Planned Parenthood paid $3 for birth control but billed Medicaid

Posted: Nov 12, 2015

A little-known whistleblower lawsuit accuses Planned Parenthood clinics in Iowa of wrongly siphoning millions of American taxpayer dollars with a series of complicated billing schemes aimed at increasing profits. Among other dishonest practices, a former manager of the clinics alleges, Planned Parenthood staffers routinely purchased birth control pills for just under $3, billed Medicaid $35 for the same package of pills, and got reimbursed for $26. The lawsuit, brought by Sue Thayer, a 17-year employee of Planned Parenthood in Iowa, coincides with a national scandal over undercover videos that show the organization’s officials in other states talking about the sale of body parts from aborted babies. The series of videos, hotly disputed by Planned Parenthood Federation of America, triggered renewed efforts by conservative lawmakers to strip taxpayer dollars from the nation’s largest provider of abortions. In her suit, Thayer alleges multiple accounts of fraud, waste, and abuse in the Iowa clinics that add up to nearly $28 million. Her allegations raise both ethical and legal questions at a time when the national Planned Parenthood organization faces a hostile climate in Washington, D.C., and beyond. From April 1991 to December 2008, Thayer managed Planned Parenthood’s clinic in Storm Lake, Iowa. From 1993 to 1997, she also was center manager of the clinic in LeMars, Iowa. The two locations since have been consolidated into Planned Parenthood of the Heartland. Thayer says she was fired at the end of 2008 after raising concerns about “webcam abortions”—a controversial practice that allows Planned Parenthood doctors to dispense abortion-inducing pills to clients remotely using video-conferencing equipment... By privately negotiating a deal with Ortho Tri-Cyclen Lo, a birth control prescription manufactured by Janssen Pharmaceuticals, Thayer said the Iowa clinics were able to purchase birth control pills for $2.89 per 28-day cycle. In late October, The Daily Signal emailed both Ortho Tri-Cyclen Lo and Janssen to confirm these numbers, but neither has responded. Thayer then said Planned Parenthood of the Heartland would bill Medicaid $35 for each birth control package and be reimbursed about $26 by Iowa Medicaid authorities. Medicaid, a government-run health care program, provides free services to low-income families and individuals. When a patient on Medicaid seeks treatment at one of Planned Parenthood’s more than 600 locations, the organization bills Medicaid on that patient’s behalf. Medicaid programs use what are called “open fee schedules” to set compensation levels for prescriptions such as birth control. According to Iowa Medicaid’s current open fee schedule, providers such as Planned Parenthood are allowed to be compensated $25.36 for each package of contraceptives (or 92 cents a pill). dailysignal.com ;