Archive for the Planned Parenthood medicaid fraud Category

Former Planned Parenthood staffers explain how Medicaid fraud is being committed

Posted in Abortion Quota, Planned Parenthood Abortion Quota, Planned Parenthood former employee, Planned Parenthood illegal activity, Planned Parenthood medicaid fraud with tags , , , , , , , , , , , , , , , , , , , , , , , , on October 16, 2017 by saynsumthn

|  (From Live Action News)

In 2015, seven former Planned Parenthood (PPFA) employees informed the House Energy and Commerce Subcommittee on Oversight and Investigations that Planned Parenthood should be investigated for a number of potentially criminal and fraudulent acts. These former employees told Committee members in a formal letter that because Planned Parenthood receives half a billion in taxpayer funding annually, Planned Parenthood should “[…] merit close Government attention as to whether or not these funds are being spent appropriately.”

The former Planned Parenthood staffers’ letter noted, “we are of one mind that the extent of theses problems with the organization is not fully understood by the American people….” They added that they “could personally attest” that Planned Parenthood has “operated as a law unto itself, gladly accepting tens of millions of dollars of taxpayer support while using the rubric of ‘reproductive rights’ to claim exemption from the normal standards of accountability that every other recipient of public funds is expected to meet.”

In recent years, additional former Planned Parenthood staffers have come forward to accuse the abortion corporation of fraudulently overbilling Medicaid, milking American taxpayers for millions of dollars.

READ: Half of WI Planned Parenthood’s Medicaid payments were fraud, auditors say

Karen Reynolds

In August 2013, the whistleblower case of Karen Reynolds, a former employee of Planned Parenthood Gulf Coast, resulted in the Houston-based Planned Parenthood affiliate paying $4.3 million to resolve civil allegations made by Reynolds under the False Claims Act in the Eastern District of Texas. According to a Department of Justice release:

The government alleged that between 2003 and 2009, Planned Parenthood Gulf Coast billed and was paid by government programs, Texas Medicaid, Title XX, and the Women’s Health Program, for certain items and services related to birth control counseling, STD testing and contraceptives when such items and services were either not medically necessary, not medically indicated or not actually provided.

According to a 2017 report called “Profit No Matter What,” published by Alliance Defending Freedom (ADF) and the Charlotte Lozier Institute (CLI), Planned Parenthood’s facilities were required “to constantly increase their ‘pay per visit’ goals which were the bills charged to Medicaid for every patient visit.”

A recent interview with former Planned Parenthood manager, Sue Thayer, indicated that Planned Parenthood also had abortion quotas:

Patricia Carroll

Patricia Carroll was employed as the Accounts Receivable Manager by Planned Parenthood Gulf Coast and stated in her claim against Planned Parenthood that she noticed “a large revenue increase” of 314.76% for PP in Huntsville “while preparing the monthly Projection report.” The Dallas Morning News said about Carroll’s Medicaid fraud accusation:

Carroll worked as the accounts receivable manager at Planned Parenthood Gulf Coast from 2007-2012. In that position, she said she discovered “a fraudulent Medicaid scheme” that dated back to 2002. She alleged that a Planned Parenthood clinic in Huntsville had an employee visit a charter school called Gulf Coast Trade Center and perform STD/HIV tests on the students there, all of whom receive Medicaid benefits.

Carroll said Planned Parenthood incorrectly coded the visits to collect Medicaid reimbursements, estimating the clinic received about $200 per student. “Thousands of claims were filed” in the ten year span, according to Carroll’s original complaint.

In May 2014, a federal district judge in Houston ruled that Carroll had “adequately pleaded factual content that allows the court to draw the reasonable inference that Planned Parenthood knowingly filed false claims.”

The ADF/CLI report added that “at least some of the services were not medically necessary due to the duplication of visits, teens already having been tested at the jails or court systems they came from, and the higher-level staff already onsite at the school who could provide the same testing and education at no cost.”

