Busted: Planned Parenthood Gulf Coast must repay $1.4 mil for Medicaid fraud
Last week I hypothesized that Planned Parenthood Gulf Coast’s announcement that it was closing three clinics in Texas had nothing to do with new pro-life Republican laws and funding cuts, as it claimed.
Rather, I wrote, ”was this really an attempt to erase dots between the shutdowns and PPGC’s problem with Medicaid fraud?”
https://twitter.com/chrisgast/status/360129927040860160
Thanks, Chris!
So as it turns out, according to a press release today by Texas Attorney General Greg Abbott:
After a whistleblower lawsuit was filed alleging improper billing practices by Planned Parenthood Gulf Coast, an investigation was opened by the Texas Attorney General’s Office and the Texas Health and Human Services Commission’s Office of Inspector General. The State’s investigation revealed that PPGC improperly billed the Texas Medicaid program for products and services that were never actually rendered, not medically necessary, and were not covered by the Medicaid program – and were therefore not eligible for reimbursement. For example, state investigators determined that Planned Parenthood Gulf Coast falsified material information in patients’ medical records in order to support fraudulent reimbursement claims to the Medicaid program.
Under the agreement announced today, Planned Parenthood Gulf Coast must pay $1.4 million to resolve the Medicaid fraud enforcement action.
PPGC is denying everything. According to DallasNews.com:
The allegations in this complaint are baseless and we are ending this case as a practical matter. Continuing this litigation in the hostile environment for women’s health would have ensured a lengthy and costly process that would have distracted our energies and required us to share the private medical information of thousands of women. We are ending this lawsuit in order to devote all of our time and energy to delivering high-quality, affordable health care.
Sure.
PPGC didn’t suddenly decide to settle the litigation. It knew last week when it floated its ruse that this was all coming down. Will MSM circle back to connect the dots? Betting not.
Now it makes more sense that PPGC would close its almost new $1.5 million Lufkin clinic – just about what it needs to repay the government.
[HT: LifeNews.com, Saynsumthn’s Blog; graphic via ketknbc.com]
Jill Stanek is a nurse turned speaker, columnist and blogger, a national figure in the effort to protect both preborn and postborn innocent human life.
“in the hostile environment for women’s health”
A hostile environment characterized by the widespread movement to ban pap smears, or something. Oh, wait, they were probably using women’s health as an euphemism for abortion again. These people need to learn to communicate in a less vague manner. The way they speak now is just confusing.
Tickled Planned Parenthood Pink
So I was right, no fraud charges. Why not? Given the AG’s history, particularly in regard to groups such as PP, this would have been an ideal opportunity to deliver more harm.
We’ve got allegations by ‘whistleblowers’ (last seen merrily shopping) and a ‘determination’ by the activist AG’s henchmen that some paperwork was questionable.
Oh well, at least he’s got another shiny ‘look what I can do’ pin to stick in his manifesto to impress the mouth-breathers if he does pursue his political ambitions.
“sure” – absolutely. How many $M’s have been lost because of the level of lost public financing since 2011 when the state reduced family planning financing and banned abortion-affiliated providers from participating in the Texas Women’s Health Program. Hardly surprising given the reprehensible tactics employed by the knuckle-draggers in their ongoing political machinations to remove funding on ideological grounds.
Those poor women in Texas, especially the poor ones.
Reality, did Lockheed Martin end up with criminal charges when it defrauded the federal government? It got the F35 contract (worth hundreds of billions) thereafter.
That’s because the right to bear arms is the most important thing, ever, Merit.
I see, so Lockheed Martin is to blame for Planned Parenthood defrauding Texas and American taxpayers, and us prolifers should go after them because fighter jets have a lot to do with abortion, euthanasia, embryonic stem cell research, etc. Do I have that right?
What’s a little fraud when your main source of $$$$$$ is killing innocent preborn human beings and wounding women and men??
psssssssssshhhhhhh
So, I hear our trolls are bringing up more red herrings. What else is new?
