Sue Thayer, a 17-year abortion clinic director of Storm Lake, Iowa, has filed a federal whistle-blower lawsuit against her former employer, Planned Parenthood of the Heartland, charging a seven-year period of fraudulent billing of Medicaid totaling nearly $28 million.
The Obama Justice Department has declined to join the suit, and will not comment on the case.
For background, read Planned Parenthood Accused of $6M Medicaid Fraud and also read Planned Parenthood Found Bilking Medicaid as well as Taxpayers Provide 46% of Abortionists' $Billion$
UPDATE 8/9/13: Federal Government Probes Planned Parenthood for Fraud
-- From "Former Storm Lake clinic director sues Planned Parenthood, claims $28m fraud" by Sioux City Journal Staff Writer 7/17/12
The lawsuit was filed in March 2011 but didn't proceed until federal and state prosecutors decided against intervening.
Planned Parenthood of the Heartland has 31 medical centers in Arkansas, Iowa, Oklahoma, Nebraska and three Illinois counties. It also has education and resource centers in Des Moines, Lincoln, Neb., and Omaha, Neb.
The lawsuit accuses Planned Parenthood of violating Medicaid rules by separately billing the government for services related to elective abortions, such as blood tests and blood pressure tests.
The lawsuit also accuses Planned Parenthood of prescribing birth control pills for as long as 14 months without having a health care professional examine patients. Those patients should have met with a health care professional at least once every three months, the lawsuit said.
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From "Planned Parenthood affiliate accused of Medicaid fraud" by Daniel P. Finney, Des Moines Register 7/11/12
“Our decision to decline intervention at this time follows an extensive review of the case with federal and state investigators, and an extensive review of a large volume of evidence,” [Iowa Attorney General Tom Miller] said. “We reserve the right to intervene at a later date upon the showing of good cause. Though the state is not currently a litigant, it remains the real party in interest, and is entitled to the majority of damages and penalties recovered on its behalf, should that occur.”
The allegations “came to light over time as I worked there,” Thayer said in an interview with The Des Moines Register. “I kept seeing things and asking, ‘Is this the right way to do things?’ I found out it was not.”
Alliance Defending Freedom, based in Scottsdale, Ariz., helped Thayer bring the lawsuit. ADF, formerly known as Alliance Defense Fund, is a private, not-for-profit Christian group that opposes abortions and same-sex unions, and supports sanctioned prayer at public meetings and the right of medical professionals to refuse to perform abortions or other procedures they find morally objectionable.
If found guilty of fraud, Planned Parenthood could face as much as $5.5 billion in fines.
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From "Planned Parenthood Collected $28M in Medicaid Fraud, Says Former Iowa Director" by Alex Murashko, Christian Post Reporter 7/10/12
"We think it's a very viable complaint that demonstrates Medicaid fraud by Planned Parenthood that we have observed in our research on not only this affiliate, but other affiliates around the country and is primarily motivated by the bottom line desire for money, not for care for women's health," ADF Senior Counsel Michael J. Norton told The Christian Post on Tuesday.
"Americans deserve to know if their hard-earned tax money is being funneled to groups that are misusing it," said Norton, a former U.S. attorney. "People may hold different views about abortion, but everyone can agree that Planned Parenthood should play by the same rules as everyone else. It certainly isn't entitled to any public funds, especially if it is defrauding Medicaid and the American taxpayer."
. . . The suit also claims that Planned Parenthood coerced "voluntary donations" for services and then billed Medicaid for them. In effect, Planned Parenthood both falsely billed Medicaid and took money from low-income women by getting them to pay for services Medicaid was intended to cover in full, the ADF lawsuit states.
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UPDATE 8/29/14: "Planned Parenthood loses legal round against ex-manager" by Tony Leys, Des Moines Register
[Previously, a] federal district judge had agreed with Planned Parenthood lawyers that the case should be dismissed because Thayer didn't have detailed enough evidence of the purported wrongdoing. However, a three-member panel of the U.S. Court of Appeals for the 8th Circuit ruled Friday that her position as a former clinic manager gave Thayer the ability "to plead personal, first-hand knowledge of Planned Parenthood's submission of false claims."
The appeals court judges agreed with the lower court, however, that Thayer did not have a strong enough basis to pursue her claim that Planned Parenthood's actions led to inappropriate claims for Medicaid payments for abortion-related services. Thayer contended that Planned Parenthood staff members told patients who bled heavily after abortions that they she should go to hospital emergency rooms and say they had miscarriages. Thayer said the hospitals then would bill Medicaid for treating the women. She contended that was out of bounds, because federal law strictly limits payments for abortion-related costs.
The appeals judges sent the case back to the lower court to hear Thayer's other contentions.
The judges' decision was hailed by the Alliance Defending Freedom, a national legal group that is representing Thayer in court.
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