Probe May Find More Medicaid Fraud at Planned Parenthood

National   |   Steven Ertelt   |   Sep 28, 2011   |   3:24PM   |   Washington, DC

Now that Congress has announced it will begin an investigation of Planned Parenthood, one question on the minds of watchdogs of the abortion business is whether it will disclose information about its history of Medicaid fraud.

Planned Parenthood has been documented in multiple states to have engaged in Medicaid fraud or overbilling. While information in these cases has already come to light, Congress could find a more significant pattern of financial impropriety from the documents officials are requesting.

In a September 15 letter obtained, Rep. Cliff Stearns, a Florida Republican who is the chairman of the House Committee on Oversight and Investigations, writes to Cecile Richards, the president of Planned Parenthood. He requests asks Richards to comply with current federal regulations and legal obligations by providing Congress with a wide range of documents within two weeks of the date of the letter.

“That Committee has questions about the politics in place and actions undertaken by PPFA and its affiliates relating to its use of federal funding and its compliance with federal restrictions on the funding of abortion,” he writes. “Please provide all internal audit reports conducted by PPFA and its affiliates from 1998 to 2010. If not clearly indicated in the audit reports, please detail how much PPFA and each affiliate expended and received in Title XIX Medicaid funding, Title X family planning, and any other federal funding.”

The letter requests any information related to improper billing concerning federally-funded programs, proof that federal funds are not being improperly used to pay for abortions by PPFA or its affiliates, audits by state agencies of any Planned Parenthood affiliate, and documentation of how many affiliates currently receive Title X family planning funding.

Planned Parenthood has already been found to have overcharged state and federal governments in five states.

A 2008 federal audit of state family planning claims resulted in a finding that the state of New York had overbilled the federal government $17,151,156 by claiming procedures as “family planning” services when they were not.

The federal audit report noted that, “Officials at Planned Parenthood providers stated that they believed that nearly all the services they provide are 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 2010, the New York Times released a new report showing Planned Parenthood Golden Gate in California faces an audit from the criminal division of the Internal Revenue Service. The report detailed how an unnamed former employee interviewed with the Oakland field office of the IRS in response to a complaint he lodged with the governmental agency.

The employee, who would not let the Times name him for fear of his future job prospects, said he filed a two-part complaint about the abortion business’ problematic relationship with its political arm and about financial problems at the abortion business.

The overbilling problems also extend to Planned Parenthood centers in New Jersey.

The U.S. Inspector General for the Department of Health and Human Services 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. [related]

New Jersey authorities 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 prescription 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.

In a section entitled “Causes of Overpayment,” the report states: “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.”

The state eventually returned $2.9 million to the federal government.

In Washington state, a 2009 audit found Planned Parenthood of the Inland Northwest overcharged the government $629,142.88. The audit found Planned Parenthood was charging excessive amounts for contraceptives and distributed and charged for prescription medication without having a valid prescription.

Also, pro-life advocates say they believe Planned Parenthood in Iowa is overbilling the state for “bilking insurance companies out of grossly inflated fees.”

Operation Rescue revealed Planned Parenthood is charging insurance companies $1,000 for the drug-induced abortion process even though the overhead costs for the abortion are lower with the abortion practitioner off site via telemed abortions

This overbilling effectively drives up the cost of health insurance for everyone, its president, Troy Newman, contends.

“Planned Parenthood of the Heartland is making a killing on medical abortions,” he said. “Planned Parenthood is gouging insurance companies twice the price of their cash abortions. That’s how they can afford to keep their smaller clinics running.”

“And if taxpayers are forced to fund these abortions, there’s no telling how much they will charge, because government funding is a blank check,” he added.

Meanwhile, also in California, a 2004 audit found that Planned Parenthood of San Diego and Riverside Counties overcharged the government $5,213,645.92 for oral contraceptives. The problem was that Planned Parenthood was supposed to charge the government the cost of the pills. Instead, it charged a much higher price.

Jim Sedlak, the director of Stopp Planned Parenthood, a watchdog group, has said the overbilling and fraud is enough to cause Congress to cancel any Planned Parenthood funding.

“Millions of dollars in overbilling and the federal government wants to keep giving Planned Parenthood our money,” he said. “The states have to repay millions of dollars to the federal government because Planned Parenthood wrongly claims that nearly all its services are “family planning” when they are not, yet the federal government is threatening to punish the states for cutting off funds to Planned Parenthood.”