Also, don’t feed the trolls etc.
So I was right, no fraud charges. Why not? Given the AG’s history, particularly in regard to groups such as PP, this would have been an ideal opportunity to deliver more harm.
Maybe he didn’t feel like being crucified by abortion industry big wigs later in his career, like Kline in Kansas.
JDC,
Thank you for the timely reminder!! :)
“JDC,
Thank you for the timely reminder!! ”
You’re welcome. :)
I’m not a lawyer — but it seems to me that fraud is a crime that is charged against an individual. Charge and trials require sufficient evidence that certain particular individuals knowingly set out to defraud the taxpayers.
I am an accountant. I know somewhat about regulatory audits — The MedicAid auditors have discovered $1.4 million in illegal charges. It does not matter whether the abuses were due to criminal intent or administrative error; the taxpayers of Texas are entitle to a refund. There may be fraud charges later, or maybe not.
In any case, PP owes reimbursement. If the pattern of abuse is serious enough, certain PP clinics may not be allowed to participate in MedicAid in the future. They are defunded! And since PP is not a charity, they are closing clinics that are not profitable.
PP has two profitable divisions: gouging MedicAid and selling abortions. Without MedicAid, they will concentrate on their abortion business. Meanwhile, PP will do damage control and blame pro-life legislators. The serpent is wounded, but still has its fangs.
At some point, this might start to look like a pattern. Iowa. San Francisco. Los Angeles. Alaska. Des Moines. San Diego/Riverside. a closed clinic in El Paso just as state auditors were examining that PP. And now, a settlement at PP Gulf Coast.
These are off the top of my head. Right now, you cannot identify the PP fraud cases with a search engine because this Texas story has been churnalism-ed so much it crowds out the search results. If anyone recalls other PP Medicaid fraud cases, please note them.
The true-believers will have a difficult time explaining away all of these carbon-copy misunderstandings and coincidences.
The truth is that we liberals have an end-game in mind: controlling everyone’s lives in our image. It takes a few broken eggs to make an omelette, and it takes a little fraud here and there to re-work society according to the Marxist dystopia. Please be patient with us: we have your best interests in mind. Just give us control and we will solve all of your problems (especially the ones we have manufactured, like the “right” to a “healthy” sex life).
If a woman goes to PP for a well woman check-up and get’s a breast check and a papsmear, ether she, her insurance, or Medicaid pays for it, right? Last I heard, they were not free. And they refer out for mammograms.
So, my question is, what to they do with all the money they exhort out of cancer organizations? If you don’t want to call it exhortion, just look at what happened to Korman.
It seems to me, that there needs to be more accounting than just use of Medicaid funds here! They need to keep digging and then some jail time for the people who were responsible for committing fraud whether it is with public or private sector funds.
From Reality:
So I was right, no fraud charges.
From the OP, quoting the Texas AG:
Under the agreement announced today, Planned Parenthood Gulf Coast must pay $1.4 million to resolve the Medicaid fraud enforcement action.
Does not compute.
Some people aren’t really people so we can kill them… provided they are too small to fight back.
Does not compute either, Will Robinson.
Chris, the fact is those who complain about Planned Parenthood will generally give defense contractor frauds a pass, even if the money is many times more. No red herring at all. It’s about the hypocrisy.
the fact is those who complain about Planned Parenthood will generally give defense contractor frauds a pass
Nice sweeping generalization. I know a lot of people that complain about PP. None of them give any type of fraud a pass. Perhaps you were speaking about specific politicians?
Here’s another one, PP is over a third of a billion dollars of fraud in WA state alone:
http://www.lifesitenews.com/news/planned-parenthood-defrauded-washington-state-medicaid-for-377-million-laws
A quote form the article: ”Last year, the ADF released a 23-page report that stated Planned Parenthood had engaged in upwards of $99 million in waste or possible fraud, including the illegal taxpayer funding of abortion and abortion-related procedures. Overbilling was rampant, according to audits launched by officials in pro-abortion states.”
