Planned Parenthood Abortion Biz Found Improperly Billing Medicaid in New Jersey

State   Steven Ertelt   Jan 1, 2009   |   9:00AM    WASHINGTON, DC

Planned Parenthood Abortion Biz Found Improperly Billing Medicaid in New Jersey

by Steven Ertelt
LifeNews.com Editor
August 16
, 2010

Trenton, NJ (LifeNews.com) — The U.S. Inspector General for the Department of Health and Human Services has uncovered a consistent problem with New Jersey-based family planning clinics run by the Planned Parenthood abortion business. They were found to be improperly billing Medicaid for services that did not qualify as family planning.

The new information comes as New Jersey lawmakers have been lobbying Governor Chris Christie to restore $7.5 million in state taxpayer funds to family planning and Planned Parenthood centers.

They want to require state residents to apply for a federal waiver which would reimburse these clinics 90% for every Medicaid service they provide, including family planning services.

Marie Tasy, the director of New Jersey Right to Life, released the new information showing the improper billing problems at Planned Parenthood.

She says state officials were sent letters in July 2007, June 2008 and August 2008 notifying them of the problems and requesting action to correct the errors. The reports found billing errors from February 1, 2001 through January 31, 2005.

An initial audit revealed New Jersey improperly received federal reimbursement at the enhanced 90% rate for 160,955 prescriptions drug claims that were billed as family planning, but did not qualify as family planning services. A letter from the Inspector General to New Jersey officials recommended that New Jersey repay $2,219,746 to the federal government.

A second audit by the U. S. Inspector General for the HHS Department found Planned Parenthood family planning centers improperly received the enhanced 90% rate for outpatient services which did not qualify as family planning services.

Of the 107 claims, 64 were for family planning services eligible for federal Medicaid reimbursement at the 90 percent rate and 43 claims did not qualify as family planning services, and were therefore ineligible for federal Medicaid reimbursement at the 90% rate.

Tasy says the report specifically cites Planned Parenthood officials who told investigators that they billed all claims to Medicaid as "family planning" and "populated the family planning indicator field on Medicaid claims even though the service provided did not meet the criteria for 90 percent Federal funding."

As a result, the Office of Inspector General sent a letter on June 17, 2008 to the Commissioner of Human Services recommending that the state refund $597,496 to the federal government and amend their procedures to prevent improper billing in the future.

A third audit found New Jersey received federal Medicaid reimbursement for 111 of the 161 claims for inpatient services which were improperly billed as family planning at the enhanced 90 percent rate. The Office of Inspector General recommended New Jersey reimburse $162,548 to the federal government and determine the amount of federal Medicaid funds improperly reimbursed at the 90% rate for inpatient hospital services following the audit period and refund that amount as well.

"The facts cannot be denied. These audits show a systematic abuse of improper billing of Medicaid for family planning services to the federal government to obtain 90% reimbursement," said Tasy of New Jersey Right to Life.

"Planned Parenthood has been cited specifically as one of the principal agents of these improper billing practices by the OIG," she mentioned.

Tasy cited page five of the 2008 report entitled, "Review of Outpatient Medicaid Claims Billed as Family Planning by New Jersey."

The report said: "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.’ Therefore, officials at these clinics often populated the family planning indicator filed 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."

Tasy responded, "Planned Parenthood’s supporters not only want to use $7.5 million in taxpayer dollars to fund these family planning clinics, they also want the state of New Jersey to permanently apply for a federal waiver to reimburse family planning clinics 90% for every Medicaid service they provide."

She says Planned Parenthood wants this "despite the clinics’ history of improperly billing Medicaid and contributing to the nearly $3 million in fees calculated by the federal government to be refunded to them."

"Taxpayers should be outraged. These facts should give every legislator who voted for Bill S2139 a good reason to now oppose any misguided effort to override Governor Christie’s veto," she concludes.

This isn’t the first time Planned Parenthood has been caught overbilling the government for family planning and birth control.

The United States Court of Appeals for the Ninth Circuit, in July, reinstated the lawsuit filed by a former vice president of a Planned Parenthood abortion business affiliate in California. The case details allegations of massive fraud where the abortion giant overbilled state officials.

P. Victor Gonzalez says the abortion business fired him because he raised concerns about illegal practices of overcharging the state hundreds of millions of dollars on birth control.

Gonzalez says his own internal audit estimates that Planned Parenthood overcharged California taxpayers for purchasing birth control by at least $180 million.

He was the vice president of finance and administration for Planned Parenthood of Los Angles and, according to a Los Angeles Times report, the overbilling began in the late 1990s.

While other public health facilities and private facilities charged the state between $8 and $9 for a cycle of birth control pills, Planned Parenthood charged almost $12. The Planned Parenthood charge to the California government was several times more than it paid for the drugs originally.

Related web sites:
New Jersey Right to Life – https://njrtl.org

 

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