Congress looks to deflate Medicare coverage of penis pumps

The U.S. House of Representatives this week passed a bill that specifically bans Medicare coverage of vacuum erection systems (VES) used to treat impotence.

On the street--or more commonly in the retirement community--the devices are known as penis pumps. They fall under the government's durable medical equipment program, which goes by the acronym DMEPOS, the Washington Post reported. The VES, according to a Health and Human Services Inspector General report, treats impotence, which is considered a "failure of the the body part" that requires medical expertise. Therefore, the pumps have been eligible for coverage under Medicare Part B.

So why the kerfuffle? Simple. Last year, the Inspector General discovered that Medicare was paying an average of $360 per device, which was more than double the average retail price for the pump on just about any online shop that sells them. That report triggered a plethora of late-night television jokes that left politicians and bureaucrats looking like they'd been caught with a VES.

Keep in mind, although there was a $3.1 million, two-year hiccup where the agency mistakenly paid for erectile dysfunction drugs, Medicare's prescription drug program specifically bans such pills. The pump, however, got a thumbs up.

In fact, between 2006 and 2011, Medicare paid 473,620 claims for penis pumps with an average copay of $90.23 per device, the Post said. The average cost for one found online, based on the Inspector General's report, was $164.74.

Since the move to eliminate the government subsidy for the device is part of a House bill that has strong bipartisan support to create tax-advantage bank accounts for people with disabilities, opposition to banning the pump is weak.

The bill, which was approved by the House, 404-17, this week, now heads to the Senate for debate. The Congressional Budget Office estimates the government will save $444 million over the next 10 years if the benefit is taken away.

- read the Washington Post story

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