If your conscience is so defective that you believe killing unborn children is okay, what wouldn’t you do for money, including defrauding taxpayers?
And Merit, your comment has no MERIT! It’s pure speculation on your part, but you state that it’s a fact. And it really has nothing to do with the discussion anyway, simply a poor attempt on your part to discredit pro-lifers.
“And Merit, your comment has no MERIT!”
I think Merit may be competing with Reality for the coveted “most ironically named commenter” award.
“Do I have that right?” – no, try again.
“Maybe he didn’t feel like being crucified by abortion industry big wigs later in his career, like Kline in Kansas.” – can’t see that happening. His political ambitions are to stand for the knuckle-draggers so he only needs to impress the mouth-breathers. I can’t see how he would give a fat rat’s what the pro-choice folk think or say. As evidenced by his track record to date.
“but it seems to me that fraud is a crime that is charged against an individual.” – so what’s stopping the AG?
“knowingly set out to defraud the taxpayers.” – his statement said his investigators had ‘determined’ that this had happened. Why not charge someone?
“It does not matter whether the abuses were due to criminal intent or administrative error; the taxpayers of Texas are entitle to a refund.” - agreed. And did you check out all the other medicaid fraud actions against numerous parties. Nearly as many as the execution notices.
“There may be fraud charges later, or maybe not.” – don’t hold your breath Del.
“Does not compute” – what, you can’t figure out the difference? There are no fraud charges, no indictments. How did that not ‘compute’ for you? The AG said ‘your paperwork is dodgy, give us back some money – look everyone, I’m an anti-choice warrior, vote for me!’
Of course, it’s hard to imagine anyone other than Reality actually winning that award.
There are no fraud charges, no indictments.
“Under the agreement announced today, Planned Parenthood Gulf Coast must pay $1.4 million to resolve the Medicaid fraud enforcement action.”
Is PPGC guilty of Medicaid fraud according to the Texas AG, Reality? Yes, or no?
What is it that you don’t understand about this JoAnna?
There are no fraud charges or indictments.
There is a fraud enforcement action based on a ‘determination’ that medicaid funds were obtained by faulty and/or fraudulent action. The AG said ‘we believe you owe $1.4M’.
Rather than fight it in the political climate which is Texas, PP chose to pay the ransom.
The AG may well personally believe PP to be guilty. But like I keep explaining to you, no one has been charged or indicted. Therefore no one has been found guilty of fraud.
If you explore the link provided for the AG’s statement you will find that in other alleged medicaid fraud cases, charges have been laid and some people have been found guilty. That has not happened in this instance.
Just curious Reality, do you have some type of legal requirement to not even entertain the possibility that someone in the abortion industry has done something wrong?
Is it common for companies to settle instead of going to court/fighting it when accused of Medicaid/Medicare frauds? (I’m genuinely asking because I don’t know).
No Jack, no legal requirement. Or any other type of requirement. But when it comes to beat-ups, exaggerations, distortions and misrepresentations regarding PP et al I will balk.
I do not know the answer to your second question. But if you peruse the AG’s news releases website you can stroll back month by month and see there are a number of cases where people have been charged over medicaid fraud (in amongst the scheduled executions).
https://www.oag.state.tx.us/oagNews/index.php?m=06&y=2013&c=
Good question, Jack. That seems a pretty good money-maker, if so. All a state government has to do is accuse a large corporation or organization of Medicaid fraud, apparently with no proof whatsoever, and the organization will pay it — even if completely innocent! — just to avoid a lengthy legal battle (and even if doing so jeopardizes their ability to bill Medicaid in the future).
There is a fraud enforcement action based on a ‘determination’ that medicaid funds were obtained by faulty and/or fraudulent action.
Is the determination justified? If not, what proof do you have that it isn’t?
Let me make sure I’m understanding your logic.
Fraud indictment = possibly guilty of fraud
Fraud charges = possibly guilty of fraud
Determination of fraud by the state AG = completely innocent and the victim of evil anti-choice political machinations; completely helpless to withstand the unjust assault
Is that correct?
