New York's Medicaid bought erectile drugs for sex offenders
ALBANY, N.Y. — New York's Medicaid program paid more than $60,000 for sexual and erectile-dysfunction drugs for 47 sex offenders over six years, a state audit released Wednesday found.
In total, Medicaid made more than $930,000 in payments for erectile-dysfunction drugs for recipients, including sex offenders, that are barred under the program, Comptroller Thomas DiNapoli said.
“There are clear rules about what conditions Medicaid will cover when it comes to erectile dysfunction drugs," DiNapoli said in a statement.
"And paying for sex offenders who’ve committed terrible crimes to get these drugs should never be lost in the bureaucratic administration of this program.”
The Comptroller's Office first identified Medicaid being used to pay for erectile dysfunction drugs, such as Viagra, nearly two decades ago, DiNapoli said, leading to reforms on the state and national level.
But his audit found Medicaid still is paying out some money to enrollees who should be barred from getting the drug.
State and federal law now bans Medicaid from paying for drugs to treat sexual or erectile dysfunction. Additionally, state law specifically bans it for registered sex offenders.
Drugs not just for sexual problems, health officials say
The state's health department ripped the audit, however, saying the drugs are not only prescribed for sexual problems. They can be used for hypertension and enlarged prostates.
The health department contends that only about $8,000 in questionable payments were made over a six-year period through the state's Medicaid program that totals more than $60 billion a year, the largest in the nation.
"The Department strongly disagrees with the Comptroller’s conclusions," the health department said.
It said the drugs "can also be used to treat other indications approved by the U.S. Food and Drug Administration. In these cases, we thoroughly review the sex offender registry to prevent sex offenders from receiving drugs that could treat ED/SD."
But the payments for erectile dysfunction were the result of a complex system involving the state and the managed-care organizations that oversee which drugs are needed for patients, DiNapoli said.
Over the six-year period, the audit found Medicaid made $2.8 million in payments for erectile-dysfunction drugs to treat other ailments, but those patients did not have those problems listed on their medical claims.
In fact, the audit found Medicaid paid $285,641 for the drugs approved for 14 sex offenders and found four of them had only a diagnosis of erectile dysfunction.