it plans to defend the constitutionality of the law in court, on behalf of the Arizona Medical Marijuana Assn.

Arizona voters approved the law in November 2010. Similar to other state laws, the measure allows the use of marijuana for medical purposes with the appropriate license and a doctor's prescription.

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Kids on Medicaid and CHIP encounter problems with seeing specialists

Children covered by Medicaid or the Children's Health Insurance Program in Cook County, Ill., are much more likely than privately insured children to be denied an appointment with specialists, according to a study published online June 15 in The New England Journal of Medicine.

Fifty-seven percent of the 273 specialist clinics contacted in Cook County accepted privately insured kids but turned away children on Medicaid or CHIP when called by people posing as parents with primary care referrals.

Clinics also screened children by type of insurance: 54% of the 273 clinics contacted in the study asked for information about the child's insurance type before telling the caller if an appointment could be scheduled. The results were consistent across eight types of specialists. Cook County has 218 specialists per 100,000 people, far above the national average of 32 per 100,000. Most Illinois children in Medicaid or CHIP are in a primary care case management system.

The Illinois Dept. of Health and Family Services funded the study, which was conducted between January and May 2010 by researchers at the University of Pennsylvania's Perelman School of Medicine. The report is online (www.ncbi.nlm.nih.gov/pubmed/21675891).

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Bill would allow nonphysicians to coordinate Medicaid care

State Medicaid programs would be required to recognize physician assistants, certified nurse midwives and advanced practice registered nurses as primary care case managers, according to a bill introduced June 3 by Rep. John Olver (D, Mass).

Olver said the measure would help improve primary care in areas with physician shortages. He noted that fees for physician assistants and nurse practitioners often are 10% to 30% less than physician fees. "This could translate into a significant savings," he said.

The measure, formally known as the Medicaid Advance Practice Nurses and Physicians Assistants Access Act, has nine co-sponsors, all Democrats.

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