I need a Pain Medication Management doc in AL- Medicaid. Posted: 04-16-08 16:05pm
I need a Pain Management doctor in Alabama
that takes Medicaid. Does anyone know of a
doctor? I don't have Medicare or any
other insurance. PLEASE HELP. My pain
doctor quit taking medicaid and I only
have a few days of medication left. He
can't refer me anywhere else because he
says he honestly doesn't know of any
doctors that handle pain medication and
take Medicaid. I'm not a druggie. I just
don't want to abruptly go off my pain
medicine. I called the Duragesic company
and they say it's not good to abruptly go
off of the patch (100 strength)! My
primary care doctor won't write me a
prescription to wean me off my patches. He
said he doesn't write prescriptions for
pain meds. I don't want to really go off
my patches at all, but if I can't find a
pain doctor that is what I am going to
have to do. What ever happened to that
word titrate? If you know of a doctor
please contact me. Thanks
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algosdoc
Experienced User , Rather EHEALTHy
Joined: 23 Mar 2004 Posts: 186
Posted: 04-19-08 13:21pm
I do not specifically know of a pain doc
in AL that takes medicaid but am aware of
several that have recently dropped the
program. With the influx of managed care
medicaid or traditional medicaid with
increasing cumbersome and arcane rules and
regulations, coupled with the
reimbursement that effectively requires
free treatment by the physician, it is not
surprising medicaid is being dropped all
across the country.
Search the following sites for lists of
pain doc names:
american board of pain medicine
www.sppm.org www.spinalinjection.com
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painfulBack
New User, Becoming EHEALTHy
Joined: 16 Apr 2008 Posts: 4
in need of a pain doc that takes Alabama Medicaid Posted: 04-19-08 14:43pm
Thanks for answering. My first pain doctor
quit taking medicaid and abruptly dropped
numerous Medicaid patients. After that I
found a great pain doctor but he moved to
Chicago. Neither of these doctors cared
enough to worry about me abruptly stopping
my medications. Heck, they wouldn't even
face me. They both let their assistants or
receptionists tell me to just "find
another doctor." It might be easy to find
another doctor if you have real insurance
but with Medicaid it's almost impossible!
Luckily a wonderful nurse, from Chicago
bound doctor's office, called me when she
applied for a job at a doctor that took
Medicaid and did pain management. That is
how I found my last doctor, the one that
is now quitting Medicaid. He may actually
be moving too. I can't get a straight
answer from anyone. All I know is that he
won't treat patients that have Medicaid
and want pain help.
So, I checked the doctors that you said to
check and they don't take medicaid. I
called one of them previously and the
first visit is $490! I am on SSI and my
monthy income is only $637. It seems
highly unlikely that I will ever have $490
unless I don't pay my rent for a few
months. But making myself homeless to see
a doctor doesn't seem like a very good
solution. They probably wouldn't see
someone that doesn't have a permanant
address. There is that horrible fear that
all poor people are illegal drug users or
drug sellers. I'm neither. I just want
pain relief!!
If a doctor won't take Medicaid it is
unlikely that he wil be willing to fill
out some Medicaid pharmacy paperwork
(prior authorizations & theraputic
duplication pharmacy override forms) so
that I could be a prescription filled.
For some reason, non-Medicaid doctors
don't want to do that paperwork! Doing
the paperwork doesn't mean that they take
Medicaid patients. Medicaid requires
extra paperwork for the pharmacy. It's
Medicaid's way of checking that there are
no double prescriptions for the same
problem (especially narcotics!) But if a
person needs two prescriptions for the
same thing, (example- breakthrough
medicine) there is a form for "
theraputic duplication" to fill out. Most
doctors hate all this paperwork. I'm used
to the paperwork because for 4 years now
I've had to have it all filled out just to
get my monthly prescriptions filled. My
first doctor (that quit taking medicaid)
was feed up with all that paperwork. He
would mention it occasionally. I am
pretty sure that is why he won't take
medicaid patients that need pain medicine.
