We are continuing our review of the presentations given at 2017 Convention in April. You may also find these presentations in our quarterly member publication, MCFL News. In this presentation, Helen Cross highlights the work of the Charlotte Lozier Institute in exposing Planned Parenthood’s financial irregularities.
MCFL Magazine editor Helen Cross discussed taxpayer funding and Planned Parenthood using a 2017 report, "Profit, No Matter What," issued by the Charlotte Lozier Institute (CLI) and the Alliance Defending Freedom. Author Catherine Glenn Foster, J.D., CLI Senior Fellow in Legal Policy, outlined the two organizations' research which found waste, abuse, and potential fraud.
Foster's report summary noted, "The weight of evidence indicates that waste by Planned Parenthood affiliates may be widespread, and suggests that such policies may be the result of, at a minimum, a policy of benign neglect over billing practices organization-wide by Planned Parenthood Federation of America. The publicly available audits as well as confidential sources who have inside knowledge of Planned Parenthood’s operations, strongly suggest that Planned Parenthood affiliates systematically take advantage of overbilling opportunities to maximize revenues in complex, well-funded federal and state programs that are understaffed and rely on the integrity of the provider for program compliance.”
Named for early feminist and contemporary of Susan B. Anthony, Dr. Charlotte Denman Lozier, CLI is the education and research arm of the Susan B. Anthony List, an organization that promotes the election of pro-life candidates for public office. The Alliance Defending Freedom advocates for religious liberty, the sanctity of life, and marriage and family.
The audits were conducted by the U.S. General Accounting Office (GAO) and the Office of Inspector General US Dept. of Health and Human Services (HHS OIG). The GAO is an independent, nonpartisan agency that works for Congress by investigating how the federal government spends taxpayer dollars. "Work is done at the request of congressional committees or subcommittees or is mandated by public laws or committee reports," says the GAO. The HHS OIG is the largest inspector general's office in the Federal Government, "dedicated to combating fraud, waste and abuse and to improving the efficiency of HHS programs. A majority of OIG's resources goes toward the oversight of Medicare and Medicaid - programs that represent a significant part of the federal budget and that affect this country's most vulnerable citizens.”
Cross asked the audience to consider a few things: "Is it reasonable to expect that organizations will be held accountable for how they spend taxpayer money? Should our representatives exercise their constitutional responsibility to make sure our taxpayer dollars are being used wisely? We also have legitimate concerns about Planned Parenthood's 'integrity as a provider.' Catherine Adair, a former Planned Parenthood employee, spoke at last year's convention about unethical business practices and the pressure put on employees to 'sell' abortions.
"The general public has no idea that abortion is a big business," Cross said. "It's especially profitable for Planned Parenthood. It's all about money.”
Foster's report shows that according to their own annual reports Planned Parenthood received $553.7 million in FY 2015. "Over the last 10 years (FY 2006 – FY 2015) Planned Parenthood affiliates have received over $4.5 billion in taxpayer dollars. In these same years, Planned Parenthood has consistently operated at a profit of millions of dollars of excess revenue over expenses, as high as $155.5 million in a single year.
"Moreover, in FY 2012, Planned Parenthood spent millions of dollars to elect politicians who support abortion and who defend and shield Planned Parenthood from any serious audit or investigation or other congressional oversight – including $12 million for President Barack Obama’s reelection alone. In 2016, Planned Parenthood Action Fund planned to spend $30 million and pay 800 canvassers to target millennial voters in order to influence the presidential and Senate races.”
Planned Parenthood unlawfully billed and was reimbursed by Title XIX agencies for medications and/or services provided in connection with an abortion procedure in violation of the Hyde Amendment, in a process known as “unbundling.” Title XIX of the Social Security Act establishes regulations for the Medicaid program, which provides funding for medical and health-related services for poor persons. The Hyde Amendment is a legislative provision that bars the use of certain federal funds to pay for abortion - except to save the life of the mother, or if the pregnancy arises from incest or rape. Wrote Foster, "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." Planned Parenthood also benefitted from exorbitant markups on the sale of contraceptives.