Carroll’s lawsuit was dismissed on January 29, 2016, for an undisclosed settlement amount, the ADF/CLI report states.

Victor Gonzalez’s complaint against Planned Parenthood

P. Victor Gonzalez

P. Victor Gonzalez was employed as Vice President of Finance and Administration by Planned Parenthood of Los Angeles (PPLA). Gonzalez accused Planned Parenthood affiliates in California of marking up the cost of birth control drugs between 1997 and 2004 for government reimbursement, resulting in improper reimbursements — at taxpayer expense — far in excess of $200 million.

“An internal email from Gonzalez states that PPLA’s actual acquisition cost for oral contraceptive pills was $1-2, but that it was charging the government $12-48 per pack – a ‘hefty markup’ ‘proscribed by DHS regulations.’ Gonzalez estimates the impact on PPLA alone as approximately $4 million in revenues in a single typical year,” the ADF/CLI report states.

Sue Thayer

Sue Thayer, former manager for Planned Parenthood of the Heartland’s Storm Lake and LeMars facilities in Iowa, claimed Planned Parenthood defrauded Medicaid out of millions by overcharging for services, illegally billing for abortion-related care.

In 2015, Thayer testified before a Congressional committee about the claim, accusing Planned Parenthood of filing “[…] false claims totaling about $28 million with Iowa’s Medicaid program for (1) illegally dispensing “medically unnecessary” quantities of oral contraceptive pills and birth control patches to C-Mail Medicaid patients and doing so without a prescription; (2) fraudulently billing the Iowa Medicaid program for abortion-related services; and (3) coercing “donations” from Medicaid patients.

In an op-ed Thayer wrote in 2017, she elaborated further:

Planned Parenthood advertises that services and supplies are free, but when Medicaid-eligible women are served, it is expected they donate fifty percent of the total cost for the visit…. Planned Parenthood receives $542,000,000 in federal funding, yet asks women who live at or below the poverty line, who depend on federally-funded healthcare to make a donation — proof that Planned Parenthood is much more concerned about its bottom line than women in need.

“Planned Parenthood counted those payments as voluntary donations and billed the full amount to Medicaid,” Thayer recounted in her 2015 testimony, adding, “There is a reason that, despite technically being a nonprofit, Planned Parenthood has reported $765 million in excess revenue over the last 10 years. It is run very much like a business – focused on increasing revenues, placing its own bottom line above the interests of women. And yet leadership would take expensive trips to Europe and Russia and throw elaborate parties at fancy venues.”

In addition, Thayer discussed the alleged fraud accusations in the video below:

Abby Johnson

Abby Johnson, the former director of an abortion center operated by Planned Parenthood Gulf Coast, (formerly Planned Parenthood of Houston and Southeast Texas) accused Planned Parenthood in her lawsuit of “repeated false, fraudulent, and ineligible claims for Medicaid reimbursements” through the Texas Women’s Health Program:

In violation of its duty to report such false, fraudulent, and/or ineligible claims and/or to reimburse the United States and/or the State of Texas for monies wrongfully received by Planned Parenthood of the Gulf Coast, Planned Parenthood Gulf Coast knowingly or willfully concealed the making of such false, fraudulent, and/or ineligible claims and knowingly or fraudulently retained funds which Planned Parenthood Gulf Coast knew it was not entitled to retain.

According to the ADF/CLI report, Johnson “alleged that Planned Parenthood of Houston and Southeast Texas filed at least 87,075 false, fraudulent, or ineligible claims with the Texas Women’s Health Program.”

As a result, Planned Parenthood wrongfully received and retained reimbursements totaling more than $5.7 million, Johnson alleged.

Abby Johnson alleges millions in fraud by Planned Parenthood

According to a report published by LifeSiteNews, the lawsuit also claimed:

… Planned Parenthood held a meeting in late 2008 or early 2009 to inform its clinic directors that it had been falsely billing the Texas WHP since January 1, 2007.  Johnson says that when she 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.”

