Government Spent $172M on Penis Pumps

At double the retail price per pump
By Kate Seamons,  Newser Staff
Posted Jan 14, 2014 11:30 AM CST
Government Spent $172M on Penis Pumps
Each claim cost Medicare about $360.   (?)

Between 2006 and 2011, Medicare spent $172 million on penis pumps, according to a report out Monday by the inspector general for the Department of Health and Human Services. That figure is outrageous for a reason other than that you might think. As NBC News reports, penis pumps, more properly known as vacuum erection systems, are actually one of the "few viable treatment courses" for men with erectile dysfunction, per the National Institutes of Health. So it's not the coverage of the item for some 474,000 men over those six years that's the problem, but the amount that was spent: Each claim cost Medicare an average $361—more than double what the pump would have cost if the user just bought it online. (And OIG verified this by ... Googling. It reports that "research on 22 different Web sites yielded pricing information for 105 VES ... the average Internet price ... was $164.74.")

And if Medicare had adjusted its "grossly excessive" coverage amount to be in line with what a non-Medicare consumer pays (and, the report noted, what the Department of Veterans Affairs pays), the government would have spent an average of $14.4 million less per year for each of the years under review, reports Reuters. And the savings wouldn't end there. Beneficiaries are responsible for 20% of the cost of the pump, plus any unmet deductible, which worked out to an average $90; a Medicare fee adjustment would have saved them roughly $3.6 million a year. It could have come to pass, had the issue been dealt with when it previously came up—in 1999, when the Centers for Medicare and Medicaid Services suggested changing the VES fee schedule, reports the Washington Free Beacon. (Another type of Medicare payment under fire: those to hospice companies.)

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