Planned Parenthood to pay $1.4 MILLION for Medicaid fraud in Texas

UPDATE: July 30,2013 Planned Parenthood Gulf Coast settled a whistle-blower lawsuit that alleged the Houston nonprofit engaged in fraudulent Medicaid billing for $4.3 million – nearly $3 million more than was announced last week by Texas Attorney General Greg Abbott, according to the Houston Chronicle.

In finalizing the settlement, which includes total state and federal recovery, the agency claimed the allegations that it submitted more than $30 million in fraudulent bills between 2003 and 2009 were “baseless.”

“This settlement is not an admission of guilt,” Planned Parenthood said in a prepared statement.

The lawsuit was brought by a former medical assistant in agency’s Lufkin clinic. The lawsuit alleged “defendant’s billing policies routinely instructed clinic staff to enter billing codes for certain services, regardless of whether patients’ charts recorded that such service was actually provided.”

Last week, the attorney general’s office, in announcing a $1.4 million settlement, said its investigation showed the agency charged for “services that were never actually rendered, not medically necessary and were not covered by the Medicaid program.”

The Texas attorney general’s office has settled a Medicaid fraud case with Planned Parenthood Gulf Coast.

The Texas Attorney General’s Office today concluded the State’s Medicaid fraud investigation into Planned Parenthood Gulf Coast, Inc. Under today’s agreement, Planned Parenthood Gulf Coast must pay $1.4 million for fraudulently overbilling the taxpayer-funded Medicaid program.

After a whistleblower lawsuit was filed alleging improper billing practices by Planned Parenthood Gulf Coast, an investigation was opened by the Texas Attorney General’s Office and the Texas Health and Human Services Commission’s Office of Inspector General. The State’s investigation revealed that Planned Parenthood Gulf Coast improperly billed the Texas Medicaid program for products and services that were never actually rendered, not medically necessary, and were not covered by the Medicaid program – and were therefore not eligible for reimbursement. For example, state investigators determined that Planned Parenthood Gulf Coast falsified material information in patients’ medical records in order to support fraudulent reimbursement claims to the Medicaid program.

Under the agreement announced today, Planned Parenthood Gulf Coast must pay $1.4 million to resolve the Medicaid fraud enforcement action. Because Medicaid is jointly funded by the State and the federal government, the federal government is entitled to a portion of the Texas recovery. Under the Texas Medicaid Fraud Prevention Act, the relator-whistleblower that uncovered the defendant’s fraudulent conduct will also receive a share of the State’s recovery.

Nationally recognized for its successful efforts to recover funds wrongfully taken from the Medicaid program, the Texas Attorney General’s Civil Medicaid Fraud Division (CMF) is responsible for pursuing fraud claims through civil enforcement actions. Since 2002, CMF’s recoveries for the State of Texas have passed the $400 million mark – while total recoveries for the state and federal governments now exceed $1 billion.

According to Life News: Karen Reynolds, who worked as a “health care assistant” from 1999 to 2009 at the Lufkin, Texas, branch of the affiliate formerly known as Planned Parenthood of Houston and Southeast Texas, submitted company memos and emails to support her charge that PPGC has engaged in a systemwide scheme to bilk Medicaid, Title XX, and the Women’s Health Program of tens of millions of dollars over the course of at least a decade.

Reynolds alleges bosses trained employees to bill government agencies for medical and family planning services not rendered, for services no reasonable medical personnel would provide, and – the biggest bombshell – for abortion-related services fudged to appear as if they were not.

In 2005, Planned Parenthood of Houston and Southeast Texas (PPHSET) entered a management agreement with Planned Parenthood of Louisiana and the Mississippi Delta (PPLAMD). PPLAMD had been operating health centers in Louisiana since 1984. In 2010, the two affiliates officially merged and became Planned Parenthood Gulf Coast, Inc. (PPGC). Planned Parenthood Gulf Coast now serves 35 counties in Southeast Texas and the entire state of Louisiana. PPGC operates 12 health centers – 7 in the Houston area, 3 in Southeast Texas and 2 in Louisiana.

After the merger, as Planned Parenthood Gulf Coast, paid their employees well according to a 2010 annual report:

Have to wonder if these six digit salaries did not come at the expense of Texas Tax Payers in the Medicaid Fraud?
CEO Peter Durkin took in $234,538
Meloney Linton $151,475
Jeffrey Palmer $124,236

Planned Parenthood reports that they killed 333,964 unborn children from abortion with our tax dollars in the year 2011 to 2012 according to their most recent report! In addition, according to Planned Parenthood’s “Services” fact sheet, its clinics performed 329,445 abortions in 2010.

According to Planned Parenthood’s 2011-2012 Annual Report, the Planned Parenthood abortion giant received $542 MILLION Dollars in Government Grants for year ending June 2012 !

READ ALSO:

Many reasons to defund Planned Parenthood: eugenics, racism, abortion, audits, misappropriation of funds, Medicaid billing practices, hiding sexual predators

Lawsuit: Planned Parenthood defrauded taxpayers in Wash. state

Case AGAINST abortion giant Planned Parenthood advances in Court

Another whistleblower sues Planned Parenthood claims the tax funded abortion giant is guilty of Medicaid Fraud

3 million in Medicaid payments puts Planned Parenthood and doc Caroline Hoke under investigation

BACKSTORY:

2012

Posted from the ACLJ Aug. 13, 2012

Our federal lawsuit against Planned Parenthood in Texas alleges that the abortion giant defrauded taxpayers by charging state and federal governments for services not actually provided, medically unnecessary services, and services that are not covered under Medicaid and other programs.