Ramona Trevino

A 2017 op-ed written by Ramona Trevino, a former Planned Parenthood North Texas facility manager, claimed further that “Medicaid patients are like mini cash cows for Planned Parenthood.” Trevino added, “Patients who went to Planned Parenthood abortion centers used federal funds to pay for post-abortion exams at Planned Parenthood’s non-abortion centers….”

Today, due in part to the broken promises of politicians to defund Planned Parenthood, American taxpayers are still forced to hand over $1.5 million per day to this fraudulent organization.

Government tax dollars going to Planned Parenthood in just the past ten years now total in the billions of dollars with little to no oversight, while Planned Parenthood continues to send hefty “campaign contributions” to its allies through its political arm. And, despite accusations of fraud, another half a billion in taxpayer dollars is slated to be handed over to Planned Parenthood in 2018.

It is past time to stop this abuse and defund Planned Parenthood.

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

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 has been cited for Medicaid fraud… so why is it still getting taxpayer funding?

Posted in Medicaid abortion, Medicaid Billing Practices, Planned Parenthood medicaid fraud with tags , , , , , , , , , , , , , , , , , , , , on October 13, 2017 by saynsumthn

|  (From Live Action News)

Planned Parenthood has been cited for overbilling abuses and Medicaid fraud, for violating patient privacy, and for failing to report child sexual abuse. So why is the abortion corporation still receiving half a billion dollars a year from taxpayers?

A study by the Government Accountability Office (GAO) and Congressional Budget Office (CBO) in 2012 showed that Planned Parenthood received $400.56 million in Medicaid reimbursements (including both federal and state dollars), according to findings published in 2017 by the Congressional Research Service. Planned Parenthood’s own 2015-2016 annual report shows that 41 percent of its funding comes from the taxpayer ($554.6 million). Numbers published in previous Planned Parenthood annual reports indicate its affiliates have received more than $4.5 billion from taxpayers.

Taxpayer funding to Planned Parenthood at 41 Percent (image: PP’s 2015-2016 annual report)

Yet, with so much tax money at stake, exactly what kind of oversight is being conducted to safeguard more than half a billion tax dollars entrusted to Planned Parenthood annually?

According to reports by watchdog agencies, very little.

In 2014, the group Alliance Defending Freedom (ADF) published a report identifying 10 types of waste, abuse, and potential fraud Planned Parenthood affiliates have been caught committing or have been credibly accused of nationwide. The potential fraud includes billing while obtaining reimbursements from Title XIX agencies for medications and/or services provided in connection with an abortion. This is illegal.

ADF’s research found that taxpayers were losing millions of dollars in the forced funding of Planned Parenthood, which now garners 35 percent of the abortion market; it is the nation’s largest single abortion provider. Despite several incidents of overbilling and potential fraud, ADF found that only “fourteen affiliates, or approximately twenty-one percent had been audited,” noting that the others “have been accused of financial fraud and worse.”

Planned Parenthood Medicaid Fraud (image credit 2017 Profit No Matter What report)

Then, in 2017, a coordinated study conducted by both the Charlotte Lozier Institute (CLI) and Alliance Defending Freedom reviewed a number of additional audits from a variety of agencies. The purpose of the study was to identify waste, abuse, and potential fraud by Planned Parenthood among its now 57 separately incorporated affiliates, and other abortion and family planning facilities, particularly with respect to federal and state Title XIX-Medicaid programs.

The 2017 Report on Publicly Available Audits of Planned Parenthood Affiliates and State Family Planning Programs identified several cases of unlawful billing, including “[b]illing in excess of actual acquisition cost or other statutorily approved cost for contraceptive barrier products, oral contraceptives, and emergency contraceptive-Plan B (i.e., § 340B drugs) products”:

A large and growing number of federal and state audits have documented that improper practices by Planned Parenthood and state family planning agencies have already resulted in losses to the American taxpayer of nearly $132.4 million, at a minimum, in Title XIX-Medicaid and other healthcare funding programs.

