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Planned Parenthood defrauds Medicaid with unnecessary procedures on incarcerated minorities: lawsuit

Ben Johnson
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HUNTSVILLE, TX, May 21, 2014 (LifeSiteNews.com) – A Planned Parenthood affiliate in Texas bilked state and federal taxpayers for 10 years by performing unnecessary medical procedures on incarcerated teens, most of whom are minorities, according to a lawsuit filed by a whistleblower.

“Planned Parenthood targets an incarcerated population of minority youth exclusively for unnecessary testing and fraudulent claim billing,” according to a lawsuit filed by Patricia Carroll, an Accounts Receivable Manager at Planned Parenthood Gulf Coast (PPGC) from October 2007 until she resigned in October 2012.

Carroll said the Gulf Coast Trade Center in New Waverly, Texas, would furnish the local Planned Parenthood with a list of minors who were eligible for Medicaid. Then PPGC employee Julio Asendio, who is not a physician, would perform two blood tests each on children incarcerated at the school – one for syphilis and another for HIV/AIDS. But Planned Parenthood billed Medicaid as though they were performed by Dr. Paul Fine in Planned Parenthood's offices in Huntsville, Texas.

The procedures were unnecessary on multiple levels, she said. “The syphilis and HIV test can be done with the same blood sample. Planned Parenthood takes blood twice from the residents in order to bill a second, higher level office visit code, and additional unnecessary laboratory tests.” As a result, minority “youths were exposed to the risks of blood tests (such as hepatitis)” for no reason except the center's profit.

Besides, “Trade Center has medical staff onsite (at a higher clinical level than provided by the Planned Parenthood non-clinical staff member) that can provide the same testing and education at no cost.”

According to her legal complaint, PPGC “received approximately $200.00 per youth on thousands of fraudulent, false, and ineligible claims,” actions that she says violate the False Claims Act and the Texas Medicaid Fraud Prevention Act.

Carroll contends that PPGC's actions, which persisted between 2002 and 2012, prove it intended to game the state's Medicaid system. “No services are provided to other schools or people in the Huntsville area. No services are provided to residents in the school unless they have active Medicaid numbers.”

U.S. District Judge Simeon “Sim” Lake ruled that her case “allows the court to draw the reasonable inference that Planned Parenthood knowingly filed false claims.” Therefore, it will go forward, according to Courthouse News Service, which reported on the case and posted Carroll's legal complaint.

Planned Parenthood Gulf Coast, based in Houston, has already paid $4.3 million last July to settle allegations of Medicaid fraud at the state and federal level, charges that echo those made by Carroll.

Karen Reynolds, a decade-long employee at PPGC, filed a lawsuit stating that her Planned Parenthood affiliate gave each of its 12 offices in Texas and Louisiana regular revenue goals and instructed them to defraud the state through deceptive billing.

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In addition to seeking reimbursement for services not rendered, or that weren't medically necessary, they also charged for abortion-related services according to Reynolds, who worked as a “health care assistant” at Planned Parenthood in Lufkin, Texas, from 1999 to 2009.

When post-abortive women came in for a follow-up visit, PPGC told its employees to “ask if she needs any other services such as birth control," then the chapter would claim the purpose of the visit was for a reason other than abortion-related care, she said. “If the client 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.”

Every post-abortive woman was given a bag of contraceptives, so the offices could put in a request for reimbursement in the form of state family planning funds.

According to a a 23-page report produced by the Alliance Defending Freedom (ADF) in 2012, Planned Parenthood has committed between $88 and $99 million in fraud and abuse.

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