Prison health care company awarded $500 million Alabama contract faces complaints across country

A Birmingham-based healthcare firm recently tapped for a $500 million emergency contract to serve Alabama prisons is facing significant scrutiny over its track record in other states.

A Troubled History

NaphCare secured its massive contract with the Alabama Department of Corrections early last month. However, the company is no stranger to controversy. Earlier this year, NaphCare was banned from operating in New York. Additionally, the Arizona Department of Corrections has pointed to the company’s services as a contributing factor in negligence that led to nine state prisons being placed under federal receivership.

Rep. Chris England, D-Tuscaloosa, a member of the Joint Legislature Contract Review Committee, expressed concerns regarding the provider’s national reputation. "Across the country, they have had some issues," England said. "If you go look at New York, I think Ohio and Washington, they have had significant issues in providing care, to the point where a couple of states are trying to get rid of them."

Contractual Shift

The move to hire NaphCare came after the state abruptly canceled a $1 billion agreement with Tennessee-based YesCare following that firm's well-documented financial struggles. Under the new agreement, signed April 29 by Gov. Kay Ivey, then-ADOC Commissioner John Hamm, and NaphCare representatives, the state is slated to pay out $98.2 million by September 2026, with further payments totaling nearly $400 million through April 2028.

Public reports paint a concerning picture of the provider's history. In March, the New York State Attorney General’s Office fined NaphCare $875,000 and barred it from state operations for five years. According to syracuse.com, the company faced backlash after operating without a license in Onondaga County, where two inmates and a newborn baby died. Meanwhile, in Ohio, a family filed a federal lawsuit against NaphCare following the death of Cornelius Howell, who allegedly suffered a medical emergency from sickle cell disease while in custody.

Staffing and Oversight Issues

In Arizona, federal monitor Dr. Marc Stern highlighted "preventable deaths" and poor quality of care under NaphCare. U.S. District Court Judge Roslyn O. Silver, who appointed a federal receiver to oversee Arizona's prisons, noted that persistent understaffing and high turnover prevented consistent care. David C. Fathi of the ACLU National Prison Project argued that the company’s business model creates a perverse incentive: "Every dollar you do not spend on health care is a dollar that you get to keep as profit, so there is an almost irresistible incentive to deny, delay, care, to maximize profits."

While some medical professionals within the Alabama system expressed relief that a new contract is in place—especially following the payroll failures that crippled YesCare—lawmakers are remaining vigilant. England emphasized that the legislature needs to sharpen its focus on vetting and selection processes.

"I think it is incumbent on us as legislators to pay more attention to the process, how they select vendors, the vetting process and put as much scrutiny on these situations as we can," England said.