Planned Parenthood: We’ll have to close our clinics if Gov. Walker investigates us for Medicaid fraud
It's not even under investigation, but Planned Parenthood is worried it is coming to the end of the line in Scott Walker's Wisconsin.
Investigators with the state's Department of Health Office of Inspector General (OIG) say that two family planning facilities alone have charged the Medicaid program more than twice their allowable cost for birth control, overbilling taxpayers by millions of dollars a year. A spokesperson for Planned Parenthood Wisconsin admitted, if the state will demand that they follow the law as written, it would have to shut down its locations across the state.
Inspectors say two facilities charged $3.5 million in fees they were not due for distributing contraception. Under state law, officials declare, the facilities may only charge taxpayers for the actual cost of the drug, plus a small distribution fee.
Instead, facilities paid $12.61 a pack for the abortifacient contraceptive Yaz, or $13 for Lutera, but charged the state $26.02.
Family Planning Health Services Inc. (FPHS) based in Wausau allegedly billed the state's Medicaid program for $2.3 million it was not owed, while NEWCAP Inc. located in Oconto asked for another $1.2 million, from 2010 to 2011.
Together, they left Wisconsin taxpayers on the hook for $3.5 million, OIG states.
Neither is an abortion facility. Both locations offer the morning-after pill and contraceptives by mail. FPHS also sells ID Glide, a personal lubricant that has no contraceptive properties. FPHS partners with the ACLU, RH Reality Check, Catholics for Choice, and Religious Coalition for Reproductive Choice.
The state is hoping to recoup that money for taxpayers – and that has sent waves of worry far beyond Wausau and Oconto.
“My hunch is that if any one of us were audited it would come out the same way,” Beth Hartung, president of the Wisconsin Family Planning and Reproductive Health Association, told journalist Kate Golden of the Wisconsin Center for Investigative Journalism. “We’re all operating the same way. It would mean, quite frankly, that we would all close.”
Hartung admitted the profits from those drug distributions underwrite the cost of other services offered at local facilities. Some perform abortion.
Planned Parenthood of Wisconsin, the state's largest recipient of such monies, would be the most affected. PPWI's public policy director, Nicole Safar, said if the OIG launches audits of its businesses, it would trigger “clinic closing” actions statewide.
“I don’t understand how they can expect anybody to be sustainable in a business when all you can charge is acquisition price. Nobody can run a business like that,” Jennifer Waloway, NEWCAP’s director of community health services, agreed. “The reimbursement right now is very low to start with, but if they’re going to recoup all the money it’s not going to be worth it.”
Matt Sande, director of legislation at Pro-Life Wisconsin, told LifeSiteNews he's not surprised the scant investigations conducted so far have uncovered dubious business practices.
He said his organization “conducted a massive open records search through the Department of Health Services and in partnership with the Alliance Defending Freedom (ADF). In that open records request, there were 26 audits of PPWI between 2006 and 2012.” All but one of them was conducted by the administration of Gov. Jim Doyle, a pro-abortion Democrat, yet they “uncovered $43,272.80 in overbilling” by Planned Parenthood.
“Those audits were very limited – in scope, in detail, in time frame,” Sande said. “What really needs to be done is that the OIG needs to do a comprehensive, thorough, robust audit of all family planning recipients, especially including Planned Parenthood of Wisconsin.”
The ADF charges that is the faintest tip of a massive iceberg of potential corruption, waste, fraud, and abuse.
“Improper practices by Planned Parenthood and state family planning agencies have already resulted in losses to the American taxpayer of more than $115 million, as a minimum, in Title XIX-Medicaid and other healthcare funding programs,” ADF noted in a report on Planned Parenthood fraud released this July.
A 2012 report accused the nation's largest abortion provider, Planned Parenthood, of using various forms of mislabeling to maximize its take of taxpayer funds, including overbilling and “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 2012 report stated, “it appeared that hundreds of thousands of abortion-related claims were billed illegally to Medicaid."
In Texas, Planned Parenthood Gulf Coast paid a total of $4.3 million in reimbursements to Medicaid after the state accused PPGC of fraud. Shortly after the settlement, a whistleblower accused the chapter of bilking Medicaid for 10 years by conducting unnecessary medical procedures on incarcerated teenagers, most of them from a minority background.
The Badger State wants to assure no similar actions are taking place at public expense. “This administration, this agency has put a great deal of effort into improving program integrity, and...protecting the taxpayers of Wisconsin is their predominant responsibility,” Department of Health Services Inspector General Alan White said. “We have to protect both the state taxpayer and the federal taxpayer.”
Assuring that taxpayer funds are spent appropriately may be the perfect calling card for Gov. Scott Walker. The potential 2016 Republican presidential hopeful is dependably pro-life but has burnished his credentials as a budget hawk in this deeply purple state, most notably in a high-profile clash with the state's public unions. Taking a more confrontational stance toward Planned Parenthood to assure proper allocation of state funds would enhance his standing as a fiscally responsible executive while helping him appeal to the party's evangelical base.
As governor, Walker has signed a bill slashing $1 million of taxpayer funds from Planned Parenthood's budget as part of the 2011 Wisconsin budget. The state deprived the abortion-provider of a $130,000 state contract later the same year. In April 2012, PPWI stopped distributing abortifacient drugs at all state locations after Walker signed a ban on telemed abortions. Five Planned Parenthood offices closed their doors as a result.
The Walker administration “removed all the money they legally can, because the rest of the money is in the Medicaid program,” Sande said. But federal courts ruled that a state may not deprive Planned Parenthood of federal dollars distributed by Medicaid, which the Obama administration has sometimes used to sidestep the will of state legislators. “And the gravy train keeps on rolling into Planned Parenthood from the Medicaid dollars.”
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As when facing any restriction, the abortion lobby complains that it is being singled out. “This is a very under-the-radar way to block access to birth control,” Safar said. Yet only two of the Wisconsin Department of Health Services' 3,950 investigations involve family planning clinics. Another 30 such facilities are in the process of undergoing review – less than one percent of DHS's caseload.
They also dispute the billing amount and mechanism. Yet OIG holds firm that the facilities are overcharging that state and must reform their ways.
Sande was unimpressed with Planned Parenthood's assertion that it could not remain open while complying with state law as requested by the OIG.
“I serve on the board of a nonprofit health clinic, Our Lady of Hope Clinic in Madison,” which offers medical care for the indigent and teaches natural family planning, Sande told LifeSiteNews. “We don't get a dime of taxpayer dollars. We raise a lot of money from private donors, and we thrive.”
“Being a member of that board, I don't have any sympathy for Planned Parenthood,” he said. “If they can't figure out how to they can go out and do their own private fundraising like we do.”
“If Planned Parenthood want to be considered legitimate health care providers, they should conduct in accordance with the laws of the state, as others are,” Sande told LifeSiteNews.
Nothing, he emphasized, could better assure that than comprehensive state audits of all family planning grants statewide.
With his eye on the White House and a reputation for slashing administrative waste, Scott Walker may be just the governor to deliver.