Planned Parenthood Pays $4.3 Million to Settle Allegations of Medicaid Fraud in Qui Tam/Whistleblower Case

Monday, August 19, 2013
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

Planned Parenthood Gulf Coast recently paid $4.3 million to settle civil allegations under the False Claims Act, according to the Department of Justice (DOJ) on August 16, 2013. The nonprofit organization is accused of fraudulently billing Medicaid and other government programs for health services provided by some of its Texas clinics between 2003 and 2009, according to the DOJ. The settlement resolves a whistleblower (qui tam) lawsuit filed by a former employee.

Click here to read the press release from the DOJ.

Planned Parenthood Gulf Coast operates 12 clinics in southeast Texas and Louisiana. The nonprofit organization did not admit to any wrongdoing according to the settlement agreement.


Planned Parenthood Gulf Coast Accused of Unnecessary Medical Care.

The government alleged Planned Parenthood Gulf Coast billed and was paid by government programs, including Texas Medicaid, Title XX and the Women’s Health Program for certain items and services that were never rendered or were considered medically unnecessary for patients. According to The Wall Street Journal this included birth-control counseling and testing for sexually transmitted diseases.

To read the entire article from The Wall Street Journal, click here.

Title XX is funded by the federal government while Texas Medicaid and the Women’s Health Program are funded jointly by the federal government and the State of Texas, according to the DOJ.


Whistleblower to Receive More Than $1.2 Million.


The settlement resolves a False Claims Act lawsuit filed by a former employee of Planned Parenthood Gulf Coast. According to the DOJ, as part of the settlement of the case, the whistleblower will receive more than $1.2 million.

Whistleblowers stand to gain substantial amounts, sometimes as much as thirty percent (30%), of the amount the government recovers under the False Claims Act (31 U.S.C. Sect. 3730). Such awards encourage employees and contractors to come forward and report fraud. To learn more on whistleblower cases, read our two-part blog. Click here for part one, and click here for part two.



Contact Health Law Attorneys Experienced with Qui Tam or Whistleblower Cases.

Attorneys with The Health Law Firm also represent health care professionals and health facilities in qui tam or whistleblower cases. We have developed relationships with recognized experts in health care accounting, health care financing, utilization review, medical review, filling, coding, and other services that assist us in such matters.

To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.


Comments?

Have you noticed any fraudulent activity at your practice or medical office? Have you thought about stepping forward? Why or why not? Please leave any thoughtful comments below.


Sources:

Department of Justice. “Planned Parenthood $4.3 Million to Settle Allegations of Unnecessary Medical Care.” Department of Justice. (August 16, 2013). From: http://www.justice.gov/usao/txe/News/2013/edtx-settlement-plan-081613.html

Koppel, Nathan. “Planned Parenthood Settle in Fraud Case.” The Wall Street Journal. (August 16, 2013). From: http://online.wsj.com/article/SB10001424127887323455104579016951262314732.html


About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.


Tag Words: Planned Parenthood, planned parenthood settlement, false claims, Medicare false claims, false claims act, unnecessary procedures, false billing, Medicare, Medicare fraud, Medicare audit, whistleblower, qui tam, qui tam lawsuits, whistleblower attorney, whistleblower lawyer, whistleblower protection, legal representation, Department of Justice (DOJ), defense attorney, defense lawyer, The Health Law Firm


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8/19/2013

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