A new report from the Charlotte Lozier Institute reveals the abortion industry’s practice of collecting millions in fraudulent Medicaid reimbursements for improperly billed procedures and even abortion services, including more than $12 million in payments made to abortion giant Planned Parenthood.
The Institute, which is the education and research arm of the pro-life Susan B. Anthony List, sifted through 51 external Planned Parenthood audits, as well as 61 audits of state family planning programs conducted by the Office of the Inspector General for the Department of Health and Human Services, only to find millions in bogus payments funneled straight from taxpayers into abortion industry coffers.
The 51 Planned Parenthood across 12 states that are known to have been audited comprise about 8 percent of the organization’s 650 or so clinics operated across America. Yet these relatively few audits alone revealed at least $12.8 million in potentially fraudulent payments made by the organization under the Medicaid program, including $4.3 million that was included in a 2013 lawsuit against Planned Parenthood Gulf Coast in Houston for “unnecessary medical care,” the Institute states.
These 51 audits found numerous improper practices resulting in significant Title XIX-Medicaid overpayments of more than $8.5 million to Planned Parenthood affiliates for family planning and reproductive health services claims. In combination with the $4.3 million settlement in the Reynolds False Claims Act lawsuit, auditors and investigators have specifically identified Planned Parenthood affiliates as the source of at least $12.8 million in waste, abuse, and potentially fraudulent overbilling and penalties. Former Planned Parenthood employees and others allege many millions more.
Additionally, OIG audits found another $124 million in overbilled payments from 61 state family planning programs across 26 states.
In the last two years, audits limited in location, time frame, and type of service examined have found overbilling to the federal program of as much as 17.32% and 14.58% of the federal share of billed costs; other audits have found overbilling as high as 53.93% of the federal share,” Charlotte Lozier Institute explained.
According to these audits, many of the services that were overbilled or improperly submitted under Medicaid were related to abortion care, including pre-abortion exams and counseling, the Institute added. This practice is known as “unbundling” or “fragmentation,” and is often used as a way to bill the federal government for services related to an abortion procedure as a shady (and likely illegal) way around the Hyde Amendment, which prohibits federal funding for abortions.
“In New York alone during one four-year audit period, it appeared that hundreds of thousands of abortion-related claims were billed unlawfully to Medicaid,” the report detailed.
If the percentage of overbilling found in these 61 audits were applied to the entire Medicaid program as a whole, “it would amount to $42.5 billion in overbilling, and an extra $13.3 billion in waste, abuse, and potential fraud of taxpayer dollars,” Charlotte Lozier calculated.
“Charlotte Lozier Institute and Alliance Defending Freedom’s research strongly suggests that Planned Parenthood and its affiliates are engaged in a pattern of practices designed to maximize their bottom-line revenues through billings to complex, well-funded federal and state programs that are understaffed and rely on the integrity of the provider for program compliance,” the report added.