The Texas Attorney General announced that Planned Parenthood Gulf Coast, Inc. (“PPGC”) has agreed to pay $1.4 million to settle claims that it defrauded the Texas Medicaid program. As Medicaid is jointly funded by the state and federal government, a portion of the settlement proceeds will be paid to the federal government.
The allegations were first brought in a whistleblower suit filed under the Texas Medicaid Fraud Prevention Act by former PPGC employee, Karen Reynolds. Ms. Reynolds was a healthcare assistant at PPGC’s Lufkin, Texas clinic from 1999 to 2009.
Ms. Reynolds alleged that employees were taught to use deceptive billing practices to defraud the Medicaid program. According to the Complaint, PPGC submitted bills to the Medicaid program for services that were never provided, were provided but medically unnecessary, or for abortion-related services that were not eligible for Medicaid reimbursement pursuant to the Hyde Amendment. The Hyde Amendment bars the use of federal funds to pay for abortions.
The whistleblower will receive a portion of the settlement proceeds as her reward under the Texas Medicaid Fraud Prevention Act.