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Texas sues PP for alleged Medicaid fraud

On Behalf of | Jan 1, 2024 | Healthcare Business

In Texas and other states in which it operates, Planned Parenthood provides many reproductive health services beyond abortion to primarily low-income patients. The organization provides cancer screening, sexually transmitted infection screening and treatment, and screening for and treating HIV infection. To try to drive Planned Parenthood out of the state, an anonymous whistleblower joined with Texas Attorney General Ken Paxton to file a lawsuit against the organization for alleged Medicaid fraud, claiming $1.8 billion in damages.

Lawsuit allegations

In 2016, the state removed Planned Parenthood from its list of organizations approved to receive Medicaid funds. Medicaid is a program funded jointly by the federal and state governments through which low-income people can access healthcare. Planned Parenthood sued, and lower courts blocked the law while the case moved through the court process. During the interim, while the law was blocked, Planned Parenthood continued to provide Medicaid-funded services. However, in 2020, the U.S. Court of Appeals for the 5th Circuit overturned the lower courts and lifted the block. This allowed the state to remove Planned Parenthood from its list of approved organizations for Medicaid funding.

The lawsuit alleges that Planned Parenthood violated the state’s Medicaid law by billing Medicaid for services it provided between 2016 and 2020 during the litigation process. The organization points out that the law was blocked during that period. It no longer provides Medicaid-funded services in Texas.

The state’s move to limit or end Planned Parenthood’s services in Texas through laws and litigation has severely curtailed the access of low-income people to reproductive healthcare. With changes the state made to its programs, the provision of Medicaid-funded long-acting birth control methods dropped by 35% while the cost of Medicaid-funded obstetric care increased by 27%. Texas also blocked Planned Parenthood from receiving Medicaid funds to complete cervical cancer, breast cancer, and HIV screening.