VIAGRA: HCFA Mandates Medicaid Coverage
The Health Care Financing Administration has decided that state Medicaid programs must cover the impotence drug Viagra, but federal officials "may eventually" discontinue coverage if they determine that "clinical abuse or inappropriate use" of the drug is occurring. Responding to inquiries from Govs. Lawton Chiles (D) of Florida and Michael Leavitt (R) of Utah, HCFA Administrator Nancy-Ann DeParle "told the governors that, with few exceptions, federal law requires that Medicaid ... cover federally approved drugs prescribed for medically approved uses." Noting that Health and Human Services Secretary Donna Shalala "is greatly concerned about the potential for clinical or financial abuse of Viagra," DeParle said HCFA will set up a "rigorous system" of state officials, physicians and consumer advocates to monitor the drug's use. DeParle encouraged states to limit Viagra refills, ensure correct physician prescriptions and "disciplin[e] doctors who prescribe Viagra when not medically necessary" in order to assure cost efficiencies. The Wall Street Journal reports that the "directive is sure to disappoint the governors, who warned ... that hot-selling Viagra could increase Medicaid costs by $100 million" annually. HCFA's decision will reverse the positions of Medicaid programs in South Carolina, Virginia and Tennessee, which declined to cover the drug while the federal directive was pending (McGinley, 7/2).
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