Action alert re Medicaid fraud: PP hit with $5.5 billion lawsuit
This article originally appeared in this issue of the WSR: 2012-07-11

Sue Thayer has filed a $5.5 billion whistleblower lawsuit against her former employer, Planned Parenthood of the Heartland.

According to an Alliance Defending Freedom (ADF) press release, Thayer alleges that Planned Parenthood knowingly committed Medicaid fraud from 2002 to 2009 by improperly seeking reimbursements from Iowa Medicaid Enterprise and the Iowa Family Planning Network for products and services not legally reimbursable by those programs.

Thayer alleges that Planned Parenthood of Greater Iowa, an affiliate now known as Planned Parenthood of the Heartland, filed nearly a half a million false claims with Medicaid from which Planned Parenthood received and retained nearly $28 million. If Thayer prevails, Planned Parenthood could be ordered to pay the United States and Iowa as much as $5.5 billion in False Claims Act damages and penalties.

The crux of the suit revolves around Planned Parenthood’s birth control pills by mail program. Women who were seen only once at Planned Parenthood (usually by personnel who were not qualified healthcare professionals) automatically received—unrequested—a year’s supply of birth control pills in the mail. While those pills cost Planned Parenthood $2.98 for a 28-day supply, Medicaid was billed $26.32. In instances where the pills were returned to PP by the postal service, PP resold them and charged Medicaid twice for the same pills.

In addition, Thayer alleges that PP personnel solicited payment from low-income women to pay for “services” Medicaid would cover in full.

Thayer joins a growing chorus of former Planned Parenthood employees filing suit against the organization to recover money wrongly concealed in its deep pockets that belongs to taxpayers.

Texas: (1) In March of 2012, former PP employee Abby Johnson filed suit against Texas affiliate, Planned Parenthood Gulf Coast, alleging that PP knowingly committed Medicaid fraud from 2007 to 2009 by improperly seeking reimbursements from the Texas Women’s Health Program for products and services not reimbursable by that program.

She says the abortion giant filed at least 87,075 false, fraudulent, or ineligible claims with the Texas Women’s Health Program. As a result, Planned Parenthood wrongfully received and retained reimbursements totaling more than $5.7 million.

(2) In October of 2011, Karen Reynolds filed a whistleblower suit against the same affiliate, Planned Parenthood of the Gulf Coast (PPGC), alleging that “PPGC trained and instructed the employees at its twelve regional clinics to bill the government for medical services that were not medically necessary, to bill the government for medical services that were not actually provided, to bill the government for services that are not covered by Medicaid, and to falsify information in patient medical charts that was material to claims submitted to the government for reimbursement in an effort to evade detection of Defendant’s fraudulent billing practices.”

California: In March 2008, former PP vice president P. Victor Gonzales filed a whistleblower suit claiming that Planned Parenthood overcharged California taxpayers for purchasing birth control by at least $180 million.

Illinois: Caroline Hoke, medical director of Planned Parenthood of Illinois, is the subject of a current Medicaid probe into her billing practices. Hoke was Medicaid’s second-highest-paid doctor in 2009, according to a report by Crain’s Chicago Business, having received over $3 million in reimbursement from Medicaid in one fiscal year. The report states that the Illinois Medicaid inspector general has launched a probe into her billing practices and is withholding any further payments to her until the investigation is complete.

Fraud across the nation: In February of 2012, ADF released to the public its report to Congress tracking Planned Parenthood’s waste, abuse, and potential fraud involving millions of dollars of taxpayer money. ADF’s fact sheet on the report shows that federal and state audits of family planning funding have found a minimum of $95,742,982.15 in waste, abuse, and potential fraud from 1995 to 2009. In addition, federal audits of family planning programs from 1995 to 2009 have identified a total of nearly $88 million in overbilling, with the sum rising as high as $99 million according to the inspector general’s office at the U.S. Department of Health and Human Services.

In light of Planned Parenthood’s systematic abuse of taxpayer dollars and burgeoning whistleblower lawsuits, it is unthinkable that it still receives $1.3 million in taxpayer funding every day and stands to rake in exponentially more through Obamacare and its huge expansion of Medicaid funding.

Take Action: Visit our Defund Planned Parenthood Action Center today to send a letter to Congress demanding that Planned Parenthood be defunded at every level.