Archive for Congressional Budget Office

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.

CBO Score on Health Care Released ! Plan is to rape the American people to a tune of $940 billion

Posted in Health Care, Obama, Pelosi with tags , , , , , , , on March 18, 2010 by saynsumthn

According to the left-wing liberal Huffington Post: Comprehensive health care reform will cost the federal government $940 billion over a ten-year period, but will increase revenue and cut other costs by a greater amount, leading to a reduction of $130 billion in the federal deficit over the same period, according to an analysis by the Congressional Budget Office, a Democratic source tells HuffPost. It will cut the deficit by $1.2 trillion over the next ten years.

The source said it also extends Medicare’s solvency by at least 9 years and reduces the rate of its growth by 1.4 percent, while closing the doughnut hole for seniors, meaning there will no longer be a gap in coverage of medication. The CBO also estimated it would extend coverage to 32 million additional people.

The CBO score is the last piece House Speaker Nancy Pelosi (D-Calif.) was waiting on before putting the puzzle together on the House floor.

The Washington Post is reporting that:

CBO: Health-care reform bill cuts deficit by $1.3 trillion over 20 years, covers 95% ( GET READY – WHEN HAS THE GOV’T EVER REDUCED SPENDING ????)

According to a Democratic source, CBO has finished its work and will release the official preliminary score later today. But here are the basic numbers: The bill will cost $940 billion over the first 10 years and reduce the deficit by $130 billion during that period. In the second 10 years — so, 2020 to 2029 — it will reduce the deficit by $1.2 trillion. The legislation will cover 32 million Americans, or 95 percent of the legal population.

Now – Cybercast News is reporting that Republicans Blast Democrats for Leaking CBO’s Cost Estimate of Health Care Reform
Thursday, March 18, 2010
By Susan Jones, Senior Editor

(Editor’s note: When the CBO finally did release its cost estimate, it stressed that the numbers are preliminary and subject to change.)

(CNSNews.com) – The number $940 billion popped up in Washington Thursday morning, much to the dismay of Republicans, who say Democrats are attaching a price tag to their health care bill, even before the Congressional Budget Office released its official estimate.

“I think momentum is growing for this bill,” the Associated Press quoted Rep. Steny Hoyer (D-Md.) as saying. Hoyer said the Democrats’ health care bill will cost $940 billion over ten years, based on the CBO estimate. According to Hoyer, it also would reduce the federal deficit by more than $100 billion over its first ten years – and by more than $1 trillion in its second decade.

Hold on a minute, said Republicans: Rep. Paul Ryan of Wisconsin, the ranking Republican on the House Budget Committee, said Democrats were talking about numbers that the Congressional Budget Office had not yet officially released.

“The Congressional Budget Office has confirmed that there is currently no official cost estimate,” Ryan said in a news release Thursday morning. “Yet House Democrats are touting to the press – and spinning for partisan gain – numbers that have not been released and are impossible to confirm.”

Ryan noted that Rep. James Clyburn was “giddy” about the unsubstantiated numbers.

“This is the latest outrageous exploitation by the Majority – in this case abusing the confidentiality of the nonpartisan Congressional Budget Office – to pass their massive health care overhaul at any cost,” Ryan said.

President Obama, at a Rose Garden signing ceremony for a separate jobs bill, also mentioned the CBO numbers on Thursday morning — right around the time the CBO actually posted them on its Web site.

“The reform we seek would bring $1.3 trillion in deficit reduction over the next two decades,” Obama said to applause. “That makes this legislation the most significant effort to reduce deficits since the balanced budget act in the 1990s.”

Obama said the Democrats’ health care bill will bring new accountability to the insurance industry and greater economic security to all Americans. “So I urge every member of Congress to consider this as they prepare for their important vote (on health care) this weekend.”

Rep. Hoyer was quoted as saying, “The more and more people have looked at this bill…a greater number of people are becoming more comfortable.”

