Abby Johnson, a Planned Parenthood clinic director at the time of the alleged fraudulent actions, has filed a federal “whistleblower” lawsuit accusing a Texas affiliate of the abortion provider of knowingly submitting at least 87,000 claims that were “false, fraudulent, and/or ineligible” for reimbursement by Medicaid, and subsequently attempting to cover up the wrongdoing.
The Obama Justice Department has declined to join the suit, and will not comment on the case.
For background, read Planned Parenthood Found Bilking Medicaid and also read Taxpayers Provide 46% of Abortionists' $Billion$ as well as Obama Stiffs Texas for Defunding Planned Parenthood
UPDATE 7/31/13: Planned Parenthood fined $4.3 million for Medicaid fraud
UPDATE 3/20/12: More Planned Parenthood ex-employees come forward with fraud accusations
-- From "Planned Parenthood accused of $6M fraud" by Cheryl Wetzstein, The Washington Times 3/11/12
“Everyone, no matter what you think about abortion, should be interested in where our money is going and how it is being spent,” Ms. Johnson said. “As someone who saw the inside of this and saw the fraudulent billing and the fraudulent claims, I felt like I had a duty, and it was necessary for me to come forward with this information.”
. . . clinic staff “falsely notat[ed]” patients’ charts to “fix” and “cover up” the frauds before inspectors or auditors came, the lawsuit said.
The lawsuit was kept under seal until Friday, when U.S. District Judge Kenneth Hoyt made it public. It alleges that the 10 clinics in Planned Parenthood Gulf Coast put in fraudulent claims worth about $5.7 million to the Texas Women’s Health Program, the state’s Medicaid program.
The lawsuit, if decided in favor of Ms. Johnson, could result in multimillion-dollar damages and penalties from Planned Parenthood Gulf Coast. As the whistleblower, Ms. Johnson could also receive as much as 30 percent of the amount recovered.
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From "Planned Parenthood Accused of Medicaid Fraud, Wrongful Reimbursements Totaling $5.7M" by Eryn Sun , Christian Post Reporter 3/10/12
The lawsuit alleges that Planned Parenthood knowingly committed Medicaid fraud from 2007 to 2009 by improperly seeking reimbursements from the Texas WHP program, a new family planning program started in 2007, for products and services not reimbursable by that program.
An estimated 40 percent of the claims submitted by Planned Parenthood Gulf Coast to the Texas WHP program were "false, fraudulent, and/or ineligible for reimbursement," the suit noted.
More specifically, at least 87,075 of the claims made were fraudulent. In turn, Planned Parenthood received and retained reimbursements totaling more than $5.7 million.
Management additionally allegedly directed employees to cover their tracks by destroying fraudulent files and fixing charts as well.
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From "Abby Johnson Is Whistleblower in Lawsuit Alleging Medicaid Fraud at Planned Parenthood" by Charlotte Hays, National Catholic Register 3/12/12
The suit was filed in 2010 in U.S. District Court for the Southern District of Texas . . .
When Planned Parenthood Gulf Coast’s alleged billing mistake was first discussed, according to Johnson, who was still working for Planned Parenthood at the time, it was during a regular staff meeting in 2009. The false billing had been going on for two years, according to the suit.
Johnson was present at the meeting, according to the suit. She told the Register that, when asked by an employee during that meeting what the affiliate planned to do about the false claims, one of the leaders said that they were going to hope that they “don’t get caught.”
[Michael Norton, chief counsel to the Alliance Defense Fund, which filed the suit on behalf of Johnson,] said that Planned Parenthood Gulf Coast was entitled to Medicaid reimbursement for birth-control-related services but that the abortion provider billed for other services that weren’t supposed to be covered.
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