A Medicare mistake: Paying for Viagra

Mar 16 2011

The Department of Health and Human Services Office of the Inspector General concluded that the program paid more than $3 million in 2007 and 2008 for this drug, even though it is against the law for Medicare to pay for Viagra prescriptions.

Bloomberg: Medicare Illegally Paid For Seniors' Viagra, U.S. Audit Says
The U.S. Medicare program improperly spent more than $3 million in 2007 and 2008 to buy Pfizer Inc.'s Viagra and other erectile dysfunction drugs for senior citizens, government investigators said. The purchases violated a 2005 ban on covering the drugs under the U.S. health program for the elderly and disabled. Medicare administrators blamed the spending on a software error and said they would try to recover payments to private insurers who administer the program's drug plans. Medicare "should not have covered these drugs," George Reeb, acting deputy inspector general for audit services at the U.S. Department of Health and Human Services, wrote in a report released today. He recommended that Medicare work with the Food and Drug Administration to maintain a list of prohibited drugs. Medicare administrators, in a response to the report, rejected the suggestion as unnecessary (Wayne, 3/14).

Politico: Medicare Mistakenly Pays For Viagra
It is against the law for Medicare to pay for prescriptions to Viagra and other erectile dysfunction drugs, but the government health program paid claims worth $3.1 million for those drugs, the HHS Office of Inspector General has found. The claims were paid in 2007 and 2008. The problem stems from a mistake in editing software that was supposed to block Part D coverage for the drugs, the HHS OIG reported (Coughlin, 3/14).

The Hill: Medicare Paid $3.1M For Viagra, Other Erectile-Dysfunction Drugs
Despite a ban on funding for sexual or erectile-dysfunction treatments, Medicare improperly paid $3.1 million for the treatments over a two-year period, according to a new internal report. Medicare's prescription drug processing system is designed to reject erectile dysfunction drugs, but the $3.1 million was approved because the program used an incomplete list of such drugs, the Health and Human Services Office of Inspector General wrote. The Medicare Part D prescription drug program, launched in 2006, excludes payments for a drug "when used for the treatment of sexual or erectile dysfunction, unless such drug were used to treat a condition, other than sexual or erectile dysfunction, for which the drug has been approved by the Food and Drug Administration" (Millman, 3/14).