- The Washington Times - Saturday, May 28, 2005


Nearly 800 convicted sex offenders in 14 states got Medicaid-funded prescriptions for Viagra and other impotence drugs, with the majority of the cases in New York, Florida and Texas, according to a survey.

A study by the Associated Press found the states that provided registered sex offenders with subsidized impotence drugs are: Florida, 218 cases; New York, 198; Texas, 191; New Jersey, 55; Virginia, 52; Missouri, 26; Kansas, 14; Ohio, 13; Michigan, seven; Maine, five; Georgia, three; Montana, three; Alabama, two; and North Dakota, one.

Medicaid, the health insurance program for the poor, is administered differently in every state. Thus, while some states allowed Medicaid payments for prescriptions for the drugs Viagra, Cialis and Levitra, other states did not.

New York, acting on a tip, was the first to uncover that Medicaid had paid for Viagra prescriptions for sex offenders. Its report prompted the federal government, which provides states with funds for Medicaid, to order states to take steps to stop the coverage for these felons.

In Virginia, the cost came to at least $3,085. Gov. Mark Warner issued an emergency order barring Medicaid from continuing to pay for the drugs for these men.

Kyle Smith, a spokesman for the Kansas Bureau of Investigation, put it this way: “Do we have programs giving clubs to wife beaters or drinks for those committing DUI? Weird things happen in this world, and this is one of the weirder.”

In Alabama, officials said the federal government previously had mandated that states pay for erectile-dysfunction drugs. “Now that we are armed with new information from the federal government, Alabama can and will deny this coverage for registered sex offenders,” Carol Herrmann, the state’s Medicaid director, said last week.

Some states had relied on a 1998 letter from the Clinton administration as a basis for providing coverage, said Matt Salo, a staff member of the National Governors Association. But that letter also said restrictions could be put in place to curb abuse. For example, the letter said states should limit the number of refills or the quantity of pills per prescription.

That letter, sent to then-Govs. Michael O. Leavitt of Utah and Lawton Chiles of Florida, said Medicaid must cover all FDA-approved drugs with certain exceptions. Those exceptions included drugs used for weight control, for cosmetic purposes or to promote fertility.

Some states did decline to provide coverage for impotence drugs to any male. South Dakota considers Viagra and similar drugs to be fertility drugs. “Our rules are specific in that we do not cover agents to promote fertility or to treat impotence,” said Larry Iverson, director of South Dakota’s Office of Medical Services.

Wisconsin officials simply ignored the directive. The state’s health and human services chief “thought the directive was ill-advised and chose to disregard it,” said a department spokeswoman, Stephanie Marquis.

Tennessee took the position that the treatment of erectile dysfunction is not medically necessary. The state has approved coverage of Viagra in five cases, not involving sex offenders, for treatment of pulmonary hypertension.

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