HUDSON, New York, December 10, 2015 (LifeSiteNews) – Medicaid overbilling continues to haunt Planned Parenthood affiliates, this time in New York and Pennsylvania.
In a June 2014 letter sent to drug manufacturers, Planned Parenthood of Western Pennsylvania CEO Kimberlee Evert said that a Health Resources and Services Administration (HRSA) investigation found that her affiliate had overcharged clients – and left manufacturers in the lurch.
The HRSA audit specifically found that Evert's organization had received manufacturers' discounts on drugs as part of the federal 340B program. According to the pro-abortion research group Guttmacher, the program “requires manufacturers to sell their drugs to a range of safety-net providers, including Title X–supported family planning centers and community health centers, below a certain price (called a price ceiling)[.]”
In an op-ed for Townhall.com, Alliance Defending Freedom Director of Life Alliances Steve Aden said groups that receive drug discounts, including Planned Parenthood, are directed to “pass [discounts] on to patients.” If they choose to purchase the drugs at a discount price, but exclude the patients from the 340B program, “they're required to notify Medicaid” because they are “bill[ing] Medicaid at the higher approved Medicaid rates rather than the discount 340B rates.”
Aden described this as “an unfair windfall” for family planning groups, and a “double rebate” for manufacturers “because [they] … will have sold the 340B drugs to the provider at a discount, and yet it will still have also had to pay a statutory rebate it owes to state Medicaid when providers bill Medicaid for drugs at market value.”
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Another Planned Parenthood affiliate, Planned Parenthood of Hudson Peconic (PPHP), audited from September 2013 through February 2014, also admitted fault in a letter to drug manufacturers. In a letter similar to Evert's, Chief Financial Officer Andrew Bracco said his group's 12 locations would repay manufacturers that were “subject to a duplicate discount.”
Unlike Evert, Bracco said that “PPHP has taken other numerous steps to avoid recurrence of the problem, which have been documented and submitted to HRSA as part of a corrective action plan.”
The repayments are just the tip of the iceberg for Planned Parenthood affiliates, which are often accused of payment issues – both accidental and intentional – with Medicaid reimbursement requests. In 2013, Planned Parenthood Gulf Coast settled a case with the U.S. Department of Justice totaling $4.3 million – though as part of the settlement, Planned Parenthood was not required to admit fault.
Since 2011, former Planned Parenthood employee Sue Thayer has sued the abortion giant as a whistleblower, saying Iowa affiliates defrauded the government of approximately $28 million.
Likewise, Victor Gonzalez has claimed since 2005 that Planned Parenthood of Los Angeles overbilled the government by $200 million. The former chief financial officer for the affiliate, Gonzalez has seen several decisions go against him under the federal False Claims Act; his attorneys have appealed to the U.S. Supreme Court.
A September 2015 Alliance Defending Freedom report looked at more than 100 audits of family planning groups and programs, including 45 “public audits or other reviews“ of Planned Parenthood affiliates. According to the report, “these limited audits have found a total of more than $129.7 million in waste, abuse, and potential fraud in federal and state family planning funding programs, the lion's share of which goes to Planned Parenthood.“