Paying bills becomes an issue. Restocking needed drugs for patients can be troublesome.
“You have to just make do with what you have,” said Calhoun, who owns Golden Springs Pharmacy in Anniston.
The Alabama Medicaid Agency, which provides health care for disabled and low-income residents, today is releasing about $75 million in funding to pharmacies, nursing homes and certain physicians across the state, their reimbursements having been delayed due to state cash flow issues in March. For some local providers like Calhoun, the delay caused problems with their finances. And with the state Legislature mulling over a 2013 budget that proposes deep cuts to the Alabama Medicaid Agency, those same providers are concerned about the reliability of future Medicaid payments.
“It concerns me — it concerns everybody,” said Chris Martin, who owns Martin’s Pharmacy in Oxford. “It’s been a problem. Maybe I’ll plan to expect Medicaid payments later.”
Robin Rawls, director of communications at the Alabama Medicaid Agency, said her agency typically releases reimbursement claims for Medicaid every two weeks. During the last scheduled payment in March, however, the funding could only be stretched so far and had to be delayed several more weeks, Rawls said.
Gov. Robert Bentley in late March ordered a nearly 11 percent or $170 million cut to the General Fund, which included about $68.4 million from the Alabama Medicaid Agency.
“Twenty percent of my business is Medicaid,” Calhoun said. “For us, anytime there is a problem with cash flow, we have to tighten our belts.”
Brandon Farmer, public affairs officer for Northport Health Services, which owns nursing homes across the state including Jacksonville Health and Rehabilitation LLC, said the Jacksonville nursing home and others all had delays in Medicaid reimbursements.
“We are fortunate that we were able to sustain that and it not impact care or hurt the staff,” Farmer said.
However, Farmer said, Northport Health Services is concerned about Medicaid payments should the state Legislature enact deep cuts into the agency.
The Ways and Means General Fund Committee of the state House approved Wednesday a $1.3 billion 2013 operating budget, which included a 30.5 percent or $175.4 million cut to Medicaid — giving the agency a total $400 million budget. The cuts are even more drastic considering that the federal government provides $2 for every $1 the state spends on Medicaid.
“This is very concerning for us,” Farmer said of the proposed cuts. “Again, nothing has been passed yet and we are working with the Legislature to come to a resolution so we’ll be able to sustain the same level of care.”
State health officer Don Williamson, who is helping oversee Medicaid’s finances at the governor’s request, said a $400 million Medicaid budget would have dire consequences.
“I do not believe with a $400 million budget, you can provide Medicaid that will not cause significant pain to everyone involved in the program,” Williamson said.
Williamson said the cuts would significantly affect many aspects of the health care industry in the state, including physician services, hospice care and pharmacies.
“There would be a host of changes … potentially even eliminating pharmacy for adults since that is not a federally mandated program,” Williamson said.
The federal government mandates that Medicaid programs provide funding for certain services and institutions, Rawls said. For instance, hospitals and checkups for children are considered mandatory and must be funded under Medicaid. However, prescription drugs and prosthetic devices are considered optional under Medicaid, she said.
While the cuts to the General Fund would not affect hospitals directly, they would eventually do so indirectly, said David McCormack, CEO of Regional Medical Center in Anniston.
“Physicians could stop taking Medicaid and so those patients would have nowhere else to go but emergency rooms and that would overwhelm us,” McCormack said. “Making such blanket cuts on health care is going to hurt everyone.”
Williamson agreed with McCormack, saying the cuts would likely mean smaller reimbursements for physicians and pharmacies, forcing them to possibly stop accepting Medicaid altogether.
“Care may not be available for some people going forward,” Williamson said.
Williamson noted that the budget still has a long way to go before it is finalized and that he hoped to provide more information about the Medicaid cuts to the Legislature by Tuesday.
“We will provide broad categories and share the consequences of a $400 million budget,” Williamson said.
Staff writer Patrick McCreless: 256-235-3561. On Twitter @PMcCreless_Star