States Ban Medicaid Coverage of Erectile Dysfunction Treatments for Sex Offenders
Several states last week began the process of outlawing Medicaid coverage of erectile dysfunction drugs such as Viagra for convicted sex offenders, the New York Times reports (Bacon, New York Times, 5/28). The issue recently gained attention after New York state Comptroller Alan Hevesi announced that nearly 200 Level 3 sex offenders in the state had received Medicaid coverage for Viagra (California Healthline, 5/25).
Nearly 800 sex offenders in 14 states have received Medicaid-funded ED treatments, according to a survey by the Associated Press. The 14 states in the AP survey that provided subsidies on ED drugs for sex offenders, in order of magnitude, are Florida, New York, Texas, New Jersey, Virginia, Missouri, Kansas, Ohio, Michigan, Maine, Georgia, Montana, Alabama and North Dakota (AP/Richmond Times-Dispatch, 5/29). Dennis Smith, director of the Center for Medicaid and State Operations, said last week in a letter to states that providing ED drugs to sex offenders could "constitute fraud, abuse or inappropriate use of Medicaid funds." Smith said each state should review its procedures for covering such drugs, adding that "failure to perform such a review and implement appropriate controls may result in sanctions."
CMS spokesperson Gary Karr said the confusion stemmed from an apparent misunderstanding of a federal Medicaid policy outlined in 1998 that requires the program to cover any drug that is medically necessary, including ED drugs (California Healthline, 5/25).
Gov. Arnold Schwarzenegger (R) on Thursday directed state agencies to stop distributing the drugs to sex offenders.
Virginia Gov. Mark Warner (D) on Thursday issued an emergency order stopping state payments for ED drugs for sex offenders. The measure gives the state one year to make the order permanent, during which time the medical assistance program will determine whether coverage should be dropped for all beneficiaries.
New York Gov. George Pataki (R) issued a temporary ban on all public funding for such drugs, giving the state Legislature time to enact a permanent measure to prevent public subsidies of ED treatments for sex offenders. The New Jersey Department of Human Services on Friday said it will inform pharmacists to stop dispensing all ED drugs to sex offenders. Meanwhile, both chambers of the Texas Legislature last week passed bills that would prohibit state payments for ED drugs for any registered sex offenders (New York Times, 5/28).
At the federal level, Senate Finance Committee Chair Chuck Grassley (R-Iowa) on May 24 introduced a bill that would end all Medicare and Medicaid coverage for ED drugs (California Healthline, 5/25).