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TX Attorney General's Office obtains $1.4 million settlement against Planned Parenthood Gulf Coast for medicaid fraud

TX Attorney General's Office obtains $1.4 million settlement against Planned Parenthood Gulf Coast for medicaid fraud
MGN-Online
CrimeWatch

POSTED: Wednesday, July 24, 2013 - 10:33am

UPDATED: Wednesday, July 24, 2013 - 10:34am

Planned Parenthood Gulf Coast fraudulently billed Texas Medicaid program for products, services not provided

The Texas Attorney General’s Office today concluded the State’s Medicaid fraud investigation into Planned Parenthood Gulf Coast, Inc. Under today’s agreement, Planned Parenthood Gulf Coast must pay $1.4 million for fraudulently overbilling the taxpayer-funded Medicaid program.

After a whistleblower lawsuit was filed alleging improper billing practices by Planned Parenthood Gulf Coast, an investigation was opened by the Texas Attorney General’s Office and the Texas Health and Human Services Commission’s Office of Inspector General. The State’s investigation revealed that Planned Parenthood Gulf Coast improperly billed the Texas Medicaid program for products and services that were never actually rendered, not medically necessary, and were not covered by the Medicaid program – and were therefore not eligible for reimbursement. For example, state investigators determined that Planned Parenthood Gulf Coast falsified material information in patients’ medical records in order to support fraudulent reimbursement claims to the Medicaid program.

Under the agreement announced today, Planned Parenthood Gulf Coast must pay $1.4 million to resolve the Medicaid fraud enforcement action. Because Medicaid is jointly funded by the State and the federal government, the federal government is entitled to a portion of the Texas recovery. Under the Texas Medicaid Fraud Prevention Act, the relator-whistleblower that uncovered the defendant’s fraudulent conduct will also receive a share of the State’s recovery.

Nationally recognized for its successful efforts to recover funds wrongfully taken from the Medicaid program, the Texas Attorney General’s Civil Medicaid Fraud Division (CMF) is responsible for pursuing fraud claims through civil enforcement actions. Since 2002, CMF’s recoveries for the State of Texas have passed the $400 million mark – while total recoveries for the state and federal governments now exceed $1 billion.

For more information about the Civil Medicaid Fraud Division’s efforts to eliminate waste, fraud and abuse in the Texas Medicaid program, access the Office of the Attorney General’s website at www.texasattorneygeneral.gov.

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