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La. Ordered To Continue Medicaid Funding for Planned Parenthood; Defunding Effort Underway in Texas

La. Ordered To Continue Medicaid Funding for Planned Parenthood; Defunding Effort Underway in Texas

October 20, 2015 — A federal judge on Sunday issued a 14-day restraining order on Louisiana Gov. Bobby Jindal's (R) effort to end the state's Medicaid provider agreement with Planned Parenthood, AP/ABC News reports.

Planned Parenthood's funding was scheduled to end on Monday. A hearing date was to be scheduled after a Monday afternoon conference call (McGill, AP/ABC News, 10/19).

Background

Earlier this summer, Jindal ordered the state to end its Medicaid contract with Planned Parenthood following the release of a series of misleading videos targeting Planned Parenthood, which were released by an antiabortion-rights group called the Center for Medical Progress. CMP secretly filmed the videos by meeting with Planned Parenthood staff while posing as buyers of fetal tissue.

Planned Parenthood has stated that the videos were heavily edited and that the filmed officials did not conduct any illegal activities. The organization said it does not profit from fetal tissue donations and only receives reimbursement for costs associated with such donations, which is legal.

Planned Parenthood Gulf Coast and three Medicaid beneficiaries in August filed a lawsuit asking a federal court to issue a temporary restraining order and a permanent injunction against the funding cuts. The two clinics in the state, which do not provide abortion services, said cutting Medicaid funding violates federal law, which allows Medicaid beneficiaries to seek care from any qualified Medicaid provider. The U.S. Department of Justice also filed a legal brief in support of PPGC, contending the state could not cancel Planned Parenthood's Medicaid contract without showing that the clinics were not adequately performing their services or were billing incorrectly.

In September, Jindal's administration said the administration was moving to end the provider contract "for cause" rather than continuing its effort to do so without providing a reason (Women's Health Policy Report, 9/14).

Ruling Details

In his ruling, U.S. District Judge John deGravelles held that the administration acted unlawfully in its effort to cancel Medicaid contracts with PPGC.

DeGravelles said defunding PPGC would disrupt the provision of health care services for 5,200 PPGC patients. "[N]ot even [the Louisiana Department of Health and Hospitals] can ensure that PPGC's current patients will" be able to find alternate sources of care, he wrote. DHH had claimed that the PPGC patients would be able to obtain care from other providers.

In addition, deGravelles said that Louisiana's argument that it was ending the contracts because of a Texas Medicaid settlement involving PPGC "contradicts DHH's own code," which "plainly and unambiguously" bars the state from ending contracts with Medicaid providers "if [the providers] do not admit liability in the settlement" (Litten [1], New Orleans Times-Picayune, 10/19). PPCG in 2013 settled allegations of improper Medicaid billing at its Texas clinics, but the organization admitted no wrongdoing as part of the settlement (Women's Health Policy Report, 8/20/13).

DeGravelles also noted that the video footage does not involve PPGC. "In fact, uncontradicted evidence in the record at this time is that PPGC does not perform abortions in Louisiana, is not involved in the sale of fetal tissue and none of the conduct in question occurred at the PPGC's two Louisiana facilities," he wrote (AP/ABC News, 10/19).

Further, deGravelles said that "it appears likely that plaintiff (Planned Parenthood) will be able to prove that the attempted terminations against it are motivated and driven, at least in large part, by reasons unrelated to its competence and unique to it." However, deGravelles in Sunday's order did not rule on Planned Parenthood's claim that the videos were Jindal's basis for cancelling the contract.

According to the New Orleans Times-Picayune, Jimmy Faircloth, executive counsel for the Jindal administration, argued that the case should be dismissed. He noted that the contract had not yet been canceled and that Planned Parenthood should instead be pursuing an administrative appeal with the state. However, DeGravelles disagreed, stating, "The agreements' termination has been threatened repeatedly since August 2015, and defendant (the Jindal administration) has now only swapped no reason for three," adding, "Based on these circumstances and well-settled law, Plaintiffs' (Planned Parenthood and patients') threatened injury is clear."

DeGravelles also cited legal challenges to efforts to cut Planned Parenthood Medicaid funding in Arkansas and Utah, where judges have ruled for Planned Parenthood.

In addition, deGravelles pointed to a potential violation of the Louisiana Medical Assistance Program Integrity Law. DeGravelles cited a recent state Supreme Court decision that found state agencies cannot pursue termination without a reason approved by the state Legislature. "Based on the evidence it has so far presented and if no actual evidence of a MAPIL-worthy-misdeed is adduced, defendant has likely run afoul of this state's statutory law," deGravelles wrote (Litten [1], New Orleans Times-Picayune, 10/19).

Comments

Melissa Flournoy, state director at PPCG, said, "It is shameful that Governor Jindal is trying to score political points by blocking women's access to critical health care" (AP/ABC News, 10/19).

Flournoy called the ruling a "victory for the more than 5,200 women and men in Louisiana who rely on Planned Parenthood for care through Medicaid" (Litten [1], New Orleans Times-Picayune, 10/19).

Separately, Mike Reed, a spokesperson for Jindal's office, said the administration intends to appeal the ruling. According to the Times-Picayune, deGravelles' latest order, which is a temporary restraining order, cannot be appealed. However, the state could appeal a preliminary or permanent injunction that deGravelles might issue once the temporary order expires (Litten [2], New Orleans Times-Picayune, 10/19).

Texas Moves To Cut Planned Parenthood Medicaid Funding

In related news, Texas' Office of Inspector General on Monday told Planned Parenthood affiliates in the state that their Medicaid contracts would be cancelled, the Dallas Morning News/Sacramento Bee reports.

According to the DMN/Bee, the move follows several other efforts by Texas lawmakers to cut funding for Planned Parenthood. However, until the latest announcement, Planned Parenthood clinics in the state were still able to receive Medicaid reimbursement for contraception, breast and cervical cancer screenings, and the prevention and treatment of sexually transmitted infections.

Cancellation Details

According to the DMN/Bee, the effort would end about $3 million in funding for the organization, most of which is federal funding, that helps cover health care services for low-income patients.

In the cancellation notice, the state OIG said the contracts were being canceled because of the CMP videos and because the undercover group accessed a Texas clinic, which created an "unsanitary work environment," DMN/Bee reports (Martin, Dallas Morning News/Sacramento Bee, 10/19).

Texas officials claimed that Medicaid beneficiaries could obtain care from providers other than Planned Parenthood (AP/Modern Healthcare, 10/19).

Comments

PPGC spokesperson Rochelle Tafolla said "Tens of thousands of women are already going without care after years of policies aimed at blocking access to care at Planned Parenthood" (Dallas Morning News/Sacramento Bee, 10/19).

Separately, Planned Parenthood Federation of America Executive Vice President Dawn Laguens said, "It is completely outrageous that Texas officials are using thoroughly discredited, fraudulent videos to cut women off from preventive health care, including cancer screenings, HIV testing, and birth control."

Laguens added, "We will fight back against this outrageous, malicious, political attack in Texas with everything we've got, and we will protect women's access to the health care they need and deserve." She cited cases in Indiana and Arizona, where courts have said federal law prohibits their cuts to Planned Parenthood Medicaid funding (AP/Modern Healthcare, 10/19).