$28 Million Planned Parenthood Medicaid Fraud Case Can Move Ahead

The lawsuit from a former Planned Parenthood abortion clinic manager who sued the abortion giant accusing it of engaging in massive fraudulent activities can move forward. That’s the ruling an appeals court handed down today.

The U.S. Court of Appeals for the 8th Circuit Friday reinstated a former Planned Parenthood facility director’s lawsuit against Planned Parenthood of the Heartland. Alliance Defending Freedom attorneys representing Susan Thayer filed suit in 2011, alleging fraud and abuse of taxpayer dollars. A district court judge had dismissed the lawsuit in 2012.

plannedparenthood124The lawsuit followed a new investigation of Planned Parenthood in Illinois and Planned Parenthood abortion companies in other states having been found to have engaged in overbilling and Medicaid fraud.

Thayer filed the lawsuit against the abortion giant’s Iowa affiliate accusing it of submitting “repeated false, fraudulent, and/or ineligible claims for reimbursements” to Medicaid and failing to meet acceptable standards of medical practice. Alliance Defending Freedom filed the suit for Thayer in March 2011.

“Americans deserve to know if their hard-earned tax money is being funneled to groups that are abusing it,” said ADF Senior Counsel Casey Mattox. “No matter what people believe about abortion itself, everyone can agree that Planned Parenthood should play by the same rules as everyone else. We look forward to continuing our defense of the American taxpayer in this case.”

The lawsuit claims that Planned Parenthood’s Iowa affiliate submitted “repeated false, fraudulent, and/or ineligible claims for reimbursements” to Medicaid and failed to meet acceptable standards of medical practice.

ADF attorneys filed the suit on behalf of Thayer under the federal False Claims Act and Iowa False Claims Act, both of which allow “whistleblowers” with inside information to expose fraudulent billing by government contractors. Attorney J. Russell Hixson, one of nearly 2,500 attorneys allied with ADF, is assisting with the case.

In its decision reinstating the case, the 8th Circuit wrote, “we conclude that Thayer has pled sufficiently particularized facts to support her allegations that Planned Parenthood violated the FCA by filing claims for (1) unnecessary quantities of birth control pills, (2) birth control pills dispensed without examinations or without or prior to a physician’s order, (3) abortion-related services, and (4) the full amount of services that had already been paid, in whole or in part, by ‘donations’ Planned Parenthood coerced from patients.”

Thayer, former director of Planned Parenthood’s Storm Lake and LeMars clinics, specifically alleges that Planned Parenthood knowingly committed Medicaid fraud. She claims the abortion giant improperly sought and received reimbursements from Iowa Medicaid Enterprise and the Iowa Family Planning Network for products and services not legally reimbursable by those programs.

Planned Parenthood fired Thayer over her opposition to its “webcam” abortions, which allowed abortion drugs to be prescribed to women without a personal meeting with a doctor. On Aug. 19, an Iowa court upheld the Iowa Board of Medicine’s new ban on “webcam” abortions after Planned Parenthood challenged the restrictions.

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“Planned Parenthood repeatedly demonstrates that it cares more about protecting its own bottom line than about protecting the women it purports to serve,” noted ADF Senior Counsel Michael J. Norton. “That’s been a pattern with Planned Parenthood across the county.”

“During my last years working at Planned Parenthood, it became increasingly clear to me that not all of their policies and protocols were completely legal and ethical.  After much thought, I contacted the Alliance Defending Freedom,” Thayer said about the lawsuit. “I believe that it is an important piece in the nationwide effort to shed light on the darkness and deception surrounding America’s largest abortion provider – Planned Parenthood.”
The lawsuit alleges that Planned Parenthood of Greater Iowa, an affiliate now known as Planned Parenthood of the Heartland, filed nearly one-half million false claims with Medicaid from which Planned Parenthood received and retained nearly $28 million.

The lawsuit explains that, to enhance revenues, Planned Parenthood implemented a “C-Mail” program that automatically mailed a year’s supply of birth control pills to women who had only been seen once at a Planned Parenthood clinic and usually by personnel who were not qualified health care professionals. After that, Planned Parenthood mailed thousands of unrequested birth control pills to those clients.

Planned Parenthood’s cost for a 28-day supply of birth control pills mailed to clients was $2.98, but the Medicaid reimbursement Planned Parenthood received for the pills was $26.32. In some cases, the Postal Service returned the pills to Planned Parenthood. Instead of crediting Medicaid or destroying the returned pills, Planned Parenthood resold the same pills and billed Medicaid twice for the same pills. The suit also claims that Planned Parenthood coerced “voluntary donations” for services and then billed Medicaid for them.

Jenifer Bowen, the executive director of Iowa Right to Life, told LifeNews her group is fully supportive of the lawsuit.

“Iowa Right to Life has been exposing Planned Parenthood’s dishonest practices for years,” she said. “That they would rip off low-income women for profit is no surprise.  Their CEO, Jill June, alone makes over $265,000 a year. I cannot wait to see how they spin this.”

ADF has been involved in several lawsuits involving Planned Parenthood secrecy and alleged fraud and recently submitted an updated report to Congress on the abuse of taxpayer money by the abortion giant’s affiliates.

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