That is the Democrats’ hope, as they try to round up the 216 votes necessary to send a health care bill to President Obama, using a controversial parliamentary maneuver.

At a joint press conference on Thursday morning, House and Senate Republicans again accused Democrats of trying to ram through a $1 trillion government takeover of health care, against the wishes of the American people.

“It’s pretty clear that Democrat leaders here in Congress and the president aren’t listening to the American people, because the American people are saying, ‘stop!’ and they’re screaming at the top of their lungs,” said House Republican Leader John Boehner (Ohio).

Boehner noted that Obama has made the point to Democrats that his presidency is on the line: “Well, sorry Mr. President, this isn’t about you… This is about the American people and the health care system that they want for our country.”

Boehner said House Republicans on Thursday will try to force a vote on a resolution requiring a “clean, up-or-down vote” on the Senate-passed health care bill. If the resolution is adopted by the House, it would prohibit Speaker Nancy Pelosi and Democratic leaders from implementing the “Slaughter Solution,” a controversial scheme by which the Senate health care bill would be “deemed” to have passed without an actual up-or-down vote by the House.

PELOSI: Buy a $15,000 Health Care Policy or Go to Jail

Posted in Health Care with tags , , , , , on November 9, 2009 by saynsumthn


JCT Confirms Failure to Comply with Democrats’ Mandate Can Lead to 5 Years in Jail

Friday, November 06, 2009

Today, Ranking Member of the House Ways and Means Committee Dave Camp (R-MI) released a letter from the non-partisan Joint Committee on Taxation (JCT) confirming that the failure to comply with the individual mandate to buy health insurance contained in the Pelosi health care bill (H.R. 3962, as amended) could land people in jail. The JCT letter makes clear that Americans who do not maintain “acceptable health insurance coverage” and who choose not to pay the bill’s new individual mandate tax (generally 2.5% of income), are subject to numerous civil and criminal penalties, including criminal fines of up to $250,000 and imprisonment of up to five years.

In response to the JCT letter, Camp said: “This is the ultimate example of the Democrats’ command-and-control style of governing – buy what we tell you or go to jail. It is outrageous and it should be stopped immediately.”

Key excerpts from the JCT letter appear below:

H.R. 3962 provides that an individual (or a husband and wife in the case of a joint return) who does not, at any time during the taxable year, maintain acceptable health insurance coverage for himself or herself and each of his or her qualifying children is subject to an additional tax.” [page 1]

– – – – – – – – – –

If the government determines that the taxpayer’s unpaid tax liability results from willful behavior, the following penalties could apply…” [page 2]

– – – – – – – – – –

Criminal penalties

Prosecution is authorized under the Code for a variety of offenses. Depending on the level of the noncompliance, the following penalties could apply to an individual:

Section 7203 – misdemeanor willful failure to pay is punishable by a fine of up to $25,000 and/or imprisonment of up to one year.

Section 7201 – felony willful evasion is punishable by a fine of up to $250,000 and/or imprisonment of up to five years.” [page 3]

When confronted with this same issue during its consideration of a similar individual mandate tax, the Senate Finance Committee worked on a bipartisan basis to include language in its bill that shielded Americans from civil and criminal penalties. The Pelosi bill, however, contains no similar language protecting American citizens from civil and criminal tax penalties that could include a $250,000 fine and five years in jail.

“The Senate Finance Committee had the good sense to eliminate the extreme penalty of incarceration. Speaker Pelosi’s decision to leave in the jail time provision is a threat to every family who cannot afford the $15,000 premium her plan creates. Fortunately, Republicans have an alternative that will lower health insurance costs without raising taxes or cutting Medicare,” said Camp.

According to the Congressional Budget Office the lowest cost family non-group plan under the Speaker’s bill would cost $15,000 in 2016.
______________________________________________________________________________________________________

Aren’t these the same “Compassionate” people who claim we cannot make abortion illegal because women would be subject to jail?

Just Say’n !