Given the relentless attacks on PP and womens rights by the Perry regime (he must be so jealous of Putin, I wonder if they swap love letters) it is brow-furrowing that the AG hasn’t taken things further legally if he thought he had a viable case.
“Is the determination justified?” – I haven’t seen the evidence. Have you? I’m not a lawyer. Are you?
“If not, what proof do you have that it isn’t?” – exactly the same proof you have that it is.
“Let me make sure I’m understanding your logic.” – If it was truly 100% justified wouldn’t there be enough evidence to indict or lay charges?
Fraud indictment = possibly guilty of fraud – enough evidence for the AG to believe a case will succeed
Fraud charges = possibly guilty of fraud – enough evidence for the AG to believe a case will succeed
Determination of fraud by the state AG = enough evidence to demonstrate false and/or fraudulent claims by some cause but not enough to actually indict or lay charges.
“Is that correct?” – it is now.
You seem pretty sure PP is completely innocent despite having the “same evidence that [I] do,” Reality.
enough evidence to demonstrate false and/or fraudulent claims by some cause but not enough to actually indict or lay charges.
So, they have alleged evidence of fraud, but not enough to bring up legal charges, yet PP’s gonna roll over and pay the fine even though they’re completely innocent? Why on earth would they do that? Why not refuse to pay the fine if there’s zero evidence that they’re complicit in fraud? What could the AG possibly do to them without evidence of wrongdoing?
Something’s not adding up.
It’s the state of Texas which isn’t adding up JoAnna.
You would be as aware as I am of the political agenda against choice and womens rights which has been perpetrated by Perry and his tribe for some time now. Like the ones against environmental protections etc.
Of course there is the alternative reasoning. Maybe the AG has less calluses on his knuckles than Perry and the others and is happy enough to have a win against PP to shout about without actually causing them too much harm.
It’s the state of Texas which isn’t adding up JoAnna.
How so? If they have no evidence, why impose a fraud action? PP can simply ignore it if there’s no evidence.
I’m not aware of any political agenda against choice or women’s rights in TX perpetrated by the current administration – only a strong effort to ensure human rights for all human beings as well as protect women’s safety by enforcing basic, common-sense safety standards in facilities that attempt to skirt regulation (and thus endanger women).
Are you referring to Dem pols who act against school choice, religious liberty, 2nd amendment freedoms, and try to aid and abet people like Douglas Karpen? I agree, they’re despicable.
Merit writes: “the fact is those who complain about Planned Parenthood will generally give defense contractor frauds a pass, even if …”
This is sooo rich!! Oh, Merit, please, I beg you, do supply us with proof of this “fact.”
I can say that abortion advocates make up “facts” from thin air. But when I say it, honey, darling, light of our lives, I can point to Bernard Nathanson’s books where you can look up and read his written confessionsthat the number of deaths of women through illegal abortions that he and his abortion colleagues used to quote was AN OUTRIGHT LIE, THAT THEY SIMPLY MADE UP AT THE TIME BECAUSE IT SOUNDED GOOD. Go look it up, Wendy. Go look it up.
It’s the state of Texas which isn’t adding up JoAnna. – my comment was generic, not specific to this event :-)
“I’m not aware of any political agenda against choice or women’s rights in TX” – because you’re on the inside looking out. Nothing you want is being taken away.
“protect women’s safety” – if only it were true.
“Dem pols who act against school choice, religious liberty, 2nd amendment freedoms, and try to aid and abet people like Douglas Karpen” – this sounds interesting, care to elaborate?
I don’t care whatever you say Planned Parenthood, spin it however you like, get your homies here to defend you. It does not matter — you caved. I am still doing a victory dance called the Texas Two Step.
“I am still doing a victory dance called the Texas Two Step.” – it’s called that because most of them can’t get past two because they count using their teeth rather than their toes :-)
Here, Ninek.
http://www.sanders.senate.gov/newsroom/news/?id=02d36680-a643-4142-954d-f8aa80cd389f
Now find me one person who has complained about Planned Parenthood that has also complained about this.
