Planned Par­ent­hood ac­cused of $6M fraud

Whistle­blower: 87,000 false or in­el­i­gi­ble claims filed

The Washington Times Daily - - Nation - BY CH­ERYL WETZSTEIN

A Planned Par­ent­hood af­fil­i­ate in Texas know­ingly sent in about $6 mil­lion in false claims to Med­i­caid and took steps to cover up its acts, says a fed­eral “whistle­blower” law­suit that was un­sealed Fri­day.

Planned Par­ent­hood Gulf Coast sub­mit­ted more than 87,000 re­im­burse­ment claims for ser­vices that were “false, fraud­u­lent, and/or in­el­i­gi­ble,” said the law­suit filed by Abby K. John­son on be­half of the United States and State of Texas in U.S. Dis­trict Court in the South­ern Dis­trict of Texas in Hous­ton.

Ms. John­son is a for­mer di­rec­tor of one of the clin­ics and had “sys­temwide” ac­cess to pa­tient records and billing ac­tiv­i­ties for about two years.

Ms. John­son, who be­came a pro-life ac­tivist af­ter viewing an ul­tra­sound and has con­verted to Catholi­cism, said Fri­day she filed the law­suit un­der the fed­eral False Claims Act in 2009 “to sim­ply ex­pose Planned Par­ent­hood and ex­pose their cor­rup­tion, and ex­pose what they are do­ing with Amer­i­can tax dol­lars.”

“Ev­ery­one, no mat­ter what you think about abor­tion, should be in­ter­ested in where our money is go­ing and how it is be­ing spent,” Ms. John­son said. “As some­one who saw the in­side of this and saw the fraud­u­lent billing and the fraud­u­lent claims, I felt like I had a duty, and it was nec­es­sary for me to come for­ward with this in­for­ma­tion.”

The law­suit was kept un­der seal un­til Fri­day, when U.S. Dis­trict Judge Ken­neth Hoyt made it public. It al­leges that the 10 clin­ics in Planned Par­ent­hood Gulf Coast put in fraud­u­lent claims worth about $5.7 mil­lion to the Texas Women’s Health Pro­gram, the state’s Med­i­caid pro­gram.

Re­quests for com­ment Fri­day from Planned Par­ent­hood Fed­er­a­tion of Amer­ica and Planned Par­ent­hood Gulf Coast were not an­swered.

The law­suit, if de­cided in fa­vor of Ms. John­son, could re­sult in mul­ti­mil­lion­dol­lar dam­ages and penal­ties from Planned Par­ent­hood Gulf Coast. As the whistle­blower, Ms. John­son could also re­ceive as much as 30 per­cent of the amount re­cov­ered.

Un­der the law, it is likely that Planned Par­ent­hood was not aware of the sealed law­suit, said Al­liance De­fense Fund se­nior coun­sel Michael J. Nor­ton, one of the lawyers rep­re­sent­ing Ms. John­son.

But once Planned Par­ent­hood re­sponds, “I sus­pect we will be, very shortly, in sort of what you would char­ac­ter­ize as an all-out war,” he said.

Ac­cord­ing to the law­suit, Planned Par­ent­hood Gulf Coast con­tracted with the state to help pre­vent un­wanted preg­nan­cies among a pop­u­la­tion of el­i­gi­ble women. The clin­ics’ main ser­vice was to of­fer women an an­nual fam­ily-plan­ning exam and con­sul­ta­tion; only of­fice vis­its “re­lated to con­tra­cep­tive man­age­ment” were re­im­bursable by the Med­i­caid pro­gram, the law­suit said.

How­ever, ow­ing to fi­nan­cial pres­sures of its own, Planned Par­ent­hood Gulf Coast lead­ers and staff col­lab­o­rated to reg­is­ter all kinds of in­el­i­gi­ble ser­vices — preg­nancy tests, sex­ual-dis­ease tests, Pap tests — for Med­i­caid re­im­burse­ment, the law­suit claims, adding that the bosses ad­mit­ted to Ms. John­son and other clinic di­rec­tors that these claims were not el­i­gi­ble for re­im­burse­ment, but told them, “We have to keep these peo­ple as pa­tients” and “We must turn ev­ery call and visit into a rev­enue-gen­er­at­ing client.”

In ad­di­tion, clinic staff “falsely no­tat[ed]” pa­tients’ charts to “fix” and “cover up” the frauds be­fore in­spec­tors or au­di­tors came, the law­suit said.

Re­gard­ing abor­tion ser­vices, the law­suit said that Planned Par­ent­hood Gulf Coast was re­quired by law to re­fer preg­nant women to doc­tors or clin­ics that did not per­form or pro­mote or re­fer for elec­tive abor­tion. But in­stead, Planned Par­ent­hood re­ferred preg­nant women “to its own abor­tion clin­ics for per­for­mance of abor­tion, in vi­o­la­tion of state law,” Mr. Nor­ton said.

The case was un­sealed Fri­day be­cause fed­eral and Texas au­thor­i­ties de­cided not to in­ter­vene in the case, Mr. Nor­ton said.

A spokesman for the Jus­tice Depart­ment in Washington said Fri­day the agency had “no com­ment” on the case. A spokesman for the Texas at­tor­ney gen­eral’s of­fice could not be im­me­di­ately reached.

The law­suit is likely to be of in­ter­est on Capi­tol Hill.

Rep. Cliff Stearns, Florida Re­pub­li­can and chair­man of the House En­ergy and Com­merce sub­com­mit­tee on over­sight and in­ves­ti­ga­tions, is plan­ning a hear­ing into fed­eral fund­ing to Planned Par­ent­hood Fed­er­a­tion of Amer­ica. A hear­ing date has not been set.

Mr. Nor­ton said that this is the third false-claims law­suit against Planned Par­ent­hood af­fil­i­ates, and “I don’t think it would be un­fair to sug­gest that more will be com­ing.”

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