Out of 51 audits, the CLI/ADF report found, “numerous improper practices resulting in significant Title XIX-Medicaid overpayments of more than $8.5 million to Planned Parenthood affiliates for family planning and reproductive health services claims….”

The report notes that “[…] auditors and investigators have specifically identified Planned Parenthood affiliates as the source of at least $12.8 million in waste, abuse, and potentially fraudulent overbilling and penalties…” and that “[t]hree federal audits specifically identify Planned Parenthood – and only Planned Parenthood – as the problem in state family planning program overbilling,” the report states.

The groups pointed out that the audits they reviewed were limited in scope, suggesting the possibility for millions of additional taxpayer dollars to be wasted or fraudulently overbilled.

READ: New report exposes millions in taxpayer fraud at Planned Parenthood

“For example, an audit may examine only one type of billing, for one type of product, for one clinic in a single year. Yet nearly every known audit of Planned Parenthood affiliates and of state family planning programs has found overbilling,” the report notes.

But of the 51 known “recent external audits or other reviews” of Planned Parenthood affiliates’ financial data and practices in 12 states, CLI and ADF uncovered at least $8.5 million in waste, abuse, and potential fraud in the following states:

  • California (two audits of two affiliates): $5,213,645.92 30
  • Connecticut: $18,791
  • Illinois: $387,000
  • Louisiana (two audits of one affiliate): $6,147.18
  • Maine: $33,294.83
  • Nebraska: $3,537
  • New York (seven audits of four affiliates): $1,615,083.25
  • Ohio: none found
  • Oklahoma: unknown, but the overbilling rates have been documented as 14.1%, 18%, and 20.3%
  • Texas (two audits of two affiliates): $538,703.10 -$658,735.97
  • Washington (three audits of two or three affiliates):$640,595.88
  • Wisconsin (27 audits of one affiliate): $95,466.04

Interestingly, the audit from Nebraska proved, as Live Action News has stated many times, that federal and state taxpayer dollars are funding abortion. The report found in the Nebraska audit “a Planned Parenthood affiliate spending federal funds on abortion expenses in violation of federal and state law.”

“In New York, alone, during one four-year audit period, it appeared that hundreds of thousands of abortion-related claims were billed unlawfully to Medicaid,” ADF’s Mattox told a Congressional hearing on the topic in 2015.

Live Action News has previously documented how taxpayer dollars are funding abortions, and Nebraska was just one example. When government funds abortion, more abortions happen, not fewer. This should never be taxpayer funded:

The potential fraudulent use of Medicaid dollars by Planned Parenthood also caught the attention of Oklahoma’s then-Governor Mary Fallin, who sent a letter to the head of the Oklahoma Health Care Authority Board, stating, “[…] more than one in every seven bills submitted for payment to your agency by these providers are inaccurately coded or insufficiently documented…. The lack of attention to the requirements imposed on a responsible provider is a continuing problem for these Planned Parenthood affiliates.”

“As a result of these patterns of irresponsible business behavior among and between the Planned Parenthood organizations,” Fallin wrote, “a dozen states have denied or withdrawn funding to Planned Parenthood affiliates.”

The researchers concluded that despite receiving billions of dollars from taxpayers, only 19 of Planned Parenthood’s 57 U.S. affiliates (33 percent) have been audited, “And others have been accused of financial fraud and worse.”

During testimony in 2015 before Congressional members, Mr. Mattox explained:

[The] Medicaid statute provides grounds for which the U.S. Department of Health and Human Services, in its discretion, may exclude a provider. These include claims for excessive charges, unnecessary services, or services which fail to meet professionally recognized standards of health care; fraud, kickbacks, and other prohibited activities; entities controlled by a sanctioned individual; failure to disclose required information, supply requested information, or supply payment information; sanctioned individuals controlling an entity; and making false statements or misrepresentations of material fact.

He then pointed out:

[…] Planned Parenthood is unlike many other Medicaid providers. Not only has it had great financial success as a Medicaid provider, but also it has been able to avoid much of the oversight and/or corrective action that most Medicaid providers would expect and have received.

