Planned Parenthood Should Face Medicaid Fraud Lawsuit, Rules Judge

A Planned Parenthood facility in Anaheim, Calif., on Sept. 10, 2020. John Fredricks/The Epoch Times

Planned Parenthood will have to face a trial that could force it to shell out up to $1.8 billion as part of a lawsuit accusing the organization of overbilling Medicare programs in two states, according to a recent district court ruling.

The lawsuit concerns “thousands” of Medicare claims that Planned Parenthood billed to the states of Texas and Louisiana even after the states terminated the organization as a provider under its Medicare insurance programs. Both Planned Parenthood and Texas asked the judge to rule in their favor. However, U.S. District Judge Matthew Kacsmaryk declined to do so. On Monday, he scheduled a trial set to start in April. 16, 2024.

The lawsuit accused Planned Parenthood of overbilling by around $17 million. However, legal penalties resulting from the case can turn out to be much higher. Planned Parenthood says its total liability could come to $1.8 billion and would affect its operations in Texas.

In a court order, which was briefly posted to the public docket but is now sealed, the judge ruled against Planned Parenthood, finding that the organization was responsible for returning some of the funds it received from Texas and Louisiana, according to Reuters. Judge Kacsmaryk did not rule on the exact amount Planned Parenthood is supposed to return.

The events in the case stem from undercover footage released in 2015 by the anonymous plaintiff in the lawsuit, identified as “Realtor Alex Doe.” The video footage claimed to show staff at Planned Parenthood discussing the sale of fetal tissue.

Following the video release, Planned Parenthood denied any wrongdoing, insisting that the videos were heavily edited. The videos led Texas and Louisiana to announce they would terminate Planned Parenthood as a provider covered by their states’ Medicaid programs.

Federal and state funds are prohibited from being used to pay for abortions. However, several states reimburse Planned Parenthood for its other services.

In October 2015, Planned Parenthood’s termination from Louisiana’s Medicaid program became final under state law. And in January 2017, Planned Parenthood was terminated from Texas’ Medicaid program as well.

Planned Parenthood then filed lawsuits in Louisiana and Texas, challenging the state decisions. The federal district courts in the two states issued preliminary injunctions based on these lawsuits.

As a result, Planned Parenthood continued to submit claims for Medicaid service payments even after both Louisiana and Texas informed the organization that it wasn’t qualified to do so.

The two states “were forced to continue making payments to Planned Parenthood” due to the preliminary injunctions, according to the Alex Doe lawsuit. While the lawsuits from Planned Parenthood were pending, the organization collected millions of dollars in state and federal funds under the Medicaid program.

The preliminary injunction orders were eventually lifted on appeal, allowing Texas to end its contract with Planned Parenthood in 2021. Louisiana ended its contract in 2022.

“Every claim that Planned Parenthood submitted after its disqualification in 2015 or 2016 was a false or fraudulent claim that resulted in an overpayment of federal and state funds to Planned Parenthood,” the lawsuit states, accusing Planned Parenthood of violating state and federal laws.

Planned Parenthood Owes Money

Planned Parenthood says it committed no wrong in billing Texas and Louisiana as the termination decisions of the two states were paused by court orders. The organization also says it cannot be held liable since the states have never asked to be paid back the money.

However, Judge Kacsmaryk on Monday dismissed these arguments, stating that once the Medicare terminations in the two states were allowed to become final by the courts, it was obligated to return the money. Judge Kacsmaryk is a Trump appointee who used to be an anti-abortion activist.

“This is a baseless case. The Texas Planned Parenthood affiliates did not commit Medicaid fraud and followed the law, period,” Susan Manning, general counsel for Planned Parenthood Federation of America, said in an Oct, 24 statement.

“The plaintiffs’ only goal in this case is to achieve their decades-long goal of shutting down Planned Parenthood to advance a political agenda. We will never back down, and we look forward to winning this case at trial.”

The court ruling comes as pro-life activists are calling for cutting government funding for Planned Parenthood.

In January, Rep. Lauren Boebert (R-Colo.) proposed a bill that aims to defund Planned Parenthood by instituting a moratorium on federal funding for the organization for a period of one year.

To receive funding, Planned Parenthood clinics will have to certify that they will not conduct abortions. “The nation’s largest abortion provider has no business receiving taxpayer dollars,” Ms. Boebert said in a press release.

“Planned Parenthood claims these funds go to healthcare for women, but last year, Planned Parenthood performed a record number of abortions while also reducing the number of well-woman exams and breast cancer screenings it performed.”

According to a report by Planned Parenthood, it received $633.4 million in government funding between July 1, 2020, and June 30, 2021. This is up from $618.1 million from the previous year.