Planned Parenthood is not the great and powerful Oz any more.
Texas Two Step — another name for a One Two Punch
“I am still doing a victory dance called the Texas Two Step…..Texas Two Step — another name for a One Two Punch” – it’s interesting how so many ‘pro-lifers’ advocate violence, demand the right to ‘pack heat’ like GI Joe and support the death penalty. I wonder what the correlation is.
“it’s interesting how so many ‘pro-lifers’ advocate violence, demand the right to ‘pack heat’ like GI Joe and support the death penalty. I wonder what the correlation is.”
And it’s interesting to me, as an anti-death penalty believer and vegetarian, how many of the people who agree with not murdering animals and convicts agree with killing humans as long as they aren’t born yet. People are complex and I don’t think anyone is fully consistent.
Still, no matter how ridiculous some supporters of any movement are, it doesn’t say anything about the validity of that movement.
Poor Merit, what you need to prove is not that contractors defrauded, but “the fact is those who complain about Planned Parenthood will generally give defense contractor frauds a pass,”
So the onus is on YOU to prove what YOU said is the fact. Still waiting… If you accuse, YOU prove it. I repeat that when I call abortion advocates liars who make up things out of thin air, I actually can cite you proof. My next question is: Have you looked up or read either of Bernard Nathanson’s books? I highly recommend you read them. After all, he was a founder of your abortion industry and you should want to hear what he says.
Abortion advocates, let me tell you something: I didn’t go to an exceptional high school. I thought it was a very ordinary education. But I underestimated my fine academic experience. Our high school debate team could trounce any abortion advocate any day, any time. I only wish I could put some of you in a time machine so I could witness the trouncing first hand. LOL! And what’s funny (kibble to the troll) is that while pro-lifers like to use verbal metaphors that sound violent, abortion fans like Reality actually use euphemism to soften the brutal and bloody murder that is the abortion of innocent children. Hypocrisy thy name is abortion advocate.
“Our high school debate team could trounce any abortion advocate any day, any time.” – could they? How many times did they have that debate? What was their win/loss ratio?
“use euphemism to soften the brutal and bloody murder that is the abortion of innocent children” – euphemism city.
Hypocrisy thy name is death penalty supporter, gw bush supporter, virtually uncontrolled firearm access supporter.
Deflect, deflect, deflect! That is the abortion fan motto. Our debate team’s could win ANY argument against you. For example, you ask about win/loss ration. Now, if they had lost even half the time against another team of great debaters, that would not be a negative reflection because there is no dishonor in losing to a better opponent. I am confident that there are no better opponents to be found among the abortion advocacy crowd. Seriously, you’ve got women wearing exterior tampons telling people that “feelings” determine whether someone is alive or in abortion-fantasy limbo. You think that’s an argument? That’s a toddler’s whine “cuz I wanna!” and you know it. The sad thing is that none of you abortion advocates are even the least bit embarrassed of your inadequacy.
Well, there’s always hope. You could still turn pro-life. But when you do, please don’t argue on our behalf until you grow some debating skills. ;>)
“Deflect, deflect, deflect!” – rubbish. You claimed they could beat any abortion advocate. Unless that has demonstrably occured it’s no more than a whimsical claim.
Oh, and would it be a ‘team’ against ‘an abortion advocate’, singular? Would that help them?
“For example, you ask about win/loss ration.” – no, I asked about their win/loss ratio in regards to debating an abortion advocate. Were their wins and losses rationed?
“Now, if they had lost even half the time against another team of great debaters, that would not be a negative reflection because there is no dishonor in losing to a better opponent.” – that sounds reasonable. But did they ever actually debate an abortion advocate?
“I am confident that there are no better opponents to be found among the abortion advocacy crowd.” – I know you are, that’s the fun part.
“telling people that “feelings” determine whether someone is alive or in abortion-fantasy limbo. You think that’s an argument?” – it doesn’t need to be an argument, it’s just expressing the reality of people in the world.
