CALIFORNIA: HMO INITIATIVE WINS PLACE ON FALL BALLOT

      Californians for Patients Rights, a coalition of groups
 opposed to managed care's growing control over medical care,
 announced yesterday that the California secretary of state has
 approved the HMO Patient Rights Initiative for the state's
 November ballot.  If passed, the proposal would ban "gag" clauses
 in HMOs' physician contracts; prohibit the use of financial
 incentives to reduce access to care; mandate minimum staffing
 levels for physicians, nurses and "other licensed and certified
 caregivers;" and prohibit HMOs from denying care "without written
 criteria and a second medical opinion."  HMOs and other insurers
 would also be required to disclose profits and overhead.  
      WHO'S BEHIND THIS?:  The HMO Patient Rights Initiative is
 backed by "a coalition of consumers, doctors, nurses, health care
 workers, labor & seniors."  Its sponsors include the Service
 Employees International Union and the California Physicians
 Alliance (release, 6/6).  A separate ballot drive, sponsored by
 the California Nurses Association and consumer advocate Ralph
 Nader is still pending; it contains many of the same provisions
 as the HMO Patient Rights Initiative, but it would also place
 limits on health insurance premium increases, impose taxes on
 health care mergers and hospital closures, establish a nonprofit
 consumer "watchdog board" and prohibit insurers from mandating
 out-of-court settlements for consumer grievances (AHL's 50-State
 Report, Summer 1996 issue).