Audit finds Planned Parenthood affiliate overcharged $629,000 to Medicaid

Spokane, Wash., Aug 13, 2009 / 18:44 pm

An audit has uncovered information that Planned Parenthood of the Inland Northwest has required unnecessary office visits by its poorest patients, securing over half a million dollars in excess payments from Medicaid.

The audit has also discovered questionable billing procedures and unauthorized staff prescribing and dispensing birth control pills, Doug Porter, Washington’s Medicaid director, told the Spokesman-Review.

The excess taxpayer-funded Medicaid payments total $629,143, out of a total of about $7.7 million in payments. Interest of one percent per month will begin accruing on August 20 if the clinic does not repay the state.

The audit was launched after staff with the Washington Department of Social and Health Services became suspicious of the frequency of clinic visits by Medicaid patients.

“Most birth control clinics will see a woman and usually determine what method of birth control is best and then they will prescribe six months to a year right then and there,” Porter explained.

However, Medicaid patients were coming to Planned Parenthood every month.

Auditors reviewed 333 procedures performed from March 2004 to February 2007. Audit sample findings were then applied to all 267,815 procedures to calculate the overpayment.

Porter told the Spokesman-Review he could not disclose whether he had referred the findings to Medicaid fraud investigators with the Washington Attorney General’s Office.

Planned Parenthood is considering appealing the latest audit’s findings. In a written statement, the organization said the audit was “routine” and would not affect patient services.

Porter told the Spokesman Review that the overbilling is considered significant.

“What we hope is that $630,000 is enough tuition to be smarter about how they operate and do business,” he said. “It’s indicative of sloppy billing practices for sure, but it’s not egregious.”

Porter also noted concerns about audit findings that drug prescriptions were being charged by unauthorized staff.

“That’s a quality-of-care issue,” he said. “You can’t have a receptionist handing out pills.”

Planned Parenthood clinics in other states are also under investigation after being exposed by student investigator Lila Rose of Live Action Films for not reporting suspected cases of statutory rape, as required by state law.