Physicians, clinics brace for Alabama Medicaid cuts

July 22--Dr. Naresh Purohit needs to hire two staffers and replace a physician at his pediatric clinic in Anniston.

He's instituted a hiring freeze instead.

Purohit wants to serve families at his Roanoke clinic, some of whom he's had relationships with for 22 years. Regardless, he might soon shut the facility down.

"I'm just worried ... I don't know what all else is going to happen," Purohit, of Purohit Pediatric Clinic, said.

Alabama Medicaid is set Aug. 1 to initiate payment cuts to primary care physicians -- with other cuts potentially to follow -- to make up for an $85 million shortfall in the program's budget. Gov. Robert Bentley hasn't called a special legislative session for state lawmakers to fix the shortfall, even though he has said it's an option. Meanwhile, some physicians are bracing for the cuts they say could result in closed clinics and fewer services.

About 1 million people rely on Alabama Medicaid, a joint state-and-federal program that provides health care coverage to the state's poorest, mainly children and the disabled. Along with the payment reductions, Medicaid is considering eliminating adult prescription drug coverage. Other services on the potential chopping block are coverage for outpatient dialysis and prosthetics.

According to a recent report by Alabama Arise, an advocacy group for the poor, more than 36,200 Calhoun County Medicaid recipients, mostly children and seniors, could be affected by the cuts.

Purohit said about 80 percent of the patients in his Anniston office use Medicaid. Around 95 percent of patients in his Roanoke clinic have Medicaid coverage, he said.

"When I talk to my patients about the cuts, they feel like they are being victimized," Purohit said.

Tameka Prothro was at Purohit's Anniston clinic Friday morning to get a checkup for her autistic 8-year-old son, Davarisyus Jones. Prothro works 40 hours a week and has employer-provided insurance, but it doesn't cover the extra care her son needs. Medicaid meets that need by paying for his extra physician visits and treatments.

"Without Medicaid I'd be worried about my son's health care," Prothro said. "My son also has severe asthma, so if they cut Medicaid, that would really hurt us health care-wise."

Wayne Rowe, CEO of Gadsden-based nonprofit Quality of Life Health Services, which owns Anniston Quality Health Care and other similar health care centers in Talladega and Cleburne counties, said he was concerned about how the cuts could affect his facilities and their patients.

About 25 percent of Rowe's health care centers' patients use Medicaid.

"It will certainly impact our ability to have the same effect on patient care," Rowe said. "When patients are not able to get needed medication, we're not able to treat the ongoing chronic conditions that they have."

Louis Bass, CEO of Regional Medical Center in Anniston, said he doubted the cuts would affect the hospital directly. Bass said, however, that RMC's clinics in Roanoke, Piedmont and Talladega are a different story.

"If they reduce those physician payments, that would impact our clinics, especially those in the outlying areas," Bass said.

Staff writer Patrick McCreless: 256-235-3561. On Twitter @PMcCreless_Star.

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