According to the Inspector General of the Office of Medicare Services, Medicare currently pays more than twice as much for vacuum erection systems (VES) as non-Medicare payers pay for these types of devices. In total, Taxpayers paid nearly $175 million (VES), commonly known as “penis pumps,” during the period studied (2006 to 2011),as the filled 473,620 VES medicare claims.
Medicare payment amounts for VES remain grossly excessive compared with the amounts that non-Medicare payers pay.
Medicare currently pays suppliers more than twice as much for VES as the Department of Veterans Affairs and consumers over the Internet pay for these types of devices.
Processes exist to remedy this imbalance by adjusting Medicare payment rates for VES. Use of the inherent reasonableness process would achieve cost savings.
If the Medicare fee schedule amount for VES had been adjusted to approximate the amount paid for the same or similar devices by non-Medicare payers, the Federal Government would have saved an average of approximately $14. 4 million for each of the 6 years reviewed, and Medicare beneficiaries would have saved approximately $3.6 million annually. That almost $100 million in savings over the six year period.
We are unable to calculate precise cost savings that would be achieved through application of the Competitive Bidding Program to VES.
However, CMS recently announced that the latest round of competitive bidding will reduce prices by 45 percentfor certain types of DMEPOS.
This report is just one more example of how our government recklessly disregards their fiduciary responsibilities.
In a related story Austin Powers still swears none of those VES claims are his.