On Friday, a federal court agreed with the ACLJ that these allegations, if proven, constitute fraud in violation of federal law. The federal court in Texas denied Planned Parenthood’s attempt to have this critical case against the abortion giant thrown out.

This is a major victory as this case to hold Planned Parenthood accountable moves forward to trial. At stake are literally hundreds of millions of dollars, and it is a case that could have a substantial impact on one of Planned Parenthood’s largest affiliates in Texas.

The federal court noted that our lawsuit on behalf of former Planned Parenthood employee turned whistleblower, Karen Reynolds, “asserts that these false claims were submitted to the United States and Texas governments for reimbursement and, to support its claims for payment, [Planned Parenthood] regularly falsified patient charts.”
H/T Texas Watchdog

Planned Parenthood of North Texas PAC fined $3,000 for campaign finance violations

Aug 26, 2010 By Mark Lisheron

The Texas Ethics Commission has fined Cary Jennings, the campaign treasurer for Planned Parenthood of North Texas‘ political action committee, $3,000 for failing to disclose spending $26,695 to support four political candidates in the November, 2008 state elections.

The Ethics Commission also found Planned Parenthood of North Texas Action Fund Political Committee had either failed to report or made mistakes with political contribution and expenditure totals on more than 17 monthly reports required by state law.

The political action committee in a November 2008 report said it spent $26,695 for mass mailings the previous month. However, the report failed to say the mailings were made in support of Wendy Davis, who was running for state Senate and Dan Barrett, Carol Kent and Chris Turner, who were running for state House seats, according to the Ethics Commission findings.

The following month, the political action committee reported spending $15,410 in one day to the same company for a blitz of campaign telephone calls on behalf of Davis, Kent, Turner and Robert Miklos, who was running for the House. The Commission took note that this disclosure of candidate support was not reflected on the report’s cover page.

The committee filed 17 corrected campaign finance reports on Sept. 14, 2009. Texas Watchdog has a call in to Planned Parenthood, and will update the blog if we hear back from the group here .
Davis, Kent, Turner and Miklos won their legislative races, while Barrett lost to Republican physician Mark Shelton.

The Ft. Worth Telegraph reported it this way: Planned Parenthood PAC failed to disclose campaign support
Posted Thursday, Aug. 26, 2010

The Planned Parenthood of North Texas Action Fund PAC fouled up 17 monthly campaign expense reports and omitted an expenditure of about $27,000 that supported four local candidates for the Legislature.

The Texas Ethics Commission posted a report this week that said the political action committee failed to identify the candidates and improperly disclosed expenditures on their behalf.

An amended finance report filed by the PAC shows that the candidates supported by the mailings were Sen. Wendy Davis, D-Fort Worth, and House candidates Chris Turner, Dan Barrett and Carol Kent, all Democrats.

The committee’s treasurer, Cary Jennings, declined to comment. He was fined $3,000, according to a commission order.

The PAC has made internal changes, Director Kathryn Allen said.

“We feel we have fixed the problem and will not make this mistake going forward,” she said. “We weren’t trying to conceal our support for those candidates.”

At question was $26,695 paid on Oct. 14, 2008. The PAC corrected filings in September 2009 to show that it paid Gold Communications to send mailers that benefited the four legislative candidates. The original November 2008 monthly report disclosed the expense but not that the money directly benefited candidates.

The commission found the error when examining a complaint about monthly reports. Between April 2008 and August 2009, the PAC filed reports that inaccurately stated the balance of cash on hand. Balances changed on average by about $6,700. The two largest changes to the contribution balance were a decrease of $25,100 and a decrease of $44,560.

Once the mistake was found, the PAC filed corrected reports within a week, Allen said.

“Our PAC is fairly new, and being new to reporting, we had some technical errors that were found,” Allen said. “They were related to cash on hand. Those have been corrected.”

Read more: http://www.star-telegram.com/2010/08/26/2428025/planned-parenthood-pac-failed.html#ixzz0xobkyfYd
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In 2009

An Audit Shows Planned Parenthood Owes Thousands, sources say debt stands at $1 million

According to this story by KFOX: Planned Parenthood Owes $154K To UMC from November 13, 2009

EL PASO, Texas — KFOX has confirmed Friday that Planned Parenthood Center of El Paso owes more than $150,000 to the county’s University Medical Center.

Through an open records request, KFOX has learned that PPCEP owes UMC $154,814. Sources close to PPCEP claim their total debt stands at more than $1 million.

University Medical Center declined any comment on PPCEP’s current balance. They did not disclose what type of contract was established.

As KFOX reported, a state audit found that PPCEP violated its state contracts after it requested reimbursement for bills that were never paid.

State representatives have told KFOX that it is unclear if the money will ever be collected, and PPCEP is currently under bankruptcy protection.

KFOX has not been able to confirm PPCEP’s bankruptcy status

View Story Here:

Inspector General Report Here

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Former Lufkin clinic employee alleges fraud in suit against Planned Parenthood
Posted: Sunday, February 12, 2012 1:15 am
By JESSICA COOLEY/The Lufkin News

Planned Parenthood Gulf Coast is a defendant in a federal lawsuit after a former Lufkin clinic employee alleged a multi-million-dollar billing scheme.

The complaint names Karen Reynolds as the whistle-blower in the allegations brought against her former employer of 10 years.

The updated complaint, filed in October 2011, alleges that while Reynolds was employed as a health center assistant, she was instructed by the organization to maximize billing revenue when the government was fitting the bill through Medicaid and the Women’s Health Program.

She claims this was the procedure in all 12 Planned Parenthood Gulf Coast locations across Texas and Louisiana.

The suit alleges that, in addition to falsifying patient records, billing the government for unwarranted services and services not covered by Medicaid, Planned Parenthood tacked on services patient did not receive.