Tag Archives: women’s health program

BREAKING: Bombshells in Parenthood Gulf Coast’s $4.3m fraud settlement

breakingnews2The good people at Alliance Defending Freedom have forwarded me the settlement agreement between Planned Parenthood Gulf Coast and the United States of America, the Texas Attorney General, and whistleblower Karen Reynolds, for charges that PPGC committed Medicaid fraud between 2003-2009. The settlement was signed by all parties on July 24 and 25.

As I wrote yesterday, PPGC has agreed to pay $4.3 million. According to the settlement, the money will be divied three ways:

$2,552,169 – United States
$1,247,000 – Karen Reynolds (bounty)
$500,831 – State of Texas

In addition, PPGC must pay Reynolds’ attorney fees. Reynolds was represented by the American Center for Law and Justice.

ADF attorney Casey Mattox was kind enough to walk me through the settlement agreement. Following are the high points, including a few bombshells. [Read ADF’s blog on this here.]

Department-Of-Justice6308The most significant component of the settlement is that the U.S. Department of Justice “contends that PPGC submitted false claims and made false statements to the United States in connection with claims submitted to” Medicaid, Title XIX, Title XX, and the Texas Women’s Health Program.

This represents the first time the U.S. Department of Justice has accused aPlanned Parenthood affiliate of fraud.

That it was Barack Obama/Eric Holder’s DOJ makes this even more newsworthy.

The WHP is the very program PP had the audacity to kick and scream about being evicted from last year, when all along at least one of its affiliates was defrauding it.

In the settlement PPGC denies the allegations are true.

But as Mattox  said, “If you believe a Planned Parenthood affiliate that has been fighting against defunding efforts, threatening lawsuits over its exclusion from the Women’s Health Program, has another Medicaid fraud case pending in federal court [Abby Johnson’s], and claims recently passed pro-life legislation is forcing it to close clinics, would pay $4.3 million just to make this case go away, I have depreciating property I’d like to show you. If PP really believed these claims were baseless, this was their chance to demonstrate that in court. Instead, they paid out a huge chunk of money.”

The settlement clearly stipulates both the State of Texas and federal government believe PPGC billed false claims.

Another huge component of the settlement is that PPGC has 90 days to identify overcharges it has made against the government and Medicaid and repay the overcharges, plus interest and penalties.

Other noteworthy points in the settlement:

  • The Inspector General and DHHS reserved the right to investigate other claims against PPGC (Abby Johnson’s lawsuit, for instance).
  • The government (state/federal) reserved the right to sue for civil or criminal liability, including “current or former directors, officers, employees, agents, or sharehoolders of PPGC.”
  • The government reserved the right to audit PPGC’s books for overcharges.
  • PPGC cannot turn around and charge former patients or insurers for government overcharges.
  • PPGC agreed to cooperate with any government investigation and turn over requested unredacted documents and reports. PPGC cannot impair employees from cooperating with the government.
  • If for some reason PPGC reneges on this settlement, such as by declaring bankruptcy, the government will increase the amount PPGC owes to “$6,432,560, which represents three times the amount the Government alleges to have be overpaid.”

The latter point means the government believes it can prove it found $2,144,186.67 million in overcharges by PPGC.

So PPGC’s $4.3 million settlement is for twice that amount. Reynold’s lawsuit alleged PPGC overbilled “several millions of dollars” over the course of six years. Mattox believes the $30 million figure mentioned by news outlets included penalties.

downloadThe amount of waste, abuse, and fraud uncovered in Planned Parenthood affiliates nationwide now totals over $12.5 million, according to Mattox. Auditors and investigators in several states have uncovered Planned Parenthood affiliate fraud.

That the federal government has identified Planned Parenthood as submitting false claims should impact the ongoing congressional hearing, said Mattox, and also help states trying to defund Planned Parenthood.

Mattox said it will be interesting to see the amount of Medicaid funds Planned Parenthood receives over the next 2-4 years. It should be tightening up its act.

We may already be seeing it. RH Reality Check complained today:

[C]laims in [the] Texas Women’s Health Program, which replaced the Medicaid Women’s Health Program at the start of this year, have declined by about 23% in the first five months of 2013, as compared to Medicaid Women’s Health Program claims during the same period last year. This is the first year the program has operated without Planned Parenthood.

RHRC was trying to claim that fewer low income women are being served. But the lower number more likely represents claims not padded by Planned Parenthood.

“It is hard to calculate the impact these lawsuits are having,” said Mattox. They are forcing Planned Parenthood to make voluntary changes in its billing practices.  My biggest hope is this will hurt Planned Parenthood by taking the Teflon off.

