Planned Parenthood's Alleged Medicaid Fraud Lawsuit Moves Forward

Planned Parenthood's Alleged Medicaid Fraud Lawsuit Moves Forward

HOUSTON, Texas–A federal court judge in Houston ruled this week that Planned Parenthood Gulf Coast, Inc. (PPGC) must face claims that it defrauded Medicaid in reference to certain blood tests performed. The lawsuit, brought by a former accounts receivable manager for the company, alleges that PPGC experienced a three hundred percent increase in revenues by falsely claiming tests were performed by a doctor when they were not.

Patricia Carroll, worked for PPGC for five years, according to an article by Cameron Langford on Courthouse News Service this week. She claims that in March, 2012, she observed that a Planned Parenthood clinic in Huntsville, Texas, sustained a large spike in revenues. Following her investigation, she discovered PPGC was billing Medicaid for STD and HIV blood tests that were performed by a non-physician on a group of teenagers at a private charter school. They filed the claims using a billing code to give the appearance the tests were done by a doctor. Instead, the tests were actually performed on Medicaid-eligible youths at the Gulf Coast Trades Center (GCTC). GCTC contracts with the State of Texas to provide job training for teenagers sent to the school under court orders. reports that Carroll resigned from PPGC in October, 2012 and promptly filed what is known as a sealed qui tam action. This type of action is used by whistle-blowers who know about fraud against the government. It provides for the litigant to file a lawsuit on behalf of the government and keep a portion of the proceeds of any settlement.

The State of Texas and the federal government did not weigh in on this case. This left Carroll as the sole plaintiff in the matter. She is alleging PPGC violated the federal False Claims Act and the Texas Medicaid Fraud Prevention Act.

In court documents obtained by Breitbart Texas, Carroll claims, “Beginning in 2002, the Trades Center contacted Julio Asendio, a Planned Parenthood HIV Program staff member, when new Medicaid numbers were available. Adendio would go to the Trades Center and take blood and urine samples from the identified youths and return the samples to the Huntsville Health Center. Asendio and Brandi Taylor, Director of the Huntsville Health Center, would then create schedules giving the appearance that the services were rendered on-site at the Huntsville Health Center. Using the provider number of a Dr. Paul Fine, Planned Parenthood’s federal tax identification number, and the National Provider Identifier or Texas Provider Identifier of various Planned Parenthood health centers, Asendio billed these services to Medicaid as ‘office visits’ for STD tests.”

Carroll further claims in the documents, that about ten days later, Asendio would return to the Trades Center and take yet another blood sample from the same students. He would go back to the Huntsville Health Center and create an additional clinic schedule giving the appearance of yet another “office visit” that did not occur. “The second blood-draw would then be billed to Medicaid as an ‘office visit’ for an HIV test,” the documents stated.

Breitbart Texas reached out to Dr. Joseph Graham, President, Texas Right to Life for comment. Dr. Graham responded, “Planned Parenthood is America’s number one taxpayer funded abortion provider, and they profit from the sale of abortion to vulnerable women.  Planned Parenthood cares less about women’s health and more about the bottom line.  So manipulating indigent and vulnerable women to fraud the government on their profits is hardly a stretch in morality when they are already murdering children and maiming women.  We are just saddened that women still fall prey to their deceptive and dangerous practices.”

According to Courthouse News Service, Judge Sim Lake ordered Carroll to file an amended complaint after he partially dismissed the case. On Wednesday, Judge Lake said, “Carroll has adequately pleaded factual content that allows the court to draw the reasonable inference that Planned Parenthood knowingly filed false claims.” He also ruled the claim is not subject to the usual six-year statute of limitations that is normally applied to False Claims Act (FCA) lawsuits.  Judge Lake ruled the Wartime Suspension of Limitations Act “applies in civil FCA cases to suspend the statute of limitations when the United States is at war.”

Kurt Arbuckle, attorney for Patricia Carroll, told the Courthouse News Service the federal government’s decision not to intervene in the case does not imply that the case lacks merit.  The lawsuit was amended to add the claim that Planned Parenthood committed additional fraud by not reporting or returning the overpayments from the actions described above.

Courthouse News Service reached out to Planned Parenthood for comment but said they did not respond to their request for comment.

PPGC Lawsuit

Photo by Sonja Harris, @SonjaHHarris

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