Archive for the Planned Parenthood Medicaid Contract Category

More audit records reveal overbilling and potential fraud at Planned Parenthood

Posted in Medicaid Billing Practices, Planned Parenthood Audit, Planned Parenthood Medicaid Contract, Planned Parenthood medicaid fraud with tags , , , , , , , , , , , , , , , , , , , , , on October 15, 2017 by saynsumthn

|  (From Live Action News)

Previous Live Action News reports have documented Planned Parenthood‘s history of potential fraud in light of half a billion tax dollars being entrusted to the abortion corporation annually. Watchdog organizations like Alliance Defending Freedom and the Charlotte Lozier Institute have published reports showing Planned Parenthood’s blatant disregard for regulations regarding Medicaid dollars.

In addition to those reports, here are more cases involving the misuse of Medicaid reimbursements by the abortion corporation:

1) Kansas

On January 23, 2017, Planned Parenthood Great Plains and Comprehensive Health of Planned Parenthood Great Plains Kansas (PGP) agreed to pay more than $18,800 for “allegedly violating the Civil Monetary Penalties Law,” according to a report published by the Office of Inspector General (OIG). According to the OIG, PGP submitted claims to Medicaid where the services were:

  • provided by advanced registered nurse practitioners (ARNPs) but were billed improperly under a supervisory physician’s name and national provider identifier
  • provided by ARNPs who were not properly enrolled or credentialed under the Medicaid program and were billed improperly under a supervisory physician’s name and national provider identifier

2) North Carolina

In 2016, the OIG reported that Planned Parenthood Health System, Inc., incorporated in North Carolina, agreed to pay nearly $1.6 million for potentially violating the Civil Monetary Penalties Law. This case involved violations Planned Parenthood disclosed to the OIG; several states were involved, including North Carolina, South Carolina, Virginia and West Virginia. The OIG found that Planned Parenthood submitted claims to Medicaid programs. Billing errors were:

  • services billed under a provider number different than the medical professional who provided the service
  • billed for services of non-physician practitioners who were not properly enrolled in their state Medicaid program

3) Michigan

An audit report of Planned Parenthood and Mid South Michigan, conducted by the Michigan Department of Community Health (MDCH) in 2013, found that Planned Parenthood claimed too much for their CEO’s salary, overcharging MDCH in the amount of $3,358. In addition, the audit noted that Planned Parenthood misclassified expenses, something Planned Parenthood defended as a “spreadsheet error.”

4) New Jersey

A 2008 Office of Inspector General report in New Jersey reveals that Planned Parenthood believes all the services they provide pertain to family planning, and thus warrant a Medicaid reimbursement, when this is not the case. The report states in part:

During our visits to family planning clinics throughout the State, many providers (especially Planned Parenthood providers) stated that they billed all claims to Medicaid as “family planning.” Officials at these clinics stated that they believed that all of the services they provided were related to family planning. Therefore, officials at these clinics often populated the family planning indicator field on Medicaid claims even though the service provided did not meet the criteria for 90-percent Federal funding. By populating this field, the MMIS designated the claim as eligible for 90-percent Federal funding.

5) New York

A 2008 audit by the Office of Inspector General in that state, which found that providers incorrectly coded the 90 Medicaid claims by marking “Yes” in the family planning indicator field, said in a footnote:

Officials at Planned Parenthood providers stated that they believed that nearly all the services they provide are related related to family planning. However, the medical review determined that the providers improperly claimed, for example, services to pregnant women, treatment for sexually transmitted diseases, and counseling visits unrelated to family planning services.

In 2011, the State of New York, Office of the Medicaid Inspector General, sent a letter to Planned Parenthood of the Hudson Peconic, requiring restitution of overpayments of nearly $31,000 after reviewing claims with payment dates of January 2006 through December 31, 2008.

A New York State Office of Medicaid Inspector General audit of Planned Parenthood Hudson Picnic, published in 2011, reviewed HIV counseling paid from July 1, 2004 through June 30, 2007, and found that nearly $2,227,000 was overpaid but only repayment of just over $2 million was required. Out of a random sample of 100 services the IG reviewed, 83 had at least one error and did not comply with state requirements; a number of those contained more than one deficiency.

 

These examples are yet more proof that serious oversight is needed to guard the millions of tax dollars being sent to the nation’s largest single abortion provider every year. Planned Parenthood’s history of fraud even extends to violations with the federal 340B Drug Discount Program, previously reported here at Live Action News and at Townhall.

