Planned Parenthood’s Houston and Southeast Texas affiliate routinely submitted “repeated false, fraudulent, and ineligible claims for Medicaid reimbursements” through the Texas Women’s Health Program over a period of years, according to a federal lawsuit originally filed in July 2010 and made public on March 9.
ADF attorneys representing Abby Johnson, former director of Planned Parenthood’s Bryan/College Station clinic, filed the suit under the Federal False Claims Act and Texas Medicaid Fraud Prevention Act, which allow “whistleblowers” with inside information to expose fraudulent billing by government contractors. By law, such cases must initially be filed under seal and may not be made public while federal and state governments decide whether to join the case.
The suit alleges that Planned Parenthood of Houston and Southeast Texas, now known as Planned Parenthood Gulf Coast, knowingly committed Medicaid fraud from 2007 to 2009 by improperly seeking reimbursements from the Texas Women’s Health Program for products and services not reimbursable by that program. According to the lawsuit, by filing at least 87,075 false, fraudulent, or ineligible claims with the Texas Women’s Health Program, Planned Parenthood wrongfully received and retained reimbursements totaling more than $5.7 million.
When Planned Parenthood realized what it had done, it didn’t come clean or try to make it right. Instead, it held a meeting in late 2008 or early 2009 to inform its clinic directors that it had been falsely billing the Texas WHP program since January 1, 2007. When Abby Johnson, shocked, asked, “What are we going to do about” the money that Planned Parenthood had improperly received, her supervisor answered, “Well, we are going to hope we don’t get caught.”
The directors then wondered, “What will happen if we get audited?” and Planned Parenthood management told them that they “would not be personally liable.” Clinic managers were told to continue to bill for ineligible products and services, and so they also continued to pre-select, purge, and falsify patient charts, changing them after the fact to make them appear legitimate.
According to Planned Parenthood management, “sometimes [fraudulent billing] happens; we really should be sending back a refund, but it’s such a hassle we try not to do that.”
Johnson’s lawsuit also alleges that, upon identifying that some clients were pregnant, Planned Parenthood improperly and illegally performed abortions on those clients rather than, as required by Texas law, referring those clients to other healthcare practitioners who did not perform or promote elective abortions nor contract or affiliate with entities that performed or promoted elective abortions.
The State of Texas is at the epicenter of many of Planned Parenthood’s recent controversies. Texas recently decided to enforce existing law to effectively ban Planned Parenthood from participating in the Texas Women’s Health Program because state law says that the state’s Medicaid agency cannot contract with “affiliates of entities that perform or promote elective abortions.”
Another Texas Planned Parenthood affiliate disaffiliated with the abortion giant after it recently decided to require that all Planned Parenthood affiliates perform abortions.
And this is only the latest revelation about Planned Parenthood affiliates’ waste, abuse, and potential fraud. Two other False Claims Act lawsuits against Planned Parenthood affiliates in California and Texas, filed by the American Center for Law and Justice, have already been unsealed. In one complaint filed in October 2011, former Planned Parenthood Gulf Coast (PPGC) employee Karen Reynolds alleged that PPGC trained and instructed its employees to bill the government for services that were not medically necessary, not provided, and not covered by Medicaid, and to falsify patients’ medical charts in order to evade detection and avoid repayment. In a 2008 complaint, former Planned Parenthood of Los Angeles CFO Victor Gonzalez alleged that Planned Parenthood’s California affiliates had been overbilling the government for six years, resulting in over $180 million of overpayments. According to that complaint, “This conservative figure only takes into account the illegal and unscrupulous billing practices of [Planned Parenthood affiliates] within the state of California.”
Further, on Feb. 7, ADF publicly released its report to Congress in which ADF identified nearly $100 million in waste, abuse, and potential fraud committed by other Planned Parenthood affiliates and other service providers. Rep. Cliff Stearns of Florida is currently leading a congressional investigation into the handling of federal funding by Planned Parenthood, the nation’s largest purveyor of abortions.
Americans deserve to know if their hard-earned tax money is being funneled to groups that are misusing it. No matter where a person stands on abortion, everyone should agree that Planned Parenthood has to play by the same rules as everyone else. It certainly isn’t entitled to a penny of public funds, especially if it is committing Medicaid fraud.
The lawsuit Johnson v. Planned Parenthood of Houston and Southeast Texas is pending in the U.S. District Court for the Southern District of Texas, Houston Division. Irving attorney Joshua Carden and Houston attorney Scot Dollinger, two of nearly 2,100 attorneys in the ADF alliance, are assisting with the case.
This post originally appeared here.