Medicaid Paid for Sex Offenders' Viagra

ALBANY, N.Y. (AP) - Scores of convicted rapists and other high-risk sex offenders in New York have been getting Viagra paid by Medicaid for the last five years, the state's comptroller said Sunday.

Audits by Comptroller Alan Hevesi's office showed that between January 2000 and March 2005, 198 sex offenders in New York received Medicaid-reimbursed Viagra after their convictions. Those included crimes against children as young as 2 years old, he said.

Hevesi asked Michael Leavitt, secretary of the U.S. Department of Health and Human Services, in a letter Sunday to "take immediate action to ensure that sex offenders do not receive erectile dysfunction medication paid for by taxpayers."

According to Hevesi, the problem is an unintended consequence of a 1998 directive from federal officials telling states that Medicaid prescription programs must include Viagra. His office discovered that the state was helping sex offenders pay for Viagra by checking Medicaid pharmacy expenditures against the state's sex offender registry.

Sen. Hillary Rodham Clinton said in a statement that it was "deeply disturbing and runs contrary to the purpose of Medicaid, which is to provide health care coverage for uninsured, low-income individuals." Clinton, a Democrat, urged Leavitt to look into the matter, and said she would explore legislative options.

New York's other senator, Democrat Chuck Schumer, said at a press conference in New York City that he hoped the issue could be resolved without a bill, but he's prepared to offer one if needed.

"While I believe that HHS did not do this intentionally, when the government pays for Viagra for sex offenders, it could well hurt many innocent people," he said.

New York auditors are reviewing whether other prescription drugs for sexual dysfunction are being reimbursed by Medicaid for convicted sex offenders, Hevesi spokesman David Neustadt said.

While the auditors didn't review the situation on Viagra reimbursement by Medicaid in other states, he said they have no indication that the policies are different elsewhere.

Hevesi Asks Feds to Change Policy After Finding 198 High-Risk Sex Offenders Receiving Viagra From Medicaid

Office of the NY State Comptroller | May 22, 2005

After his Office found that in New York 198 Level 3 sex offenders are receiving Viagra paid for by Medicaid, New York State Comptroller Alan G. Hevesi has asked Michael Leavitt, Secretary of the U.S. Department of Health and Human Services, to change federal policies on distribution of the drug, Hevesi announced today. Level 3 sex offenders are those considered by the courts most likely to commit crimes again.

“Federal, state and local reimbursement for the cost of erectile dysfunction drugs for sex offenders raises serious policy considerations and has the potential to place the public at risk. I am asking that you take immediate action to ensure that sex offenders do not receive erectile dysfunction medication paid for by the taxpayers. I urge you to take administrative action to remedy the situation or draft an amendment to the underlying statute as appropriate,” Hevesi wrote to Leavitt.

“Medicaid is a critically important federal and state program providing essential health services to millions of New Yorkers. Our role is to support the program while exposing abuse where ever it occurs,” Hevesi said. “The audits conducted by my staff have improved the State’s Medicaid operations and, since 1994, identified more than $826 million in actual and potential overpayments.”

“This probe makes it crystal clear that combating sex crimes requires vigilant, comprehensive solutions. There is not excuse for allowing Level 3 sex predators, the absolute worst of the worst, to have Viagra. The emotional and physical harm inflicted by sexual predators warrants tough, effective measures and I join Comptroller Hevesi in calling on the federal government to act immediately to end this outrage,” said Assembly Speaker Sheldon Silver.

The Comptroller also alerted the State Department of Health, which administers the Medicaid program in New York.

In July 1998, the United States Department of Health and Human Services (HHS) informed states that Medicaid programs covering prescription drugs must cover Viagra, when medically necessary. States not covering the drug would be subject to financial sanctions.

The New York Sex Offender Registration Act (SORA) requires the Division of Criminal Justice Services to maintain a Sex Offender Registry. Sex offenders are those convicted of crimes such as rape, sexual abuse, and sexual conduct against a child. Sex offenders are classified according to their risk of re-offending.

There are three levels of risk: Level 1 (low), Level 2 (moderate), and Level 3 (high). There are many factors considered in determining risk, including number of offenses, whether the victim was a child, use of weapons, and response to treatment. As a general rule, the sentencing court will determine an offender's risk level either at the time of sentence (in probation cases) or when the offender is released from custody (in jail or prison cases).

Because the court may not possess up-to-date information on an offender being released from prison or jail, SORA established a Board of Examiners of Sex Offenders to evaluate these cases and make a risk level recommendation to the court. The risk level assigned governs the amount and type of community notification authorized for a particular sex offender. The Act requires that the Division also maintain a Subdirectory of Level 3 Sex Offenders, which is available on the Internet.

During a review of Medicaid pharmacy expenditures, Comptroller’s Office auditors discovered that some sex offenders were receiving Medicaid-reimbursed Viagra. The auditors matched the names of Level 3 sex offenders currently listed on the Subdirectory on the Internet with the names of individuals receiving Medicaid and specifically looked for individuals receiving Viagra.

The search found that, for the period January 1, 2000 through March 31, 2005, 198 Level 3 sex offenders received Medicaid-reimbursed Viagra after being convicted of a sexual offense. Among the crimes committed by these sex offenders were crimes with children as young as two years of age and a woman as old as 90 years of age and the crimes ranged from rape in the first degree to sexual touching.

The review, which is still underway, has not yet examined whether any of the Level 3 offenders are receiving prescriptions for other erectile dysfunction drugs which came on the market after the 1998 directive. Level 1 and 2 offenders’ names are not listed on the Internet and were not included in this review.

“The findings from our review undoubtedly are an unintended consequence of the 1998 HHS directive issued pursuant to Section 1927 of Title XIX of the Social Security Act of 1965. It is a consequence that clearly is worthy of corrective action,” Hevesi wrote.