Despite this evidence, and after years of politicians promising to defund this abortion behemoth, Planned Parenthood is again poised to receive another half a billion taxpayer dollars in 2018.

  • This article is reprinted with permission. The original appeared here at Live Action News.

Planned Parenthood’s fraud that Texas is pulling funds for political reasons

Posted in Medicaid Billing Practices, Planned Parenthood Medicaid Contract, Planned Parenthood medicaid fraud, Texas Abortion with tags , , , , , , , , , on October 23, 2015 by saynsumthn

This week, the state of Texas informed Planned Parenthood of its plan to remove its affiliates from the state’s Medicaid program. The announcement came after revelations that Planned Parenthood and specifically their Houston affiliate, Planned Parenthood Gulf Coast ( PPGC) is involved in a baby harvesting operation which has caused the nation to recoil in horror.

Planned Parenthood Houston  abortion mega

Investigators from the Center for Medical Progress, posing as buyers for a Biotech company captured under cover conversations with the Director of Research for Planned Parenthood Gulf Coast, Melissa Farrell. Farrell was recorded offering intact fetal cadavers for research as a “matter of line items.”

Alter-process-intact-fetal-cadavers-Planned-Parenthood

In addition to mentioning the CMP video, the letter obtained by Live Action News from Texas Health and Human Services Commission’s inspector general, Stuart Bowen, tells Planned Parenthood Gulf Coast that his office had information suggesting that, “fraud and other related program violations have been committed by a number of Planned Parenthood affiliates enrolled in the Medicaid program in Texas, including you.”

Planned Parenthood clinics in Texas received $3.05 million in federal funds through Medicaid for family planning services last year, according to a report in the Texas Tribune.

The letter also states that the Planned Parenthood Gulf Coast is “liable directly, or by affiliation for a series of serious Medicaid program violations,” and that Planned Parenthood affiliates in the state are, “no longer capable of performing medical services in a professionally competent, safe, legal and ethical manner.”

The letter details cases where Planned Parenthood’s credibility as a Medicaid provider for the state was called into question:

    “In Reynolds, a Planned Parenthood Whistleblower alleged sufficient evidence of fraud to assure the federal court handling the matter that the case was worth pursuing, after which Planned Parenthood promptly settled the lawsuit for $4.3 million. Furthermore, when the United States Department of Justice (DOJ) announced the 2013 settlement in Reynolds, it openly and compellingly criticized PPGC for “abuse of programs that are extremely important to the well-being of many American women.” Further, the DOJ was “particularly grateful to the Whistleblower” who came forward for revealing that Planned Parenthood Gulf Coast had billed the Texas Medicaid program, Title XX, and the Women’s Health Program “for items and services that were either medically unnecessary or were never actually provided.”

In the 2013 case mentioned in the letter, the state had accused Planned Parenthood of submitting more than $30 million in fraudulent bills between 2003 and 2009.

In addition to the Reynolds case, in 2014, another whistle-blower case alleged that PPCG defrauded Medicaid with regard to blood tests performed on Texas teens. The case was brought by Patricia Carroll who served for several years as the accounts receivable manager for Planned Parenthood Gulf Coast. The complaint stated that Carroll noticed “a large revenue increase” of 314.76% for a Planned Parenthood clinic in Huntsville while preparing the monthly projection report.

Patricia Carroll

Rather than looking at the hard cold facts that the citizens of Texas should not be forking over hard earned tax monies to an organization embroiled in so many accusations of fraud, the media is attempting to paint Planned Parenthood as some sort of a victim. And, although there are thousands of options for women’s healthcare in the state of Texas, other than Planned Parenthood, PPGC spokeswoman Rochelle Tafolla called the move by Texas “politically motivated.”

Planned Parenthood Medicaid revoked Texas

But, while the media publishes Planned Parenthood’s faux outrage the organization’s mother ship in the state, PPCG is hardly lacking financially. According to Planned Parenthood Gulf Coast’s most recent 990 report the Houston abortion business netted over $43 million dollars in assets by the end of 2013. In addition, 10 out of 11 officers or staff listed on the Planned Parenthood report made a hefty six digit salary.

