Recently, the abortion industry has been fighting hard to bring about the repeal of the Hyde Amendment, which prohibits the use of federal tax dollars to fund abortions through Medicaid, except in rare cases. One initiative they’ve been pushing to counteract this longtime safeguard is the passage of the EACH Woman Act (HR 2972). Through this legislation, they want to force taxpayers to cover all abortions for anyone who receives care or insurance through the federal government.
As the abortion industry fights to obtain more federal funding for abortions, let’s examine how they have been utilizing our Medicaid system so far. We’ve zeroed in on our nation’s largest abortion provider, Planned Parenthood, and here’s what we’ve found:
According to state filings, 40% of Planned Parenthood’s revenue comes from Medicaid. That being said, Planned Parenthood is currently under investigation for filing more than 500,000 false, fraudulent, or ineligible Medicaid claims, according to the Alliance Defending Freedom law firm. The fines for these charges are said to accumulate to over $5.5 billion.
Forty-four audits of Planned Parenthood affiliates have also uncovered a shocking total of at least $8.3 million in waste, abuse, and potential fraud in nine states, according to the latest report by the Alliance Defending Freedom. Here are the audits and their details, as documented in the report:
According to the report, an audit of Planned Parenthood of Illinois conducted from 2006 to 2007 by the Illinois Department of Healthcare and Family Service’s Inspector General found 641 missing records, 31 instances of billing for services not covered by Medicaid, and 10 instances of billing for services performed by someone else, including improper procedure codes.
PPIL agreed to pay the state $367,000 as a settlement, while Planned Parenthood Westside Clinic paid the state $20,000. Nevertheless, even after committing such extensive overbilling, Illinois Planned Parenthood and its employees continue to receive increasing reimbursements from the state.
In 2004, State of California audits of Planned Parenthood San Diego and Riverside Counties revealed that the affiliates were billing Medi-Cal in excess of the costs for contraceptive barrier products, oral contraceptives, and Plan B products, totaling $5.2 million. The California Department of Health required Planned Parenthood to repay the amounts billed over the acquisition cost.
In 2010, the IRS audited Planned Parenthood Golden Gate (PPGG) and found, at a minimum, “inaccurate information.” PPGG filed three sets of numbers with the IRS, with losses between $1.9 and $2.8 million. They also failed five out of nine of PPFA’s indicators of financial health in their 2004 accreditation review. In addition, the California Attorney General’s office reprimanded PPGG for not having filed copies of its tax documents for at least ten years.
The U.S. HHS –OIG conducted an audit of Planned Parenthood of Connecticut Inc. & Subsidiary in 1999 and found $18,791 of overbilling. Full audit and settlement records are still being collected.
The Louisiana Department of Health and Hospitals conducted an audit on one Planned Parenthood clinic and found evidence of improper billing. Planned Parenthood repaid the DHH $6,147.18 to settle the findings.
The Maine Department of Health and Human Services conducted an audit of Planned Parenthood of Northern New England in 2010 and found that they had billed Levonorgestrel IUD’s for almost double their actual cost under a certain procedure code. Planned Parenthood agreed to repay the state $33,294.83 as a settlement.
New York: $1,615,083.25
In January of 2009, New York State audited Planned Parenthood of New York City, Inc./Margaret Sanger Center, uncovering overpayments that resulted in PPNYC repaying $207,809.00 to the state.
In June of 2009, New York State Office of the Medicaid Inspector General audited the Medicaid payments for family planning and reproductive health services paid to Planned Parenthood Hudson Peconic, Inc. Significant overpayments in the amount of $15,723.91 (inclusive of interest) were found. In response to OMIG’s audit report, PPHP said that it was unfair to request repayment or documentation “four to five years after the fact.”
In June of 2009, OMIG audited the payments to PPNYC/Margaret Sanger Center for diagnostic and treatment center services paid by Medicaid and found total overpayments of at least $1.2 million. They also found five improper practices:
- “Missing documentation”
- “Inadequate documentation of HIV pre-test counseling visit”
- “Visit billed for managed care client within network”
- “Medical entry not signed”
- “Incorrect rate code billed”
In December 2009, an audit of PPNYC’s Medicaid payments for family planning and reproductive health services by OMIG found overpayments of $886.26 (inclusive of interest). PPNYC had improperly billed Medicaid $719.55, and OMIG calculated $166.71 in interest, resulting in a repayment of $886.26.
In February/May of 2010, three audits of Planned Parenthood affiliates in New York discovered overbilling for six improper practices:
- “Multiple initial prenatal care visits”
- “Initial, follow-up, and postpartum services billed incorrectly after delivery”
- “Laboratory services billed fee for service that are included in the Prenatal Care Assistance Program (PCAP) rate”
- “Ultrasound services and diagnostic procedure services billed fee for services that are included in the PCAP rate – facility billed”
- “Ultrasound services and diagnostic procedure services billed fee for services that are included in the PCAP rate – physician billed”
- “Vitamin and iron supplement services billed fee for service that are included in the PCAP rate.”