Mr. Mattox then alluded to the reason: “… [B]etween local affiliates and the national organization, Planned Parenthood has spent many millions of dollars to support the election of its preferred candidates.”

In 2018, despite large sums of taxpayer dollars being previously misused and few Medicaid audits underway to safeguard additional tax dollars, Planned Parenthood is poised to receive yet another half a billion forced taxpayer funding. This, despite repeated promises by GOP Senators, members of Congress, as well as President Trump, to defund Planned Parenthood — which has not yet happened, despite the fact that Planned Parenthood’s legitimate health care services and patient numbers have been declining for years:

The continued misuse and fraud of American tax dollars by Planned Parenthood is unacceptable. When will it stop?

Read the full report detailing Planned Parenthood’s potential fraud and waste of taxpayer funding here.

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

Here are a dozen things the media won’t tell you about Planned Parenthood

Posted in HIPPA, Planed Parenthood abortion death, Planned Parenthood, Planned Parenthood 3% myth, Planned Parenthood abortion numbers, Planned Parenthood abortion stats, Planned Parenthood and Rape, Planned Parenthood and Sex Trafficking, Planned Parenthood fined by state, Planned Parenthood medicaid fraud, Planned Parenthood services, Planned Parenthood six digit salary, Planned Parenthood's botched surgery, Privacy, Title X with tags , , , , , , , , , , , , on September 21, 2017 by saynsumthn

Planned Parenthood should be defunded. Despite all its scandals over the years, the pro-abortion mainstream media has largely kept the evidence of this from taxpayers. Perhaps it’s because the media approves of Planned Parenthood’s agenda, and the agenda of the politicians who defend the organization.

The media manipulates the American public by refusing to tell the truth about Planned Parenthood’s abuses, a fact Live Action News previously documented. Instead, the media repeats Planned Parenthood’s PR-approved talking points while failing to report important investigations exposing Planned Parenthood’s lies and deceptions.

Here are some facts about Planned Parenthood that mainstream media has failed to report:

Fact #1: Planned Parenthood is a private corporation whose political action committee contributes heavily to the same politicians sending them millions of dollars each year — over half a billion annually. PP is a master manipulator and marketer politically and this drives the dollars politicians send them. Planned Parenthood’s CEO, Cecile Richards, was not hired for her health care “experience” but for her political savvy, as Live Action News’ Rebecca Downs has explained:

Planned Parenthood may claim to be a health organization, but Richards herself has no health experience — her background is in politics, a background which even the Planned Parenthood website emphasizes. In addition to running Planned Parenthood, she also runs Planned Parenthood Action Fund, which is — you guessed it — a political organization. After Richards spoke before Congress in September 2015, the Oversight Committee expressed concerns that there was an overlap in where Planned Parenthood’s taxpayer money was going. Are Planned Parenthood and Planned Parenthood Action Fund really so different?

Fact #2: Planned Parenthood masquerades as a health care provider. This scheme to reinvent themselves was developed years ago, as Live Action News has detailed here, to mask the fact that they are the largest chain of abortion facilities in the United States.

Fact #3: There are thousands of federally qualified health centers which provide far superior health care to Planned Parenthood. Planned Parenthood has lost more than half a million patients (600,000) since 2011. Yet, taxpayer-funded health centers, as identified by the federal Health Resources and Services Administration (HRSA), increased patients by over 2 million by 2015, providing care to 24,295,946.

Fact #4: Planned Parenthood services are on the decline despite major increases in government funding. Except, of course, when it comes to abortion, where Planned Parenthood garners nearly 35 percent of the market share.

