Tuesday, October 16, 2018
Politics

PunditFact: Medicare really does spend millions on penis pumps

The statement

"Medicare has spent $172 million on penis pumps in the last five years at $360 a pop."

Ilyse Hogue, president of NARAL Pro-Choice America, March 12 on The Daily Show

The ruling

"Vacuum erection systems" (that's a more technical term) are one of several ways a man might treat erectile dysfunction, which affects 30 million men, according to the National Kidney and Urologic Diseases Information Clearinghouse.

We found an inspector general report from the Department of Health and Human Services detailing the issue.

The December 2013 report didn't weigh in on whether it was inappropriate for Medicare to pay for penis pumps. The crux of the review was to find out whether Medicare was paying exorbitant rates for them.

The devices are among the medical supplies eligible for Medicare Part B, which offers supplementary health insurance for medically necessary and preventive services for seniors. The cost of a device such as a penis pump is subtracted from a beneficiary's deductible, and Medicare picks up 80 percent of the cost after that.

The auditors' findings: Medicare payments for vacuum erection systems were more than twice the average payment rate for non-Medicare payers. The difference was "grossly excessive," the report said.

From 2006 to 2011, Medicare paid a total of $172.4 million for 473,629 claims for pumps, or about $364 a pump. That's almost exactly what Hogue said (though spending was measured over a six-year period ending in 2011, not the last five, as she said). Over those six years, annual claims payouts almost doubled, jumping from $20.6 million in 2006 to $38.6 million in 2011, the report said.

Medicare would save $18 million a year, and its beneficiaries would pocket $4.5 million, if the program retooled its fee schedule rate to be more in line with those of other programs and the private market. The report suggested that the Centers for Medicare and Medicaid Services either establish a payment limit or seek authority from Congress to include the products in its competitive bidding program.

We'll stay out of saying whether it's legitimate for Medicare to cover vacuum erection systems for older men. The Daily Show was trying to make a humorous point about tax money paying for some male sexual health products, which hasn't been a source of controversy.

As for Hogue's statement, she gets the dollars right but misses on the time frame.

That's a minor point in judging her overall claim. We rate the statement Mostly True.

Edited for print. Read the full version at PunditFact.com.

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