Primary Pulmonary Hypertension News - Menu Florida Acts To End Payment Of Erectile Drugs For Ex-Cons By GARRETT THEROLF gtherolf@tampatrib.com Attorney General Charlie Crist said Medicaid has paid $93,000 to buy Viagra, Cialis, Levitra and other erectile dysfunction drugs for 218 offenders in the past four years. "It's ridiculous. Common sense and government don't often meet. This is the biggest example of that that I have ever heard of,'' Crist said in an interview. Florida's Medicaid discovery was made as all 50 states scrutinized their records after a report released Monday by New York State Comptroller Alan Hevesi that showed his state had provided 198 rapists and other serious offenders with Viagra since 2000. The federal Center for Medicare and Medicaid Services immediately issued a letter to the 50 state administrators of the state-federal program, which provides health care for the poor and disabled, mandating that they immediately impose procedures to prevent sex offenders from receiving the drugs. In Florida's case, that meant the end to reimbursement for every Medicaid recipient's erectile dysfunction prescription, with the exception of patients who use Viagra to treat primary pulmonary hypertension, a potentially life-threatening condition. Alan Levine, who leads the state Agency for Health Care Administration, said, "Last year, Florida spent $4 million on drugs [through Medicaid] aimed at enhancing sexual performance, but Medicaid's obligation to taxpayers and participants alike makes it improper for the state to continue paying for such prescriptions.'' His agency was unable to say whether any of the sexual offenders who received the drugs went on to commit a sexual offense, but a spokesman said staffers are looking into the issue. The spokesman, Jonathan Burns, also declined to release the names of the offenders who received the medications, citing federal privacy restrictions that prohibit releasing such medical information to the public. But advocates for sexual abuse victims noted that such prohibitions do not always prevent the sharing of such information among government agencies. "We have information at our fingertips to protect taxpayers from waste and to protect children from abuse that we are just not using,'' said David Caton, executive director Florida Family Association, an organization pressing state agencies to share databases in an effort to locate more than 1,000 of Florida's 35,000 convicted sex offenders who have gone missing. Said Laura Ahearn, executive director of Parents for Megan's Law, the national victims' rights group based in Stony Brook, N.Y.: "Sex offenders are the most cunning of all of our criminals so they tend to be one step ahead of us. We are often caught in surprises like this.'' Ahearn said her agency would press for regulations to prohibit all sex offenders - Medicaid recipients or not - from receiving erectile dysfunction medications. Issues related to sexual offenders in Florida have received increased attention since the sexual assault and slayings of Tampa Bay area girls Jessica Marie Lunsford, 9, and Sarah Michelle Lunde, 13, in recent months. State Sen. Durrell Peaden Jr., R-Crestview, and chairman of the Senate Health Care Committee, said the push to prevent all sex offenders from receiving erectile dysfunction medications will become a priority for the Legislature. "I think we ought to cut that thing off,'' Peaden said. ``At the first meeting in the fall, that'll be the first thing to come up.'' The Legislature has already tried to limit the use of such drugs, which cost $8 or $9 per pill, at least by Medicaid patients because of disagreement whether the program should be covering such medications in the first place. Meanwhile Tuesday, Congress moved to eliminate federal payments for Viagra and other drugs that treat impotence. Sen. Charles Grassley, R-Iowa, introduced legislation that would eliminate all federal payments, both Medicaid and Medicare, for these drugs. Legislation introduced in the House in early February with 29 co-sponsors would exclude coverage for Viagra under the Medicare prescription drug benefit. Researcher Michon Ashmore contributed to this report, which includes information from The Associated Press. Reporter Garrett Therolf can be reached at (850) 222-8382. Florida now to deny Viagra to all Medicaid recipients By DAVID ROYSE May 24, 2005 - Gov. Jeb Bush said the state was planning to seek federal approval to make the change, but officials at the state Agency for Health Care Administration announced late Tuesday that it would go forward immediately with the cutoff and will submit a formal amendment to the state's Medicaid plan to federal officials later this year. An official at the federal Centers for Medicare & Medicaid Services said while states are required to cover the drug when it is medically necessary, they are free to determine how to define medical necessity, so Florida is allowed to make the change without getting approval first. It's not clear how many people in Florida are being reimbursed for Viagra or other drugs to treat erectile dysfunction, or ED. But AHCA spokesman Jonathan Burns said the state paid out $4 million for about 170,000 claims for ED drugs in calendar year 2004. Centers for Medicare & Medicaid Services spokesman Gary Karr said he didn't know of any other states that had cut off use of the drug to non-sex offenders, but wasn't sure that Florida was the first, noting that some other states had strict restrictions. The federal government told all 50 states on Monday that they don't have to pay for Viagra for sex offenders on Medicaid. That move came after the New York comptroller's office found nearly 200 rapists and other high-risk sex offenders in the state received Medicaid-reimbursed Viagra after their convictions. Florida officials soon found similar funding here. Bush said he didn't think it made sense to pay for it in most cases. "My hope is that we will be able to just stop subsidizing ED drugs," Bush said. "These drugs are also used for other purposes, which are more than appropriate, but I don't think the Medicaid budget ought to be used for funding any of this for anybody, certainly not for sex offenders." Florida Attorney General Charlie Crist said earlier that Medicaid has paid $93,000 to provide Viagra to 218 sex offenders in Florida over the last four years. After the federal government clarified that the program can cut sex offenders off from the drug as not medically necessary, AHCA Secretary Alan Levine said Florida would immediately do so - but also said the state would go further. "Last year, Florida spent $4 million on drugs aimed at enhancing sexual performance, but Medicaid's obligation to taxpayers and participants alike makes it improper for the state to continue paying for such prescriptions," Levine said. There are a few people in Florida who may still be able to get it - notably women prescribed the drug for the treatment of primary pulmonary hypertension. Burns said the state would send federal officials an amended outline of its Medicaid program in June that will include the change, and Karr said the federal government would take the Florida change under advisement. But Karr noted that states are allowed to determine whether Viagra is medically necessary - and Florida essentially has determined it is not. Karr noted that the amount spent by all states nationally on ED drugs was extremely small as a portion of the total Medicaid budget - $38 million out of nearly $300 billion.
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