Bill targets abortion services “unbundled” for Medicaid reimbursement

A bill has been introduced into the U.S. House by a Wisconsin Congressman which would stop abortion providers from “unbundling” abortion services so they can submit separate claims to Medicaid.

U.S. Representative Sean Duffy (R-WI) said that he introduced the ‘‘Medicaid Abortion Funding Prohibition Accountability Act“ to target Medicaid providers who improperly submit reimbursement claims to pay for abortions, and related services.

“These companies submit separate claims for abortion related procedures in order to receive increased Medicaid reimbursements. It is a process known as “unbundling” and is in violation of federal law,” Rep. Duffy said in his press release.

“All too often, abortion providers – such as Planned Parenthood – are able to line their pockets with taxpayer funds by using a complex billing system and taking advantage of programs that rely on provider integrity for compliance,” Rep. Duffy added.

The bill reads in part:

To amend title XIX of the Social Security Act to audit States to determine if such States used Medicaid funds in violation of the Hyde Amendment and other Federal prohibitions on funding for abortions, and for other purposes…

Annual audit of claims for payment for items or services furnished, or administrative services rendered, under a State plan under this title, to determine if any payments made under section 1903(a)(5) were made in violation of any Federal law that restricts the use of funds under this title for abortions.

In New York alone, one audit uncovered $3 million in improper reimbursements and another uncovered $17 million; in that case one-quarter of the improper claims were for abortions or related procedures.

In 2013, Planned Parenthood’s Houston-based affiliate settled with the state of Texas after an audit revealed that the agency “fraudulently over billing the taxpayer-funded Medicaid program.”

A few weeks ago, Life Dynamics reported that a letter requesting an investigation into family planning centers and Planned Parenthood centers in Wisconsin was signed by 28 Wisconsin State Representatives and 4 State Senators in the state.

The letter detailed what it called “red flags” already discovered by the Office of the Inspector General (OIG) at the Department of Health Services against two family planning facilities, (NEWCAP and Wisconsin Family Planning Health Services) in the state which over-billed the state a combined total of $3.5 million.

The letter states that several other states report, “similar findings with Planned Parenthood and other Medicaid family planning providers,” and pointed to a Milwaukee Journal Sentinel article which states, “All of the family planning clinics, including those run by Planned Parenthood of Wisconsin, are paid the same rate by the state.”

In response to the previous investigation of the prior family planning facilities, Nicole Safar, director of policy and legal advocacy for Planned Parenthood of Wisconsin, told the Journal, “We are all doing it the same way.”

The lawmakers wrote that Planned Parenthood’s statement in that article was troubling, “It is peculiar and deeply troubling,” they said, “that any large recipient of taxpayer dollars would pre-emptively divulge that they are guilty of massively defrauding the government and actively in violation with their billing practices, with no plans to change or reimburse taxpayers–and yet that is precisely what Planned Parenthood of Wisconsin is admitting to,” the letter read.

Rep. Duffy says that a handful of federal and state audits of abortion-related claims have already uncovered millions of dollars of improper reimbursements and he believes that there needs to accountability to ensure taxpayer dollars are used appropriately.

“The American people overwhelmingly agree that taxpayer funding should not be used for abortions – and the law supports that belief. We need an honest accounting to ensure taxpayer dollars are used appropriately and this bill aims to do that, ” Rep. Duffy said.

On January 28, 2015 the bill was assigned to a congressional committee which will consider it before possibly sending it on to the House or Senate as a whole.