Medicaid Covered Viagra for Sex Offenders in 14 States

Nearly 800 convicted sex offenders in 14 states got Medicaid-funded prescriptions for Viagra and other impotence drugs, a survey by Associated Press shows.

Most of the cases were in New York, Florida and Texas.

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.

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. That comes to 788 cases.

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

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 Assn. But that letter also said restrictions could be put in place to curb abuse.

That letter, sent to then-Govs. Mike Leavitt of Utah and Lawton Chiles of Florida, said Medicaid must cover all FDA-approved drugs with certain exceptions, including drugs used for weight control, 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.

Wisconsin officials 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 was not medically necessary. The state has approved coverage of Viagra in five cases, not involving sex offenders, for treatment of pulmonary hypertension.

The federal government told states last week that they had to take steps to ensure such drugs did not go to sex offenders. But the fallout could be much broader because Congress has proposed banning coverage of impotence drugs for all Medicaid and Medicare recipients.