Texas wants Planned Parenthood to give back millions of dollars in Medicaid reimbursements — and pay far more in fines on top of that — in a lawsuit that appears to be the first of its kind brought by a state against the largest abortion provider in the U.S.
A hearing was set for Tuesday in front of U.S. District Judge Matthew Kacsmaryk, who earlier this year put access to the most common method of abortion in the U.S. in limbo with a ruling that invalidated approval of the abortion pill mifepristone.
The case now before him in America's biggest red state does not surround abortion, which has been banned in Texas since the U.S. Supreme Court overturned Roe v. Wade last year. But Planned Parenthood argues the attempt to recoup at least $17 million in Medicaid payments for health services, including cancer screenings, is a new effort to weaken the organization after years of Republican-led laws that stripped funding and imposed restrictions on how its clinics operate.
At issue is money Planned Parenthood received for health services before Texas removed the organization from the state's Medicaid program in 2021. Texas had begun trying to oust Planned Parenthood four years earlier and is seeking repayment for services billed during that time.
“This baseless case is an active effort to shut down Planned Parenthood health centers," said Alexis McGill Johnson, president of Planned Parenthood Federation of America.
Texas brought the lawsuit under the federal False Claims Act, which allows fines for every alleged improper payment. Planned Parenthood says that could result in a judgement in excess of $1 billion.
It is not clear when Kacsmaryk will rule.
The lawsuit was announced last year by Republican Texas Attorney General Ken Paxton, who is now temporarily suspended from office pending the outcome of his impeachment trial next month over accusations of bribery and abuse of office.
Spokespersons for the office did not return a message seeking comment Monday. Last year, Paxton said it was “unthinkable that Planned Parenthood would continue to take advantage of funding knowing they were not entitled to keep it.”
Jacob Elberg, a former federal prosecutor who specialized in health care fraud, described Texas' argument as weak.
He called the False Claims Act the government's most powerful tool against health fraud. Cases involving the law in recent years have included a health records company in Florida and a Montana health clinic that submitted false asbestos claims.
Elberg said it is “hard to understand” how Planned Parenthood was knowingly filing false claims at a time when it was in court fighting to stay in the program and Texas was still paying the reimbursements.
“This just isn’t what the False Claims Act is supposed to be about,” said Elberg, faculty director at Seton Hall Law School's Center for Health & Pharmaceutical Law.
Planned Parenthood has roughly three dozen health clinics in Texas. One has closed since the Supreme Court ruling last year that allowed Texas to ban abortion.
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