Report: Planned Parenthood Groups Engage in Medicaid Fraud

National   |   Steven Ertelt   |   Feb 7, 2012   |   1:22PM   |   Washington, DC

A report released today by two leading pro-life organizations alleges more Planned Parenthood affiliates have engaged in fraud than the ones that have already become public knowledge and part of an investigation of the abortion business by Congress.

Today the Alliance Defense Fund and the Susan B. Anthony List released a new report to Congress identifying waste, abuse, and potential fraud by Planned Parenthood. ADF attorneys prepared the report to aid Congress in its investigation of the nation’s leading abortion business.

The report alleges that millions of dollars of waste, abuse, and potential fraud have been revealed in state and federal audits across the country. It identifies twelve types of potential fraud being committed by Planned Parenthood affiliates nationwide, including fraudulent billing and reimbursement by Title XIX agencies for medications and/or services provided in connection with an abortion, illegal under federal law.

The billing violations include billing in excess of actual acquisition cost or other statutorily approved cost of contraceptives and Plan B products as well as inappropriately billing for services that were not medically necessary, billing for multiple initial prenatal care visits, and incorrectly billing initial, follow-up, and postpartum services.

“After 40 years of receiving taxpayer funds, not one oversight hearing of Planned Parenthood has occurred.  Now is the time for such scrutiny on behalf of its most important benefactor, American Taxpayers,” SBA List president Marjorie Dannenfelser said today.

She said the report detailed “findings of systemic financial waste, abuse and potential fraud spanning many years” – problems that “reveal a pattern of gross financial mismanagement.”

“Planned Parenthood receives 46 percent of its budget from taxpayers,” Dannenfelser said. “Taxpayers spend over $1 million a day on this nonprofit entity which reports over a billion dollars of net assets.  No organization is entitled to taxpayer funds especially one mired in controversy and under investigation.  Organizations who receive such largess from taxpayers deserve scrutiny.”

“Planned Parenthood campaigns to destroy those who ask questions should be a matter of questioning itself.  Their current posture of entitlement is that of a spoiled teenager, not a mature non-profit committed to programs with integrity,” she added. “Congressman Stearns took a prudent and responsible action in committing to oversight hearings.  There is much to scrutinize.  We encourage him to pursue them now, and the Congress to watch closely.”

“Americans deserve to know if their hard-earned tax money is being funneled to groups that are misusing it,” said ADF Senior Counsel Steven H. Aden. “Planned Parenthood has to play by the same rules as everyone else. It certainly isn’t entitled to a penny of public funds, especially if it is committing Medicare fraud.”

The ADF report found:

* Federal and state audits of family planning funding have found a minimum of $95,742,982.15 in waste, abuse, and potential fraud from 1995 to 2009;

* Of this waste, abuse, and potential fraud, at least $7,867,547.15 has been identified in separate state audits to have occurred in a total of seven audited Planned Parenthood affiliates in New York state, California, Washington state, and Texas due to a variety of abuses, including extensive overbilling and illegal billing for abortion-related procedures that are ineligible for government reimbursement under federal laws, including the Hyde Amendment; [related]

* These audited amounts include both state and federal funds under the various matching formulas for these programs;

* In addition, federal audits of family planning programs from 1995 to 2009 have identified a total of nearly $88 million in overbilling, with the sum rising as high as $99 million according to the Inspector General’s Office at the U.S. Department of Health and Human Services;

* Of the 38 federal family planning audits covering federal funding streams and 19 states, two audits, in New Jersey and New York, specifically identified Planned Parenthood, and only Planned Parenthood, as a source of overbilling in the family planning programs. The combined waste in these two audits alone was $1,516,312.

* All told, extensive waste, abuse, and potential fraud have been identified to date in 9 percent of Planned Parenthood’s 79 U.S. affiliates. Two others,
one in Texas and one in California, are the subject of federal whistleblower lawsuits by former Planned Parenthood employees alleging fraud;

ADF concludes: “The extent of possible waste, abuse, and potential fraud at the nation’s remaining percent of Planned Parenthood affiliates is unknown and merits congressional review by the House Energy and Commerce Committee. This investigation is especially pertinent given Planned Parenthood Federation of America’s extensive management, operational, and fiscal authority over the policies and conduct of its affiliates, as well as its ongoing requirement that each of its affiliates avoid deficits in its expendable net assets.”

See the full 26-page report here.