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BigKNY3
Friday July 3, 4:27 pm Eastern Time
Calif. agency studying HMO's Viagra policy --
LOS ANGELES, July 3 (Reuters) - A California state agency is investigating health maintenance organization Kaiser Permanente's decision to exclude coverage of anti-impotence drug Viagra, the Los Angeles Times reported Friday.
The state Department of Corporations has been reviewing the decision by Kaiser ''for over a month,'' department spokeswoman Julie Stewart told the Times.
Kaiser, one of the nation's largest HMOs with over 9.1 million members in 19 states and the District of Columbia, announced it would exclude Viagra coverage back on June 19 citing the high cost of coverage.
Kaiser estimated national coverage of providing 10 Viagra pills per month would cost at least $100 million, well above the $59 million Kaiser spent for all anti-viral drugs in 1997.
The agency's investigation was revealed on Thursday after state legislators requested a review into whether Kaiser's policy violates state law requiring HMOs to include treatment for medical necessities in covered benefits, the Times said.
A Kaiser spokesman declined to comment on whether an investigation is ongoing, but said ''if there is an investigation, certainly we will cooperate.''
''We think we made a decision that was well thought out,'' said spokesman Jim Anderson.
Agency officials were unable to be reached for comment.
News of the investigation comes on the heels of a federal government order requiring states to pay for Viagra prescriptions under Medicaid programs.
Thursday, the U.S. Health and Human Services Department said federal law requires Medicaid to pay for all drugs prescribed for medical reasons and put Viagra within that category.
Viagra, made by drug company Pfizer Inc., was only recently approved for use by men to treat impotence, but it has become controversial because some government officials and health groups do not want to pay for it. |