PPGC 2013 990

PPCG interest 2013 990

PPGC’s statement of revenue shows $8,941,664 in total revenue that year which included $920,368 in government grants and $7,577,972 in contributions, gifts, and other grants. And, between 2009 and 2013, PPGC reported receiving $30,830,0483 in gifts, grants or contributions earning a whopping $3,603,781 in interest, dividends, and other investment income. In other words, Planned Parenthood Gulf Coast alone potentially earns as much revenue in interest as the amount the state of Texas is pulling through the state Medicaid program. So, when Planned Parenthood claims that women will be hurt by the mere $3 million state dollars the taxpayers will no longer have to pay through Medicaid, they are misleading the public.

State serves subpoenas on several Planned Parenthood centers

Posted in Planned Parenthood Medicaid Contract with tags , , , , , , , on October 23, 2015 by saynsumthn

Members of the Texas Office of the Inspector General made unannounced visits at Planned Parenthood centers in Houston, Dallas and San Antonio, staying in some cases for several hours and giving Planned Parenthood 24 hours to deliver thousands of pages of documents stored at its facilities across the state, the organization told Reuters.

The Inspector General Office declined to comment, as did health officials. Inspector General agents were seen on local news reports entering a Planned Parenthood facility in San Antonio.

http://up.anv.bz/latest/anvload.html?key=eyJtIjoiZ3JheSIsInAiOiJkZWZhdWx0IiwidiI6IjMzMTQ1MTYiLCJwbHVnaW5zIjp7ImRmcCI6eyJjbGllbnRTaWRlIjp7ImFkVGFnVXJsIjoiaHR0cDovL3B1YmFkcy5nLmRvdWJsZWNsaWNrLm5ldC9nYW1wYWQvYWRzP3N6PTY0MHg0ODAmaXU9LzMwMTcyMTcxNS9LR05TJmNpdV9zenMmaW1wbD1zJmdkZnBfcmVxPTEmYWRfcnVsZT0xJnZwb3M9cHJlcm9sbCZlbnY9dnAmb3V0cHV0PXhtbF92YXN0MiZ1bnZpZXdlZF9wb3NpdGlvbl9zdGFydD0xJmNvcnJlbGF0b3I9Jyt0cysnJmNtc2lkPTQ1OTUmdmlkPUFOVl9HUlRWXzMzMTQ1MTYifX0sImFuYWx5dGljcyI6eyJwZGIiOjgwMjk1NDk4fX19

State #3 yanks Planned Parenthood Medicaid contract over gruesome baby parts vids

Posted in Medicaid Billing Practices, Planned Parenthood Medicaid Contract with tags , , , , , , , , , , , on August 6, 2015 by saynsumthn

Saynsumthn has been blogging about Planned Parenthood’s Medicaid Fraud for a while, so when they claim these states (below) are conducting a war on women, set the record straight.

From Life Dynamics:

A third state has terminated the Medicaid contract they held with Planned Parenthood following videos exposing their baby parts operation.

Earlier this week, New Hampshire’s Executive Council voted, 3 to 2, to reject contracts that would have provided Planned Parenthood centers in the state with about $638,000 over two years, roughly one-third of the public funding for the centers, which is primarily federal.

A report from WMUR reads in part:

    In rejecting the contract, Republican councilors cited recently released videos by anti-abortion activists showing the organization’s officials discussing providing medical researchers with tissue from aborted fetuses. Conservatives are alleging that the organization is profiting from selling fetal tissue, a charge it denies. Planned Parenthood of Northern New England does not engage in the voluntary tissue donation program, but the Republican councilors told Gov. Maggie Hassan the state should launch a state-based investigation.

    “You can’t divorce what’s going on nationally from Planned Parenthood of Northern New England and we need a real investigation,” said GOP Councilor David Wheeler.

Chris SUnunu

Republican councilor Chris Sununu who previously voted to support Planned Parenthood contracts said that he is pro-choice on abortion but he received more than 1,000 messages from constituents who overwhelmingly urged him to reject the contract.

Things are different now. We have to take a step back and just take a pause and say ‘Is this a company and a business that we should be actively engaging (with)?'” he asked.

Also pulling funding was Louisiana Gov. Bobby Jindal who announced that his state cut off Planned Parenthood from Medicaid funding August 3rd.

According to the announcement, the Louisiana Department of Health and Hospitals informed Planned Parenthood it was exercising its right to terminate Planned Parenthood’s Medicaid provider agreement, the press release stated.

