Is Medicare Fraud Behind 500% Increase in Spending for Penis Pumps?

Over the past decade, Medicare spending for penis pumps has shot up over 500 percent. The Center for Medicare and Medicaid Services reports that annual spending on penis pumps has increased from $7.2 million in 2000 to over $36 million in 2011. While this is still a very small portion of the $7.5 billion Medicare spends annually on durable medical equipment (DME) and outpatient supplies, the rapid increase in spending is suspicious.

Federal fraud investigators suspect that Medicare fraud is the explanation for this precipitous increase, according to the East Valley Tribune. For the past four years, federal investigators have looked into over $8 million in payments for “male vacuum erection systems.” Their investigation has uncovered a number of extremely suspicious cases:

• Two Florida residents were paid over $28,000 for a total of 75 penis pumps that were purportedly sold both to male and female Medicare recipients. None of the pumps were actually shipped;
• An Illinois resident bought cheap penis pumps online, reshipped them to Medicare recipients who had not requested them, and then billed the Medicare program for almost 11 times what he paid for the devices; and
• Two Georgia companies billed Medicare over $3.6 million from 2003 to 2009 for penis pumps using invalid Medicare provider numbers.

Medicare reimburses providers for the legitimate cost of penis pumps as durable medical equipment (DMEs) when they have been prescribed as “medically necessary” to treat erectile dysfunction.

Waters & Kraus is a national firm with highly skilled lawyers practicing qui tam litigation in four offices, including Dallas, Los Angeles, San Francisco, and Baltimore. Our attorneys have decades of experience successfully representing whistleblowers in a variety of fraud cases. Contact us or call our attorneys at 800.226.9880 to learn more about our practice and how we can assist.