“Planned Parenthood knows it now has people looking over its shoulder,” Mattox said. “I can guarantee you PP went into this with the mindset, ‘How much can we bill and get away with?’ Now PP’s mindset is, ‘What can I defend to a judge?'”

Pro-life blog buzz 1-4-13

by Susie Allen, host of the blog, Pro-Life in TN, and Kelli

We welcome your suggestions for additions to our Top Blogs (see tab on right side of home page)! Email Susie@jillstanek.com.

  • Live Action reports that Planned Parenthood of Michigan actually applied for a grant to teach abstinence in schools (after claiming on their website that abstinence education doesn’t work) – and were denied. Is getting tax funding is an addiction with them?
  • At the LTI Blog, Scott Klusendorf shares a short story that cuts to the heart of the “noise” surrounding the pro-life issue.
  • ProWomanProLife showcases the baffling hypocrisy of feminists who are protesting an award being given to the Israeli pro-life group Efrat, which provides women with counseling, financial help, and alternatives to abortion. Would those same feminists protest if the award instead went to a group that provided financial aid for abortion?

  • The Abstinence Clearinghouse points out Planned Parenthood’s odd sense of humor about sexually transmitted diseases. PP stocks STD Plushies – made to look like “microbes of herpes, syphilis, and gonorrhea,” calling them “cute and cuddly.” One commenter to PP’s Facebook page remarked, “Clearly, Planned Parenthood will do anything to treat sexual health as a non-issue.”

When you profit from the killing of innocent human beings on a daily basis, perhaps a warped way of thinking isn’t far behind. Are these plushies supposed to make people feel like STDs aren’t serious illnesses?

  • Americans United for Life cheers the common sense court decision allowing Texas to remove Planned Parenthood from its state-funded healthcare program.
  • Judie Brown is choosing to view 2013 with cautious optimism, thanks to a “recipe for success”:



• One generation of young enthusiasts
• One helping of articulate speakers
• One measure of self-sacrificing black leaders
• One generous sprinkling of faithful public witness
• One heaping cup of reliable guidance

Stir with the largest amount of total surrender to God’s will possible and allow it to rise.

When the dough is ready, the nation will be on its knees, prepared to surrender to His truth and right the wrongs that once nearly destroyed America.

  • Pro-Life in TN comments on a new viral photo of little Nevaeh Atkins’ birth via c-section, in which she reaches out to grasp the surgeon’s finger. While most reactions to the photo have been positive, this was not the case with a similarly remarkable photo (pictured right) taken by Michael Clancy more than 12 years ago at Vanderbilt University during the spina bifida surgery of Samuel Armas’ at 21 weeks, after which Clancy “was chastised and called a liar by the attending doctor and the hospital.”


More on the latest photo:

Life Links 5-1-12

web grab.jpgby JivinJ, host of the blog, JivinJehoshaphat

  • Minnesota Gov. Mark Dayton (predictably) vetoed another pro-life bill:

    Gov. Mark Dayton on Monday, April 30, vetoed bills requiring doctors to be present when abortion-inducing drugs are administered and creating a health care compact.

    The governor said he vetoed the abortion bill because it’s another attempt to place a regulatory burden on certain health procedures, existing options are safe and it intrudes on federal medicine and medical safety practices.

  • The State of Alabama has shot down abortion clinic owner Diane Derzis’ laughable attempt to stay on as de facto owner:

    Lease documents submitted to the state in support of Ochata Management’s application indicated that the clinic’s current operator, Diane Derzis, would serve as landlord to the applicant, and would be paid the difference between the clinic’s overhead and income each month in lieu of rent. That arrangement would clearly violate the terms of the consent decree, Dr. W.T. Geary Jr., director of the Bureau of Health Provider Standards, wrote in a letter rejecting the application.

    “It is clear that this arrangement would allow Ms. Derzis to remain involved in the center’s financial affairs and to be entitled to all the profits from the continued operation of the center; it does not allow for the proposed new operator to independently operate the center,” Geary wrote.

  • Judge Lee Yeakel (pictured left) has stayed a Texas law which would have prevented the funding of Planned Parenthood:

    U.S. District Judge Lee Yeakel in Austin ruled there is sufficient evidence that a law banning Planned Parenthood from the state’s Women’s Health Program is unconstitutional. He imposed an injunction against enforcing it until he can hear full arguments. Texas Attorney General Greg Abbott appealed Judge Yeakel’s decision to the 5th U.S. Circuit Court of Appeals, asking that it remove the injunction.

    Judge Jerry Smith then stayed Yeakel’s ruling so Texas won’t have to fund Planned Parenthood at this point:

    The ruling… reversed a lower court ruling Monday in favor of the family planning organization. The decision on Tuesday means the state is free for now to enforce a new rule banning Planned Parenthood from the Women’s Health Program, Texas officials said.