The audits found total overpayments of $136,061.08.
Texas: $640, 595.88
In July of 2009, the Texas Health and Human Services Commission, Office of the Inspector General, conducted an audit of Planned Parenthood Center of El Paso. It found several instances where subcontractors remained unpaid for their services. The outstanding billings totaled somewhere between $409,675.10 and $529,707.97. State sources are not sure if the billings will ever be repaid.
In March of 2015, the U.S. Department of Health and Human Services, Office of the Inspector General, released an audit of the billings by Planned Parenthood of North Texas by the Texas Health and Human Services Commission in 2008. Three categories of overbilling were found:
- Billing “Unrelated to Family Planning”
- “Incorrect billing”
- “Missing documentation”
The resulting overpayment totaled $129,028.00
In addition to this, a $4.3 million settlement was reached in the Reynolds False Claims Act Lawsuit in which a former employee accused Planned Parenthood Gulf Coast of knowingly engaging in continued violations of federal and state law by utilizing company-wide billing policies for the purpose of maximizing revenue from government healthcare programs.
In 2000 and 2001, an audit of a Planned Parenthood clinic found “inflated billings.” An apparently “untenable and illicit agreement” resulted.
An audit conducted from 2007 to 2009 on Planned Parenthood of the Inland Northwest affiliate (PPINW) uncovered several instances of overbilling and other “irregularities,” which totaled $629,142.88 in overpayment. PPINW settled to pay only $354,000 back to the state. The audit uncovered the following:
- Seventeen instances of prescription drugs being dispensed without authorization
- Sixteen instances of missing or improper documentation
- Thirteen instances of billing the HRSA on contraceptives for more than their acquisition fees.
- One instance of billing for a pregnancy test not medically necessary
- One instance of billing medication in a bundled service as a separate commodity
- Two instances of oral contraceptives being ordered without a clinician’s signature and not following standing order protocol.
In May 2012, Planned Parenthood of the Great Northwest paid $11,453 back to the Medicaid program after concerned citizens alleged “questionable billing practices,”and an audit was conducted by the Washington Medicaid Fraud Control Unit.
In August 2006, four separate audits of Planned Parenthood of Wisconsin were conducted on payments made for physician office visits. They found that Planned Parenthood had billed Medicaid for non-covered services, which came to $1,990.16 in total overpayments. The audit recommended that Medicaid seek repayment.
In September of 2006, another audit conducted on payments to Planned Parenthood of Wisconsin was conducted and found that Planned Parenthood billed for “duplicate and incorrect services,” in the total amount of $74.28. The audit recommended that Medicaid seek repayment.
In July of 2007, seven separate audits of Planned Parenthood of Wisconsin were conducted on payments made for physician office visits. The audits found that Planned Parenthood had billed for non-covered services with potential overpayments in the total amount of $5,819.91. The audit recommended that Medicaid seek repayment.
In October 2010, an audit of payments made to Planned Parenthood of Wisconsin uncovered billing for duplicate services (contraceptive implants and patches) with potential overpayments of at least $1,864.42. The audit recommended that Medicaid seek repayment.
In December of 2010, ten audits of payments made to Planned Parenthood of Wisconsin found billing for duplicate services, with potential overpayments of $31,319.77. The audits uncovered that Planned Parenthood was “likely billing multiple times for each intrauterine contraceptive device (IUD).” The audit recommended that Medicaid seek repayment.
In August of 2012, an audit of payments to Planned Parenthood of Wisconsin found duplicate and excessive billing for IUD’s, progesterone contraceptive injections, vaginal rings, and contraceptive patches, with $2,204.26 in overpayments. Once again, the audit recommended that Medicaid seek repayment.
Recently, in August of 2016, new reports of suggest that nearly half of Wisconsin Planned Parenthood’s Medicaid payments were fraudulent, according to auditors. Matt Sande, Pro-Life Wisconsin’s legislative director, told reporters:
“Pro-Life Wisconsin, working with Alliance Defending Freedom attorneys, recently conducted an open records request of Planned Parenthood of Wisconsin. The findings revealed 26 Department of Health Services” audits uncovering $43,000 in Medicaid overbilling by PPWI from 2006 to 2012. Now DHS audits have uncovered $50,000-plus in Medicaid overpayments by PPWI in 2014.”
These shocking findings are pretty blaring evidence that our federal and state funds have been manipulated and misused. As they fight for more federal funding, reports of fraud are continuing to come to light. Is the abortion industry trustworthy enough as it stands to make use of our hard earned taxpayer dollars? At the present, handing them over any more looks like a very…very…bad idea.