Bobby Jindal

Governor Jindal said that, because of the videos, he directed DHH to investigate Planned Parenthood’s activities in Louisiana and also sent a letter to both the Louisiana Inspector General and the F.B.I. asking them to assist in the investigation.

“In recent weeks, it has been shocking to see reports of the alleged activities taking place at Planned Parenthood facilities across the country. Planned Parenthood does not represent the values of the people of Louisiana and shows a fundamental disrespect for human life. It has become clear that this is not an organization that is worthy of receiving public assistance from the state,” the 2016 presidential candidate said.

In addition to Louisiana and New Hampshire, today republican Alabama Governor Robert Bentley has announced that the state has terminated their Medicaid contract with Planned Parenthood.

Yellowhammer obtained a copy of the letter sent to Planned Parenthood CEO Staci Fox.

Alabama cuts off medicaid Planned Parenthood

“The nation is shocked by videos depicting Planned Parenthood employees callously discussing the dismemberment of babies and the sale of baby body parts for profit. This is like a story out of Nazi Germany,” said Sen. Bill Hightower (R-Mobile) during the committee hearing.

The federal authorities may allow this type of thing, but Alabama won’t – and upon final passage, Alabama will have a law that reflects Alabama’s values.”

Bill Heightower Ala Planned Parenthood

Sen Hightower also introduced legislation in the state that will make it a felony to offer or accept money for aborted babies, “Because if the feds don’t deal with it, we will,” he added.

An Alabama Senate committee approved the bill today which will now move to the full Senate.

“The deplorable practices at Planned Parenthood have been exposed to Americans, and I have decided to stop any association with the organization in Alabama,” said Governor Bentley. “As a doctor and Alabama’s Governor, the issue of human life, from conception to birth and beyond, is extremely important to me. I respect human life, and I do not want Alabama to be associated with an organization that does not.”

Robert Bentley ALAa_o-e1434479146404

Alabama Congressman Bradley Byrne is now calling on the Department of Justice to investigate Planned Parenthood.

Last month, Life Dynamics reported that a Wisconsin lawmaker introduced a bill that could eliminate at least half of the funding Planned Parenthood gets in the state by reducing over-billing through Medicaid by the abortion giant.

The legislation came following calls from 24 lawmakers asking for a Planned Parenthood audit.

The state of Texas has sued Planned Parenthood for Medicaid fraud, a point Governor Greg Abbot bragged about recently on twitter announcing his call for an investigation:

Gov Gregg Abbott Planned Parenthood

“I already sued Planned Parenthood for Medicaid Fraud. Now Texas will look into these organ harvesting claims,” the Governor tweeted.

In 2013, Planned Parenthood Gulf Coast, the very affiliate operating the Houston abortion clinic now exposed by the Center for Medical Progress, settled for $4.3 million with the state of Texas after an audit revealed that the agency charged for “fraudulently over billing the taxpayer-funded Medicaid program.”

According to the Houston Chronicle, on July 30,2013, Planned Parenthood Gulf Coast settled fraudulent Medicaid billing lawsuit with the state to the tune of $4.3 million – nearly $3 million more than was originally announced by then Texas Attorney General Greg Abbott.

tx-ag-medicaid-fraud

Americans United for Life has also documented alleged abuses by Planned Parenthood.

In a published entitled, The Case for Investigating Planned Parenthood, they list the misuse of federal health care and family planning funds and admissions by former employees as detailing a pattern of misuse by some Planned Parenthood affiliates. (read here)

A 2014 report by the legal group, Alliance Defending Freedom, entitled, “Profit No Matter What,” makes similar claims.

Clinic Worker Cover FB

Through Life Dynamics’ Clinic Worker project, employees of Planned Parenthood can report fraud and other illegal activity.

Clinic Worker poster

Life Dynamics has been working with abortion clinic and Planned Parenthood employees for many years helping to gather evidence of criminal activity such as:

    • Income Tax Evasion • Physical Assault of Patients
    • Medicaid Fraud • Sexual Harassment of Employees
    • Insurance Fraud • Sexual Assault of Patients
    • Money Laundering • Failure to Report Statutory Rape of Minors
    • Consumer Fraud • Health and Safety Code Violations

For a Clinic Worker kit that you can use outside your local abortion and Planned Parenthood facility, contact Life Dynamics.