Planned Parenthood Pays Hefty Settlement in Texas Medicaid Fraud Case

By:  Dave Bohon
08/12/2013
       
Planned Parenthood Pays Hefty Settlement in Texas Medicaid Fraud Case

Planned Parenthood's Gulf Coast, Texas franchise has settled a whistleblower lawsuit for a hefty $4.3 million over allegations of Medicaid fraud.

The final settlement in a Planned Parenthood whistleblower Medicaid fraud lawsuit in Texas turned out to be significantly higher than the $1.4 million announced July 30 by Texas Attorney General Greg Abbott. The Houston Chronicle reported that Planned Parenthood Gulf Coast will pay a total of $4.3 million to the federal government, the state of Texas, and Karen Reynolds, the former Planned Parenthood employee who blew the whistle on the abortion business.

In the specifics of the case, the Southeast Texas Record, a state legal journal, reported that “Planned Parenthood Gulf Coast allegedly improperly billed the Texas Medicaid program for services and products that were not rendered, not medically necessary, and were not covered by the Medicaid program. The alleged improper billing practices were not eligible for Medicaid reimbursement. Planned Parenthood Gulf Coast allegedly falsified material information in the medical records of patients to support fraudulent Medicaid reimbursement claims.”

Reynolds brought the alleged fraud, which she contended stretched back over the 10 years of her employment, to the attention of the Texas attorney general's office, which launched an investigation. LifeNews.com reported that the investigation uncovered compelling evidence that Planned Parenthood Gulf Coast had submitted false claims and made false statements in connection with claims submitted to Medicaid and the Texas Women’s Health Program.

According to the lawsuit, Planned Parenthood's “billing policies routinely instructed clinic staff to enter billing codes for certain services, regardless of whether patients' charts recorded that such service was actually provided.”

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