  • South Carolina authorities are waiting on autopsy results to determine what additional charges to file against Aris Nichols after he stabbed his pregnant girlfriend in the neck:

    Brittney Jordan, 21, was several months pregnant when she was stabbed in the neck, police say.

    Aris Nichols, 39, is being held without bond in the Chester County jail on a single count of criminal domestic violence of a high and aggravated nature. Chester Police Chief Andre Williams said more charges are expected in the death of the unborn child….

    The unborn child, a boy, was named Tavaris Jordan, according to an obituary in Monday’s Herald. A graveside service is planned for today.

[Photo via utexas.edu]

Life Links 4-11-12

web grab.jpgby JivinJ, host of the blog, JivinJehoshaphat

  • A female infant in India has died after being beaten by her father:

    Police arrested her 25-year-old father, Umar Farooq, who relatives alleged tortured the child as he was upset at having a daughter instead of a son.

  • Authorities in China allegedly caught a group of people providing illegal gender tests via ultrasound.
  • Planned Parenthood affiliates in Texas are suing in an attempt to get funds via the Women’s Health Program:

    The lawsuit, filed in federal court in Austin, asks the court to file a preliminary injunction to stop enforcement of a rule that Texas legislators approved in 2005, denying participation in the program to any clinic affiliated with an abortion provider.

  • A ban on abortions after 20 weeks has passed the Arizona House and Senate (the bill also includes other pro-life provisions) and just needs Gov. Jan Brewer’s signature to become law:

    The proposal increases the current requirement that an ultrasound be performed before an abortion from one hour to 24 hours before. It also requires abortion clinics to post signs providing notice that it’s illegal for anyone to coerce a woman to have an abortion.

    In wording similar to that in the laws of other states with 20-week bans, the Arizona legislation specifies that the state’s ban would start from a point “as determined with reasonable probability by the attending physician.”

Texas defies Obama: Defunds Planned Parenthood despite threats of Medicaid cut-off

Love Texas!

Will President Obama choose Planned Parenthood over poor women in the Lone Star State? An old fashioned Western showdown looms.

From The Texas Tribune, February 23:

If there was any hope that the state was seeking a compromise with the federal government over Texas’ Women’s Health Program, it’s fading fast.

At the direction of lawmakers and Texas Attorney General Greg Abbott, the Texas Health and Human Services commissioner signed a rule on Thursday that formally bans Planned Parenthood clinics and other “affiliates of abortion providers” from participating in the program – something the Obama administration has said is a deal-breaker for the nearly $40 million-per-year state-federal Medicaid program.

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Life Links 2-15-12

web grab.jpgby JivinJ, host of the blog, JivinJehoshaphat

  • Debra Saunders hits on one of my pet peeves in a column on Obama’s mandate:

    For its part, the administration keeps stretching the English language to the brink. The U.S. Department of Health and Human Services frames the issue as one of “access” to “preventive health-care services.” “Access” no longer means being able to obtain something. “Access” now means being able to get something for free and making someone else – even someone who objects on moral grounds – pay for it.

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Life Links 12-13-11

web grab.jpgby JivinJ, host of the blog, JivinJehoshaphat

  • The federal government denied a request from the state of Texas which would have prevented Medicaid patients from using family planning money at abortion clinic:

    As for the state’s request to ban clinics that perform abortions from getting money through the Women’s Health Program under a separate Medicaid waiver, [Cindy] Mann [director of the federal Center for Medicaid and CHIP Services] said it violated federal law.

    “Medicaid does not pay for abortions and will not pay for abortions,” Mann said. “The issue here is not whether Medicaid funding is involved, but whether a state can restrict access to a qualified health provider simply because they provide other services that Medicaid doesn’t pay for. The law does not permit this.”

    “We are disappointed in the decision, which is inconsistent with federal law that gives states the authority to establish qualifications for Medicaid providers,” said Stephanie Goodman, a spokeswoman for Texas Health and Human Services.

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Breaking: Whistleblower alleges Texas Planned Parenthood committed massive Medicaid fraud

A former employee of Planned Parenthood Gulf Coast has filed a whistleblower’s complaint with both the Texas and United States Attorneys General alleging her management engaged in massive Medicaid fraud.

Karen Reynolds, who worked as a “health care assistant” from 1999 to 2009 at the Lufkin, Texas, branch of the affiliate formerly known as Planned Parenthood of Houston and Southeast Texas, has submitted company memos and emails to support her charge that PPGC has engaged in a systemwide scheme to bilk Medicaid, Title XX, and the Women’s Health Program of tens of millions of dollars over the course of at least a decade.

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