Kaiser Need Not Pay for Viagra, Court Says
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An appeals court ruled Thursday that state HMO regulators cannot force Kaiser Permanente to pay for the anti-impotence drug Viagra, upholding a lower court ruling.
The California Department of Managed Health Care had argued that the law required health plans to cover all medically necessary prescription drugs for members if the HMO chose to offer any drug coverage at all.
For the record:
12:00 a.m. July 4, 2002 For The Record
Los Angeles Times Thursday July 04, 2002 Home Edition Main News Part A Page 2 National Desk 9 inches; 331 words Type of Material: Correction
AIDS vaccine--A brief item in Friday’s California section stating that California law requires all health plans to cover an AIDS vaccine also should have said that such a vaccine is not yet available. HMOs will automatically be required to cover a vaccine if it is approved for marketing by the U.S. Food and Drug Administration and recommended by the U.S. Public Health Service.
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The appeals panel said agency officials misinterpreted state law and that health plans can decide which drugs to offer members, except in certain cases. Among drugs that must be covered are painkillers for the terminally ill, contraceptives for women, an AIDS vaccine and insulin for diabetics.
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