“That’s a toddler’s whine “cuz I wanna!” and you know it.” – pot, kettle.
“The sad thing is that none of you abortion advocates are even the least bit embarrassed of your inadequacy.” - pro-choicers don’t get embarrassed by anti-choicers reflections.
“Well, there’s always hope. You could still turn pro-life.” – I am pro-life.
“But when you do, please don’t argue on our behalf until you grow some debating skills. ;>)” – ‘cos you need the help?
Not all pro-lifers are pacifists. Not all pacifists are pro-life. Though, many are both. The two are not interchangeable.
Mr. President and Ms. Richards where are your tweets now that your beloved PP is on the hook for $1,400,000 to settle a Medicaid fraud enforcement action? No bus tour? No paid protestors? Will it be the subject of your next fundraising email?
“No paid protestors? “
Hopefully they won’t be able to afford them anymore. :)
“Not all pro-lifers are pacifists. Not all pacifists are pro-life.” – ain’t that the truth!
Maybe they could run a competition where you win free flights to a rally, like the one I entered on behalf of xalisae and myself a while back :-)
I thought I made it clear, way back at July 25, 2013 at 10:30 am.
Fraud charges may still be forth-coming, if the prosecutors have sufficient evidence that specific persons were criminally intent on fraud.
Meanwhile, auditors already know that Planned Parenthood has illegally charged MedicAid for unlawful reimbursement. Texas taxpayers want to be paid back.
$1.4 million isn’t much money. I estimate that PP’s fraud is closer to $100 million.
The real question here is this: Why is PP closing their clinics? Is it because they can’t persuade a hospital to cover for their risks and mistakes? Or is it because they expect the fraud investigation will uncover some major crime?
I think it is the fraud concern. Suppose that a clinic has been significantly gouging MedicAid, as the whistleblowers claim. If that clinic stops the fraud, its profits will drop severely. This is a red flag to auditors, both internally for PP and for the State. Closing the clinic is the only way to cover for that crime. Especially when a change in legislation provides an external excuse for the closing…..
If I were a pro-abortion Democrat in the Texas legislature, I would urge PP to close the clinics that are under investigation — so I could pressure the Attorney General’s office to drop the investigations. “Texas taxpayers don’t want to see money wasted on an investigation of a clinic that is already closed, just to feed a Republican AG’s witch hunt against Planned Parenthood.”
Let’s just be glad the clinics are closed. So many more women will be safe from Planned Parenthood.
And I made it clear – don’t hold your breath.
“I estimate that PP’s fraud is closer to $100 million.” – roflmbo
“Why is PP closing their clinics?” – I thought I made it clear – the level of lost public financing since 2011 when the state reduced family planning financing and banned abortion-affiliated providers from participating in the Texas Women’s Health Program.
‘…conspiracy theory 101…”
“So many more women will be safe from Planned Parenthood.” – correction, so many more women will be at the mercy of the patriarchy and have their health put at risk.
I can’t find anywhere if there is a deadline imposed for this settlement to be paid out by PP. Do you have this info Jill?
@Xalisae: “Maybe he didn’t feel like being crucified by abortion industry big wigs later in his career, like Kline in Kansas.”
I disagree. Prosecution would be costly and there is no guarantee of a win. A settlement ensures that the State gets reimbursed w/o any additional costs from Texas taxpayers. Unless of course, PP plays the delay game and Texas AG will have to enforce the settlement. But I am sure Abbott’s office inserted a clause in there to address this eventuality.
I have read Reality’s comments here with great interest as they pertain to reducing women to irrelevancy (just my opinion). Reality contends that PP has had some vital role in ensuring women’s health. What? Subjecting women to an unsafe and potentially harmful procedure she considers as healthcare. Another issue that boils my blood is this entire discussion about PP’s role in “family planning.” I don’t know about anyone else but to me family planning is not about abortion. How many here have looked at PP’s number of abortions in the black American community? Some family planning, heh?