After discovering “alarming” instances of billing inconsistencies, Oklahoma Gov. Mary Fallin ordered health care officials to block all state funding for the two Planned Parenthood clinics located in Oklahoma.
“More than one in every seven bills submitted for payment [by Planned Parenthood] … are inaccurately coded or insufficiently documented,” Fallin wrote Wednesday in a letter addressed to Oklahoma Health Care Authority Director Nico Gomez. “These results are alarming.”
Fallin was referring to high error rates found in a Program and Integrity Review of Payments for the two Planned Parenthood affiliates operating in Oklahoma. One review found “a 20.3 percent error rate” and another discovered a “14.1 percent error rate.”
“These errors result in overbilling to the Oklahoma taxpayer,” Fallin said. “[W]hether willful or simply negligent, the consistent submission of improper billings should disqualify these Planned Parenthood providers from participation in the Oklahoma Medicaid program.”
The Oklahoma Medicaid program reimburses Planned Parenthood of Central Oklahoma and Planned Parenthood of the Heartland in Tulsa for services it provides to low-income patients.
In a joint statement, both Planned Parenthood clinics called Fallin’s actions “premature” and “incredibly disappointing.”
“The findings of these audits are a normal part of the process in reviewing health care reimbursement,” they said, adding:
Often, it is simply a matter of submitting additional documentation that supports the request for full Medicaid reimbursement. Planned Parenthood of the Heartland and Planned Parenthood of Central Oklahoma are currently reviewing the results of the audits and both agencies have every intention of responding through the appropriate channels once we have.
According to the governor’s office, in 2015, the state paid Planned Parenthood affiliates in Oklahoma $100,145 for a total of 19,546 claims. In addition, “[t]he vast majority of Planned Parenthood services qualify for a 90 percent federal match, making the total payment slightly more than $1 million. In 2014, the state paid $204,631 for 36,741 claims [and] federal matching funds made the total slightly more than $2 million.”
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