December 15, 2015 — Planned Parenthood in Texas is still receiving federal and state funds to provide health care services for low-income women in the state, despite threats and initial actions taken by conservative lawmakers in the state to defund the organization, the Texas Tribune reports (Ura/Walters, Texas Tribune, 12/12).
The Texas Office of Inspector General in October sent a "notice of termination" to Planned Parenthood, initiating the process of determining whether the organization should retain its status as a Medicaid provider in the state. In their notice to Planned Parenthood, state officials cited a series of misleading videos targeting the organization.
If the state terminates Planned Parenthood's Medicaid provider agreement, Planned Parenthood would lose about $3 million, most of which is federal funding that helps cover health care services for low-income patients.
In November, Planned Parenthood filed a federal lawsuit against Texas officials in response to the defunding efforts, noting that the decision to terminate the Medicaid provider agreement could take effect as soon as Dec. 8. The organization was joined in the lawsuit by 10 patients.
In the lawsuit, Planned Parenthood argued that Texas' defunding effort violates Medicaid's "freedom of choice provision," under which beneficiaries can seek care from any qualified provider. Planned Parenthood also said the state's defunding effort violates the 14th Amendment by subjecting the organization to "unfavorable treatment without adequate justification." Planned Parenthood also noted that if it is removed from Texas' Medicaid program, more than 13,000 patients each year would lose access to services such as contraception, cancer screening, HIV testing and other care.
Meanwhile, courts have blocked similar efforts to cut federal funding for Planned Parenthood in other states, including Arkansas, Louisiana and Utah. In addition, federal health officials in October warned Texas that its efforts to remove Planned Parenthood from its Medicaid program could violate federal law (Women's Health Policy Report, 11/24).
U.S. District Judge Sam Sparks was scheduled to consider Planned Parenthood's request for a restraining order on Dec. 8, but he canceled the hearing after it was disclosed that Texas state health officials had never filed a final notice of funding termination.
Sarah Wheat, vice president for Planned Parenthood of Greater Texas, said, "Planned Parenthood has not received official notice from the state for termination of our health centers' continued participation in Medicaid so our court case is delayed." She added, "When the state issues an official notice to terminate our health centers from the Medicaid program, Planned Parenthood is ready to continue to stand up for our patients in court."
Meanwhile, spokespeople with the state health commission's inspector general declined to comment and the governor's office did not respond to a request for comment. According to the Tribune, it is unclear when or if the state will issue the final notice of termination.
State Has Pattern of Inaction on Planned Parenthood
According to an analysis by the Tribune, Texas' inaction on Planned Parenthood's status as a Medicaid provider is one of a series of instances in which the state had made substantial allegations against the organization and then opted not to follow through on related threats.
The analysis found that in the last five years the state health agency's inspector general has conducted six audits of the organization, which claim that Planned Parenthood has improperly billed the state for nearly $1.7 million. However, according to the Tribune, the state has never collected any of those funds.
According to the analysis, the state in its investigations typically alleged that Planned Parenthood wrongly billed the state in an isolated incident and then, using extrapolations from a statistical model, concluded there were additional instances of improper billing. The extrapolated findings can multiply the alleged improper billing amount to up to 31 times the original amount.
For example, investigators said one Planned Parenthood clinic in Hidalgo County, Texas, had distributed more condoms than "medically necessary," alleging that the clinic in fiscal year 2011 had improperly billed $6,932. The state then extrapolated that amount to over $126,000. The clinic since has ended its relationship with Planned Parenthood.
Meanwhile, according to the Tribune, Planned Parenthood has denied most of the allegations made by the state in its various audits. Chris Cutrone, a spokesperson for the health commission's inspector general, said the audits were "pending," but Planned Parenthood states that it has not heard from the state on many of those audits since the organization appealed them, some more than three years ago.
Mark Chouteau, an attorney representing Planned Parenthood in several appeals over the audits, said, "We've had those things on appeal now for three years or more, without anything happening on them. I haven't heard a word since [the appeals were filed]." He said that the lack of response from the state could indicate the state "didn't want to defend those audits" (Texas Tribune, 12/12).