"There are 51 known external audits or other reviews of Planned Parenthood affiliates’ financial data and practices - nearly all of the audits have found overbilling," Foster reported. "The 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. Of the 42 audits of Planned Parenthood for which dates covered are known, as much as $5.2 million was overbilled in one audited year in a single audit.
"Three federal audits specifically identify Planned Parenthood –and only Planned Parenthood–as the problem in state family planning program overbilling. 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."
The scope of Planned Parenthood's fraudulent activities can best be understood by the "whistleblower" lawsuits described in the report. "The federal False Claims Act (FCA) forbids government contractors from submitting 'false or fraudulent' claims for payment, and authorizes whistleblowers to bring suit against the offenders in order to recover the fraudulently obtained funds.”
Planned Parenthood Gulf Coast recently agreed to pay $4.3 million or more to settle claims that the U.S. Department of Justice called Medicaid fraud. Employee Karen Reynolds “alleged that Planned Parenthood’s clinics were required to constantly increase their ‘pay per visit’ goals which were the bills charged to Medicaid for every patient visit. The policies were intended to maximize ‘the financial payments and grants made by Medicaid, either directly or through Texas’ programs.’”
Abby Johnson also filed suit against Planned Parenthood Gulf Coast, “alleging that Planned Parenthood knowingly committed Medicaid fraud by submitting ‘repeated false, fraudulent, and ineligible claims for Medicaid reimbursements.’ As a result, Planned Parenthood wrongfully received and retained reimbursements totaling more than $5.7 million. Johnson’s suit alleged that Planned Parenthood officials acknowledged that they had received taxpayer reimbursements to which they were not entitled, and that their policies had resulted in waste, abuse, and potential fraud. When Johnson pressed them about what they were going to do with those funds, she said, a Planned Parenthood official responded, ‘We’re going to hope we don’t get caught.’”
Victor Gonzalez, employed as Vice President of Finance and Administration by Planned Parenthood of Los Angeles, “alleged that Planned Parenthood was involved in an ongoing statewide scheme to overbill Medicaid for oral contraceptive pills and contraceptive devices.” An internal email from Gonzalez states that PPLA’s actual acquisition cost for oral contraceptive pills was $1-2, but that it was charging the government $12-48 per pack. Gonzalez estimates the impact on PPLA alone as approximately $4 million in revenues in a single typical year. In response to news that California’s Department of Health Services would be auditing PPLA’s contraceptive purchases, CEO Mark Salo wrote that if Planned Parenthood could only charge the government “only what we paid for the product,” “this could kill many of us.”
Sue Thayer, former manager of Planned Parenthood of the Heartland’s Storm Lake and LeMars clinics, “alleges that Planned Parenthood’s Iowa affiliate knowingly committed Medicaid fraud by filing nearly one half million false claims with Medicaid for products and services not legally reimbursable, 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.
In a birth control pill by mail scheme, Planned Parenthood billed Medicaid $26.32 for pills costing them only $2.98. In some cases, when the pills were returned to Planned Parenthood by the Postal Service, Planned Parenthood resold the same birth control pills and billed Medicaid twice for the same pills.
Planned Parenthood engaged in “unbundling,” separating out charges for services and products rendered in connection with abortions, and submitting them as separate claims for Medicaid reimbursement. “This scheme was applied systematically to virtually every client who received an abortion at one of Planned Parenthood’s clinics.”
The report recommended further investigation of Planned Parenthood by the GAO. “Empower auditors and state Medicaid Fraud Control Units to investigate, prosecute, and recover overbilling by PPFA and its affiliates and other family planning businesses. Insist on greater transparency in reports maintained by federal and state Medicaid authorities on family planning program claims and reimbursements, as well as in the annual audits and quality control reviews. Update state False Claims Act laws according to HHS-OIG guidelines to encourage legitimate whistleblowers to come forward. Investigate whether Planned Parenthood is double-dipping by billing Medicaid (and thus federal taxpayers) for services that other entities and individuals are already paying it to provide.”