Funny thing is, I think he will still do
blocks for people on Medicaid. That
doesn't seem right either! To treat one
thing and not the whole person... I'm sure
too that it was a money move. He probably
didn't make very much money, if any, on an
office visit for pain medicine. There is
more money in procedures.
I've had 4 low back operations. The
procedures didn't seem to help after the
second operation. I don't want another
operation, though I'm sure that is my only
option if I can't get pain relief any
other way. I also have fibromyalgia which
started right after I had an anterior
cervical fusion. My neck and shoulders
still hurt constantly. I also probably
need another cervical fusion, but the
first one didn't help and only brought
fibromyalgia. I don't want to do it again.
I had a block on my neck before my second
doctor quit. It didn't help at all.
One of those local pain clinics does
clinical trials. (found at
clinicaltrials.gov) I can't afford the
place but I thought maybe I could get in
volunteering for a clinical trial. But,
no one will call back. My luck I'd get
the placebo anyway. But I'd be willing to
try anything if I can't afford to pay $490
to see them for a first visit.
I don't know what I am going to do. It
sure would take a load off the system if
all the pain patients just ceased to
exist, wouldn't it!!? I guess that is
what the doctors are pushing poor pain
people to do. Only rich people could
afford to pay $490 for a doctor visit.
And the poor people should just suffer, I
guess. Why do the doctors of this area
want me to suffer so much? Why can't they
just take Medicaid? Maybe just a limited
amount of patients or something.
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algosdoc
Experienced User , Rather EHEALTHy
Joined: 23 Mar 2004 Posts: 186
Posted: 04-19-08 19:01pm
There is one study that shows 60% of
Medicaid patients receiving chronic opiate
narcotics are engaging in substance abuse
or are selling/trading the prescribed
drugs. Medicaid patients have a much much
higher rate of having prescription
narcotics lost or stolen, have a much
higher "no show" rate for scheduled
appointments, use illegal drugs more
frequently, have a higher rate of running
out of their prescribed narcotic
medications early, and make more frequent
calls to the clinic for an array of
problems. The paperwork for Medicaid
patients is a nightmare and the
rules/regulations are constantly in flux
for Medicaid, which would require a
physician to check the Medicaid website
daily for changes in some states. For
some physicians, it is not the fact they
are treating Medicaid patients for free
(they make enough to pay for the
secretarial and nursing time to answer the
hundreds of Medicaid patient telephone
calls and stay on the telephone for 30min
to an hour with Medicaid for each patient
needing a preauthorization for some
medicine or procedure), but instead the
reasons some physicians don't want to
treat the Medicaid population is the
misbehavior of the Medicaid population
itself. Individuals with Medicaid, no
matter how compliant with clinic policies
regarding prescription narcotics, are
lumped with the Medicaid population that
cannot control their use of the
prescrption narcotics.
In most states, Medicaid is not an
insurance plan, it is a law. A patient
having Medicaid cannot pay out of pocket
to the provider above that permitted by
Medicad for services covered under
Medicaid, and a physician charging cash
and not filing Medicaid paperwork may be
committing Medicaid fraud if they are
aware the patient has Medicaid.
It is not the fault of the individual
that they have to rely on a social welfare
program such as Medicaid, but there is a
disproportionate percentage of Medicaid
patients that create a drug abuse or
diversion nightmare for physicians. The
low reimbursement by governments is
ridiculous and is certainly a factor, but
many physicians would happily treat the
poor for a steeply discounted rate if they
did not have to deal with the paperwork
nightmare created by your state
government.
So there are many factors the poor must
face in finding medical care, and in the
realm of pain medicine, the population
behavior of the pain patients as a whole
has made treating them hell for the
physician. I have no good solutions,
other than continue to expand the radius
of your search for a physician that will
accept medicaid.
