Michigan Won't Pay For Sex Offender ED Drugs: MDCH Issues Guidance To State Health Plans, Prohibits Sex Offenders From Obtaining Viagra-Like Drugs

Contact: T.J. Bucholz (517) 241-2112
Agency: Community Health

May 26, 2005

Governor Jennifer M. Granholm today announced that Michigan will enhance the current prior authorization process to obtain erectile dysfunction (ED) drugs by instituting a sex offender background check for individuals enrolled in Medicaid before authorizing prescriptions.

In line with federal guidance issued on May 23, state officials will now include the background check by using the Michigan’s sex offender registry to prevent listed individuals from receiving ED prescription drugs.

“Our goal is to always ensure that patients in the state’s Medicaid program get the prescription drugs they need to improve their health, but we also want to use state resources wisely,” said Janet Olszewski, Director of the Michigan Department of Community Health. “Those that absolutely need a prescription drug – like Viagra – to treat a health condition will continue to receive it – convicted sex offenders will not.”

Currently, all ED prescriptions issued to Medicaid patients require prior authorization to verify that a patient’s clinical situation supports the drug’s established uses. For its part, the state of Michigan has recently added a check of the sex offender registry for patients receiving ED drugs, Olszewski said.

In the last six months, 302 ED prescriptions have been paid for by the state’s Medicaid program for 300 beneficiaries statewide. The total expenditure for those prescriptions was $76,000.

The highest costs for ED prescriptions in Michigan’s Medicaid program result from individuals who are diagnosed with primary pulmonary hypertension (PPH). In those cases, ED drugs are used – by both men and women – to treat the illness. ED drugs may still be used in those cases, but before the drug is prescribed, state physicians will work with local medical providers through the state’s prior authorization protocols.