I need a Pain Medication Management doc in AL- Medicaid.

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

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.

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.