  • MAMMOGRAMS: Planned Parenthood performed zero, because Planned Parenthood facilities do not have mammogram machines. Yet, in 2015, federal health centers performed mammograms on over 521,000 patient,  an increase from 470,000 in 2014.
  • BREAST EXAMS dropped 12 percent in 2015 at Planned Parenthood, and between 2004 and 2015, breast exams at Planned Parenthood declined by more than 65 percent.
  • PAP TESTS: Planned Parenthood’s 2015 report reveals that Pap tests declined 75 percent from 2004. Yet, in 2015, federal health centers administered over 1.8 million Pap tests to patients — an increase from 1.7 million in 2014.
  • CANCER SCREENINGS declined at Planned Parenthood from last year’s figures, and, between 2004 and 2015, cancer screenings there plummeted 69 percent.
  • PRENATAL CARE: Planned Parenthood is deceptive about providing prenatal care, which was nearly cut in half in 2015. Since 2010, prenatal care at Planned Parenthood has decreased nearly 70 percent. Yet, in 2015, federal health centers cared for a total of 552,000 prenatal patients — an increase from 528,000 prenatal patients in 2014.

Fact #5: Planned Parenthood claims defunding their organization will hurt poor women yet Planned Parenthood’s own officials rake in hefty six digit salaries, getting regular raises. An analysis of CEO compensation at Planned Parenthood by STOPP revealed that the top 68 people at Planned Parenthood take home $18.1 million combined.

Fact #6: Planned Parenthood has been netting a profit for many years, exceeding its expenses — not just by a few dollars, but by tens of millions of dollars (yearly surpluses range from $12.2 million in 2001 to a high of $155.5 million in 2010).

Fact #7: Women can die after receiving Planned Parenthood’s “services.” Cree Erwin-Sheppard recently died after her abortion at a Michigan Planned Parenthood. Tonya Reaves was left bleeding inside Planned Parenthood’s Chicago facility for hours. She died later at a hospital.

Abortion deaths and injuries at Planned Parenthood (image by Operation Rescue)

Fact #8: Emergencies at Planned Parenthood are on the rise. The pro-life watchdog group Operation Rescue (OR) has documented that a number of Planned Parenthood centers have had to call for emergency transports of patients. OR reports that “since January 1, 2016, Operation Rescue has documented 40 such incidents at Planned Parenthood abortion centers alone.”

Fact #9: Undercover footage from the Center for Medical Progress caught Planned Parenthood haggling over prices for aborted baby parts. Planned Parenthood’s CEO admitted they still participate in fetal harvesting, saying at the time, “Planned Parenthood is proud of its limited role in supporting fetal tissue research.”

The House Select Investigative Panel on Infant Lives‘ final report into the fetal parts industry found several disturbing issues with Planned Parenthood. Live Action News contributor Susan Michelle-Hanson reviewed the 471-page report and noted that Planned Parenthood “committed systematic violations of the HIPAA Privacy Rule from about 2010 to 2015, and that “violations occurred when the abortion clinics disclosed patients’ individually identifiable health information to StemExpress to facilitate the [tissue procurement business]’s efforts to procure human fetal tissue for resale.”

Fact #10: Planned Parenthood has violated the trust of patients by violating patient privacy, as stated above. In addition, an analysis by Live Action News found many other instances of privacy leaks by the government funded abortion business.

Fact #11: Planned Parenthood has been cited for overbilling abuses and has been accused of Medicaid fraud.

2017 report, conducted by the Charlotte Lozier Institute and Alliance Defending Freedom, looked at publicly available audits and discovered several egregious examples of fraud and abuse associated with Planned Parenthood.

Among other abuses, the study found:

  • Planned Parenthood affiliates have been identified as the source of at least $12.8 million in waste, abuse, and potentially fraudulent overbilling and penalties.
  • One audit uncovered $5.2 million in overbilling by two California Planned Parenthood affiliates; the average overbilled amount per audited year in a single audit was $94,409. 
  • Three federal audits specifically identify Planned Parenthood – and only Planned Parenthood– as the problem in state family planning program overbilling.

Fact #12: Planned Parenthood has been caught failing to report child sexual abuse (a violation that alone should result in the organization losing millions of taxpayer dollars granted to it under the federal Title X Family Planning Program). Reports also found that victims of sex trafficking are sometimes taken to Planned Parenthood centers for forced abortions by their pimps.

