Although abortion has been heavily restricted in Texas following the overturning of Roe v. Wade last year, this particular lawsuit is focused on money it took from the Medicaid system while it was not officially considered a “qualified” care provider.
Texas has asked a federal judge to fine the company more than $1 billion for thousands of Medicaid claims that it believes were fraudulent over a span of several years.
After considering fines, penalties and interests, the total at stake could reach $1.8 billion, an amount that could be financially devastating for Planned Parenthood. It might even result in them having to cease operations altogether in Texas.
In fact, the company said in a statement that it believes forcing them to close was the goal of the suit, claiming: “This lawsuit was brought with the sole goal of shutting down Planned Parenthood.”
The suit was filed under the federal False Claims Act, which enables them to pursue fines for each improper payment. The case also involves a relator, which is a whistleblower who can file a public lawsuit on behalf of the government and may receive a percentage of the money that is awarded. The whistleblower in this case maintains that PP and its affiliates not only violated the False Claims Act but also the Texas Medicaid Fraud Protection Act.
The problem can be traced back to 2011, when the state started taking measures to protect taxpayers from having to fund PP. Around that time, videos were released that uncovered how they had been trafficking aborted fetal organs. Texas ultimately decertified PP as an official provider of Medicaid.
Inspector General Stuart Bowen Jr. stated at the time: "The state has determined that you and your Planned Parenthood affiliates are no longer capable of performing medical services in a professionally competent safe, legal and ethical manner."
They were informed that they would be expelled from the program in January 2017 following a period during which they could appeal. However, they chose not to appeal and instead filed a lawsuit. They later lost the suit in the 5th Circuit Court of Appeals, but in the meantime, they continued to bill for – and receive – $10 million worth of claims that should not have been filed in the first place.
The current suit seeks to be repaid twice the amount of these fraudulent claims, in addition to civil penalties of up to $11,000 per claim, court costs and attorney fees.
It’s not the first time the abortion provider has been accused of taking funds it was not entitled to. In a previous case, a whistleblower revealed internal memos instructing Planned Parenthood locations to “defraud Medicaid by filing phony claims.”
At the time, a woman who worked for Planned Parenthood for more than a decade explained how their local offices swindled Medicaid through tactics such as billing for medical services that were not necessary or were never carried out, billing for services that Medicaid did not cover, and falsifying medical records to support fraudulent billing. They settled that case for $4.3 million but did not admit guilt, even as then-U.S. Attorney John Bales said they were abusing federal programs.
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