Planned Parenthood in Spokane Fined 700K for Medicaid Overbilling on Abortion

State   |   Steven Ertelt   |   Aug 10, 2009   |   9:00AM   |   WASHINGTON, DC

Planned Parenthood in Spokane Fined 700K for Medicaid Overbilling on Abortion

by Steven Ertelt Editor
August 10
, 2009

Spokane, WA ( — The Planned Parenthood abortion business in Spokane, Washington has been hit with a $700,000 fine from the state health department. The result of an audit by state officials shows it was routinely overbilling Medicaid for abortions as well as contraception and family planning services.

According to the audit, state health officials found Planned Parenthood of Spokane was "unbundling" abortion claims and falsely billing for doctor visits when customers were picking up prescriptions.

Mary Emanuel and Jonathan B, who run the web site Abortion in Washington (AIW), obtained copies of the audit documents from the Department of Social and Health Services.

They say they show Planned Parenthood has been ordered to reimburse the state $630,000 plus interest for the overpayments.

"The audit did not get into the question of whether the overbilling was part of a systematic fraud scheme, but it also was clear that if this practice continued PPS would lose its Medicaid billing privileges," they write.

AIW says the audit found five categories of overbilling.

One involved "unbundling" post-abortion drugs and billing them to Medicaid as family planning, which is prohibited. The practice appears at odds with longstanding Planned Parenthood claims that family planning money doesn’t pay for abortions or abortion-related services.

Other cases included billings for pregnancy tests done on women who never said they thought they were pregnant and without any indication the tests were medically necessary.

They also included overbilling on fraudulent birth control prescriptions or for drugs sold without a prescription, billing for more than three times the cost of condoms, and billing office visits to pick up a prescription or get an injection.

AIW indicates the audit covered a three year period and that Planned Parenthood of Spokane could face further fines for Medicaid overbilling.

"The audit covered the three-year period from Spring 2004 through Spring 2007, and made a point that it didn’t claim to have been exhaustive, meaning that PPS shouldn’t assume that they are free and clear if they are guilty of additional overbilling from this period not discovered in the audit," the blog writes.

"The audit didn’t address the question of whether these practices were going on prior to 2004, or after 2007, including up to the present, or the question of whether it was systematic and intentional, thus rising to the level of fraud," it added.

AIW indicates Planned Parenthood must be concerned about future problems as officials at PPS have hired attorneys and a Medicaid expert to defend itself.

The blog is also concerned about future Medicaid overbilling, or fraud, and whether other Planned Parenthood affiliates in Washington state are engaging in the practices.

"The audit itself also didn’t deal with the question of who is going to ensure that these overbillings are not going on right now," it said.

"Some might argue that Medicaid billing is complicated and errors are inevitable. But no organization on earth should have more expertise in how to bill Medicaid correctly for contraceptives than Planned Parenthood," the writers conclude.

Related web sites:
Audit documents

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