So, when it comes to health care for women, Planned Parenthood is far from the worthy organization it claims to be. The bottom line is that American taxpayer should not be obligated or forced to hand millions of dollars to an abortion corporation with fraud and serious abuses on their record.

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

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TX Gov : I hope Planned Parenthood sues so I can put officials under oath

Posted in Medicaid Billing Practices, Planned Parenthood medicaid fraud, Texas Abortion, Texas abortion clinics with tags , , , , , , , on October 28, 2015 by saynsumthn

The Governor of the State of Texas said he hopes Planned Parenthood files legal action against their move to cut off Medicaid funding to the abortion biz so he can put their officials under oath.

Greg ABbot Medicaid Planned Parenthood

Newly elected Governor Greg Abbot told Fox’s Bill Hemmer that in Texas, Planned Parenthood has very serious issues that violate federal law.

“One, the Inspector General says he has evidence showing that Planned Parenthood altered the abortion procedure in order to obtain fetal tissue. This violates federal law as well as state law,” Gov. Abbot said.

That fact was detailed in several undercover videos published by the Center for Medical Progress. One of the clinics that CMP filmed was a Planned Parenthood mega center in Houston.

Planned Parenthood houston

Abbot, who was the previously Attorney General of the state before being elected as Governor in 2014, continued:

Second, the Inspector General showed, that he had evidence where Planned Parenthood allowed unsanitary conditions that could cause the spread of infectious diseases.”

“Third…the fact that Planned Parenthood has already previously been found in violation of Medicaid fraud for billing for items and services that were either unnecessary or never provided. And, the Inspector General says he has uncovered more instances of these types of violations,” the Texas Governor added.

Days ago, Live Action News detailed these Planned Parenthood Medicaid fraud cases in a report you can read here.

When asked to respond to Planned Parenthood’s charge that this move by the state is a “scandal” Abbott called it “cover for the very serious violations they face.” He accused Planned Parenthood of bilking the taxpayers of the State of Texas and the US out of money which they did not deserve. He pointed out that there are thousands of places where women can receive the health care they need through the Medicaid Program.

Asked if he expected a legal challenge, the Texas Governor responded, “I hope for a legal challenge here because I want to put these Planned Parenthood officials under oath and get them to swear about the practices that they were conducting in the state of Texas.

“Either, their horrific practices will be revealed or they may be found in violation of laws for perjury.”

Abbott then reiterated that the State’s legal actions would have occurred without the CMP videos.

“Legal action had already been taken both by the state of Texas and by the United States Department of Justice for Medicaid fraud in the State of Texas long before these videos…”

Texas does have hard evidence showing Medicaid Fraud,” Governor Abbott stated.

Hours after this interview, the state raided several Planned Parenthood centers serving subpoenas on Planned Parenthood centers in Houston, Dallas and San Antonio. Read Live Action News’ report in this here.

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.

IG audit reveals $129,000 in Medicaid payments to Planned Parenthood did not comply with requirements

Posted in Medicaid Billing Practices, Planned Parenthood medicaid fraud with tags , , , , , , , on April 1, 2015 by saynsumthn

The Department of Health and Human Services, Office of the Inspector General, conducted a review which covered 3,251 clients with claims for Medicaid family planning services (Medicaid services) that Planned Parenthood of North Texas ( PPNT ) submitted, totaling $493,112 ($443,800 Federal share), during the period March 1, 2007, through September 30, 2008 (audit period).

The IG conducted their field work at Planned Parenthood locations in Dallas and Ft Worth.

In Texas, the State agency is responsible for administering the Medicaid program. In addition to family planning services for Medicaid recipients, Texas established the waiver under section 1115 of the Social Security Act to provide a limited and defined set of family planning services to uninsured women who are not eligible for Medicaid

Texas 2015 Audit Planned Parenthood

The review also covered 5,548 clients with claims for waiver family planning services (waiver services) that PPNT submitted totaling $800,000 ($720,000 Federal share), during their audit period. They selected a stratified random sample of 105 clients from each of these client populations. They then reviewed the services and determined the unallowable Federal share of the payments made.

