Governor Fallin wants to terminate Planned Parenthood contracts; high rate of billing errors

Governor Fallin wants to terminate Planned Parenthood contracts; high rate of billing errors

By Governor Fallin's office

OKLAHOMA CITY, Okla._Governor Mary Fallin has requested Oklahoma Health Care Authority to terminate its contracts with the two Planned Parenthood affiliates operating in the state because of their high rate of billing errors.

Governor Fallin urged OHCA Chief Executive Officer Nico Gomez to consider appropriately terminating contracts with Planned Parenthood of Central Oklahoma in Oklahoma City and Planned Parenthood of the Heartland in Tulsa. She also asked Gomez to recommend terminating contracts with similar providers found to have a high billing error rate, have had past findings of overbilling or associate with other providers who do not rigorously adhere to the high standards that are required to be granted access to public funds.

In 2015, the state paid the two Planned Parenthood affiliates $100,145 for 19,546 claims; the 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; federal matching funds made the total slightly more than $2 million.

The governor earlier this year asked the OHCA to review Planned Parenthood's operations to ensure no state funds were being misused. The review of the two affiliates showed no improper use of state Medicaid funds, but showed a billing error rate of 20.3 percent rate at one and a 14.2 percent error rate at the other.

"These results are alarming," wrote Governor Fallin in a letter to Gomez. "These errors result in overbilling to the Oklahoma taxpayer.  The lack of attention to the requirements imposed on a responsible provider is a continuing problem for these Planned Parenthood affiliates."

Terminating the contracts with the two Planned Parenthood affiliates, which operate in about six metropolitan locations in Oklahoma City and Tulsa, will not interfere with a woman's ability to have a free choice of healthcare provider services, Governor Fallin wrote.

More than 120 other metropolitan and rural health care providers are available in the state, the governor wrote. These include federally qualified health clinic sites, rural health clinics and private Medicaid providers, all of whom provide a broader spectrum of health care services than Planned Parenthood's metropolitan locations.

"We have a joint responsibility to the citizens in Oklahoma to hold providers to high standards that are imposed to allow an entity to receive taxpayer dollars," Governor Fallin wrote. "The recent behavior of the Planned Parenthood affiliates clearly demonstrates that these providers do not value the opportunity to serve their fellow Oklahomans with taxpayer funds.  Indeed whether willful or simply negligent, the consistent submission of improper billings should disqualify these Planned Parenthood providers from participation in the Oklahoma Medicaid program."