Planned Parenthood guilty of tens of millions of dollars in fraud charge whistleblowers, report
LUFKIN, TEXAS, February 15, 2012, (LifeSiteNews.com) – The Congressional investigation into Planned Parenthood that touched off the controversy over Susan G. Komen’s funding of the abortion giant may soon expand into a series of national hearings in the nation’s capital and court cases around the country that could expose hundreds of millions of dollars of financial impropriety, critics say.
Karen Reynolds, a decade-long employee of Planned Parenthood Gulf Coast (PPGC) in Texas, has filed a lawsuit claiming 12 Planned Parenthood mills in Texas and Louisiana bilked the government by billing medical agencies for services that were unnecessary or that were never actually provided. “Fraud is fraud,” said Reynolds’ attorney, Mike Love.
Her allegations are part of a cascade of negative publicity drawing attention to the dubious or possibly illegal accounting practices of roughly 20 percent of Planned Parenthood’s national affiliates.
Responding to the new allegations of wrongdoing, Congresswoman Marsha Blackburn has written a letter to House Speaker John Boehner calling for a “full-scale series of congressional hearings to expose the damage Planned Parenthood has caused to our nation.”
The Tennessee Republican cited a recent 23-page report issued by the Alliance Defense Fund (ADF) that found upwards of $99 million in waste or possible fraud, including the illegal taxpayer funding of abortion and abortion-related procedures.
“There have been 38 federal HHS Office of Inspector General audits of state family planning programs, of which Planned Parenthood gets the lion’s share, between 1995 and 2009,” Steven Aden, vice president for human life issues and senior council at ADF told LifeSiteNews.com on a conference call last week. “These have discovered between $88-99 million in waste, abuse, and potential waste and fraud.”
“Two of those federal audits, in New York and New Jersey, specifically identified Planned Parenthood and only Planned Parenthood as a source of overbilling in the family planning program,” he said.
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Only seven of the nation’s 79 Planned Parenthood affiliates had been officially investigated, as far as the ADF knows, he said. The 10 known audits took place in California, New Jersey, New York, Texas, and Washington state – mostly Democratic states that favor legalized abortion.
Yet those investigations uncovered numerous instances of financially questionable practices including wrongly billing Medicaid for medications provided as part of an abortion in violation of the Hyde Amendment, overbilling for prescription drugs, dispensing prescription drugs – including oral contraceptives – without a prescription, double-billing, charging for medically unnecessary services, falsely claiming some services were provided for family planning, and several instances of unsigned or missing documentation. The ADF report identifies 12 types of potential fraud, in all.
A common practice was “unbundling,” in which services provided as part of an abortion procedure were billed separately, as though they were unrelated services.
“In New York alone during one four year period,” the report states, “it appeared that hundreds of thousands of abortion-related claims were billed illegally to Medicaid.” (Emphasis in original.)
A 2008 New York audit found 102 of 119 sample cases improperly received such reimbursement – including funds that paid for 27 abortions. An audit the previous year found nearly half of New York’s 100 sampled cases involved a laboratory being reimbursed for abortion-related services, for which it should not have received any money.
A June 2008 audit in New Jersey found several clinics, “especially Planned Parenthood providers,” billed all their services as family planning, allowing 90 percent of their costs to be reimbursed by the federal government.
“Thus, Planned Parenthood’s primary motivation appears not to be to provide quality healthcare to patients who seek family planning services, but rather to enhance its profits,” ADF reports.
Two federal whistleblower lawsuits in California and Texas charge even more affiliates with Medicaid fraud in the tens of millions of dollars.
Karen Reynolds of Lufkin, Texas, worked more than 10 years at Planned Parenthood. In her court complaint, she charges PPGC with “billing for medical services not rendered, billing for for unwarranted medical services, billing for services not covered by Medicaid, and creating false information in medical records which was material to billing for medical services.”
Reynolds quotes a PPGC memo that stated, “If the client [getting an abortion] is getting on birth control make this the focus of the visit and put a note in the chief complaints that the client had a surgical or medical abortion ‘x’ weeks ago.”
Another former Planned Parenthood employee, P. Victor Gonzalez, who was chief financial officer for Planned Parenthood of Los Angeles, claimed in a 2010 lawsuit that PPLA paid “$225,695.65 for Ortho Tri-Cyclen birth control pills, yet billed the government $918,084 – for a profit of $692,388.35.” These and other actions, which he said deliberately violated the False Claims Act (FCA), amounted to $100 million in financial impropriety.
Marjorie Dannenfelser, president of the Susan B. Anthony List, told LifeSiteNews.com the audits coupled with the whistleblowers’ inside accounts “reveal a pattern of gross financial mismanagement” at the nation’s largest abortion provider. Yet “after 40 years of receiving taxpayer funds, not one oversight hearing of Planned Parenthood has occurred,” she said. “Now is the time for such scrutiny on behalf of its most important benefactors, the American taxpayers, and on behalf of the young women that it claims to serve.”
Instead of submitting itself to an inspection, she said Planned Parenthood had struck a “posture of entitlement” and waged “campaigns to destroy those who ask questions.”
Aden said, “Americans deserve to know if their hard-earned tax money is being funneled to groups that are misusing it.”
“Planned Parenthood has to play by the same rules as everyone else,” he said. “It is not entitled to a dime of taxpayer funds, especially if it is committing Medicaid fraud.”
“This is part of ADF and our allied organizations…effort to encourage the House Oversight Committee to hold public hearings hearings, to have Planned Parenthood’s national officers testify and be held accountable for the financial mismanagement that one-in-five of their affiliates has been implicated in.”
Thus far, less than ten percent of Planned Parenthood’s 79 national affiliates had been audited; eight other affiliates are implicated in ongoing lawsuits that allege financial malfeasance.
When asked whether a similar pattern would be found if the remaining 90 percent of affiliates were audited, Dannenfelser told LifeSiteNews.com, “It’s the responsibility of the Oversight Committee to do just that, to find the audits – and if they’re not available, to do the audits.”
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