According to data collected by the Centers for Medicare and Medicaid Services (CMS), Medicare has spent more than $240 million of taxpayer money on penis pumps for elderly men over the past decade, and will surpass a quarter of a billion dollars this year for costs since 2001.
The cost to taxpayers for the pumps more than quadrupled during that period, from a low of $11 million in 2001 to a high of more than $47 million in 2010. And these represent only the costs for external devices, technically classified as “Male Vacuum Erection Systems,” not implantable devices or oral drugs such as Viagra.
Easy to Qualify
In order to obtain a pump, according to CMS’s Local Coverage Determination (LCD) revised in October this year, the “patient’s medical record must contain sufficient documentation of the patient’s medical condition to substantiate the necessity for the type and quantity of items ordered,” noting erectile dysfunction (ED) can “commonly occur in men in the Medicare age group.”
The National Institutes of Health previously estimated between 15 percent and 25 percent of 65-year-old men experience ED on a long-term basis, which the LCD notes may be caused by “diabetes, other endocrine abnormalities, vascular abnormalities, trauma, neurogenic, psychogenic, side effects of many medications, and other causes.” The Cleveland Clinic also points to “psychological factors, such as stress, depression, and performance anxiety” as possible causes.
If a medical exam and history shows a senior on Medicare meets the relevant threshold—a diagnosis of ED—he becomes eligible for a wide range of options under the Medicare Prosthetic benefit. Treatment Options covered by Medicare include “oral medications, pharmacological injections, intra-urethral suppositories, vacuum erection devices, and implantable penile pumps.”
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