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Planned Parenthood Accused of Medicaid Fraud, Wrongful Reimbursements Totaling $5.7M

March 10, 2012|11:49 am

Former clinic director turned pro-life activist Abby Johnson is accusing Planned Parenthood of committing Medicaid fraud, according to a federal lawsuit made public on Friday.

Johnson, represented by Alliance Defense Fund attorneys, claimed that her former employer Planned Parenthood Gulf Coast, previously known as Planned Parenthood of Houston and Southeast Texas, Inc., made fraudulent claims seeking Medicaid reimbursements through the Texas Women's Health Program.

ADF attorneys filed the lawsuit under the Texas Medicaid Fraud Prevention Act (TMFPA), which allows "whistleblowers" with inside information to expose fraudulent billing by government contractors.

Even though the suit was filed in July 2009, documents were not revealed until now because under federal law, such cases like the one presented by Johnson had to be initially filed under seal and not be made public while federal and state governments decided whether or not to join the case.

"Americans deserve to know if their hard-earned tax money is being funneled to groups that are misusing it," Michael J. Norton, senior counsel for ADF, said in a statement. "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 alleges that Planned Parenthood knowingly committed Medicaid fraud from 2007 to 2009 by improperly seeking reimbursements from the Texas WHP program, a new family planning program started in 2007, for products and services not reimbursable by that program.

An estimated 40 percent of the claims submitted by Planned Parenthood Gulf Coast to the Texas WHP program were "false, fraudulent, and/or ineligible for reimbursement," the suit noted.

More specifically, at least 87,075 of the claims made were fraudulent. In turn, Planned Parenthood received and retained reimbursements totaling more than $5.7 million.

Johnson was employed with Planned Parenthood Gulf Coast since 2001, having many roles including Health Center assistant, Community Services specialist, and Health Center director.

The now pro-life activist said that she and other clinic managers were pressured by upper management to maximize revenues and increase the bills to the Texas WHP program.

"The continued employment of Ms. Johnson and other Planned Parenthood Gulf Coast clinic managers and staff was threatened if such clinics failed to enhance revenues to Planned Parenthood Gulf Coast by raising the number of billable client fees," the suit read.

During 2009, Planned Parenthood Gulf Coast management was reported to have lain off 13 workers, using those layoffs to show other employees what could happen to them if more revenues were not received from the Texas WHP program and other government programs.

Management additionally allegedly directed employees to cover their tracks by destroying fraudulent files and fixing charts as well.

Though Planned Parenthood Gulf Coast knew it had received reimbursements for false, fraudulent and/or ineligible claims, the suit noted that they failed to reimburse the United States and the State of Texas.

Currently, Planned Parenthood is banned from participating in the Texas Women's Health Program. State law now prohibits Medicaid agencies from contracting with "affiliates of entities that perform or promote elective abortions."

Rep. Cliff Stearns of Florida is currently leading a congressional investigation into the handling of federal funding by Planned Parenthood.

The lawsuit is now pending in the U.S. District Court for the Southern District of Texas, Houston Division.

Planned Parenthood Gulf Coast did not immediately respond to request for comment by The Christian Post.

Source URL : http://www.christianpost.com/news/planned-parenthood-accused-of-medicaid-fraud-wrongful-reimbursements-totaling-5-7m-71179/