Planned Parenthood North Texas 2015 Medicaid Fraud Audit

Here is what they found:

The State agency did not always claim Medicaid reimbursement for family planning services provided by PPNT in accordance with Federal and State Medicaid requirements or the conditions of the waiver, whichever was appropriate.

Of the 210 sampled Medicaid and waiver client records:

    (1) 50 Medicaid client records contained 1 or more deficiencies (totaling $3,983) on insufficient supporting documentation, and 39 waiver client records contained 1 or more deficiencies (totaling $1,855) on insufficient supporting documentation;
    (2) 23 Medicaid client records contained 1 or more deficiencies (totaling $738) on incorrect billing, and 28 waiver client records contained 1 or more deficiencies (totaling $972) on incorrect billing; and
    (3) 5 Medicaid client records contained 1 or more deficiencies (totaling $104) on services unrelated to family planning.

The State agency did not always properly claim Medicaid reimbursement for family planning services because it did not ensure that:

    (1) PPNT maintained the appropriate required supporting documentation,
    (2) PPNT properly billed for family planning services, and
    (3) services claimed had a family planning purpose.

As a result of these errors, the State agency incorrectly claimed a total of $7,651 for Medicaid and waiver services.

Medicaid Sample - Planned Parenthood North Texas audit

On the basis of their sample results, the IG estimated that the State agency improperly claimed a total of $129,028: $67,019 for Medicaid services and $62,009 for waiver services.

The agency is now recommending a refund of $129,028 to the Federal Government: $67,019 for Medicaid services and $62,009 for waiver services that did not comply with Federal and State requirements for family planning service.

According to the audit:

THE STATE AGENCY DID NOT ENSURE THAT PLANNED PARENTHOOD OF NORTH TEXAS HAD SUFFICIENT SUPPORTING DOCUMENTATION

Providers must keep records to fully disclose the extent of services provided to Medicaid beneficiaries. Additionally, all Medicaid records must be kept for 5 years from the date of service or until all pending audit questions are resolved, whichever is longer. Records and supporting documentation must be made available upon request to the Texas Department of Health or its designated agent.

    For 50 of the 105 Medicaid clients in the IG’s sample, PPNT did not have the required supporting documentation for at least 1 family planning service.

    For 39 of the 105 waiver clients in the sample, PPNT did not have the required supporting documentation for at least 1 family planning service.

    For example, all of the medical records for the dates of service were missing, or the records did not have sufficient information to support the services claimed.

    These errors occurred because the State agency did not ensure that PPNT maintained the appropriate required supporting documentation for family planning services.

    As a result, the State agency improperly claimed $3,983 for Medicaid services and $1,855 for waiver services.

The Medicaid program pays for services provided to a client only when the extent of the services is fully disclosed.

According to the official coding guidelines,billing codes are determined using several components, including client’s history, examinations, medical decision making, counseling, coordination of care, the nature of the presenting problem, and the amount of time spent with the client.

    For 23 of the 105 Medicaid clients in our sample, at least 1 family planning service was incorrectly billed.

    For 28 of the 105 waiver clients in our sample, at least 1 family planning service was incorrectly billed

    Examples of this type of error included billing an incorrect office visit code when the client received only a birth control injection, billing a counseling code in addition to another code that already included the counseling, or billing for a service that was claimed during a previous visit and that was not allowed to be billed again.

    These errors occurred because the State agency did not ensure that PPNT correctly billed for family planning services. As a result, the State agency improperly claimed $738 for Medicaid services and $972 for waiver service

The State agency said that it would collect the overpayment from Planned Parenthood North Texas and refund the Federal share.

In 2013, Planned Parenthood’s Houston-based affiliate 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.”

TX AG MEdicaid Fraud

Details of other Planned Parenthood state and federal audits are linked at this blog post (here).