Texas AGO obtains $1.4 mil settlement against PP for Medicaid fraud

[SassySmartie]

What does this have to do with the Gulf Coast PP having to pay $4.3 million to the state of Texas?

They aren't paying 4.3 million to Texas. They're paying 1.4 million to Texas and 3.1 million to the Federal Gov't.

 

[mac]

They got part of the complaint dismissed in August of 2012. I imagine the next few months were spent negotiating a settlement. These things don't move quickly. After only having part of the complaint dismissed, they would have to defend against the rest, they opted to pay out a settlement rather that deal with the expenses. Since, as I said, they'll be involved in many of the states litigations against the new wave of new laws recently passed. I'm sure they had to make some decisions about how to spend the finite amount of money they have.

If they got part of it dismissed, why not the whole thing?

 

[mac]

The false charges allegations in the Catholic Healthcare link that yeat2late posted and I reposted took place in 1990s and they finally settled in 2011.

And they admitted their error. They didn't pay up claiming they were innocent but paying anyway.

See the difference?

 

[Dr. Chuckles]

What latitude? Also mincing how? there is a legal difference between a judgment and a settlement.

the fact that you keep pushing the idea that a settlement is some how a clear distinction that no wrong doing was done ...

I understand how settlements work.

then you should try to be more honest

All settlements have a clause that the defendant is not admitting wrongdoing.

Yes, I am aware of that, but such isn't proof against wrong doing

Sometimes, companies settle because they cannot afford the costs of going to trial.

And sometimes it's an easier means in dealing with their wrong doing

From examining the pleadings I found online, it seems like PP was just avoiding the costs of litigation in this case, since Reynolds had no specific proof.

really? Because you originally tried to deflect from the issue, then you started attacking the AG on some irrelevant point. But the one thing I don't recall you doing, is offering an actual analysis of the case or the evidence against PP

Can you post a link?

 

[sangha]

really? Because you originally tried to deflect from the issue, then you started attacking the AG on some irrelevant point. But the one thing I don't recall you doing, is offering an actual analysis of the case or the evidence against PP

Can you post a link?

Actually, she already posted an argument that described the lack of any credible evidence indicating any wrongdoing by PP as well as links to support her argument.

The only things the abortion banners have is innuendo, speculation and lies.

 

[Dr. Chuckles]

Actually, she already posted an argument that described the lack of any credible evidence indicating any wrongdoing by PP as well as links to support her argument.

Actually, no, it made no mention of actual evidence, only that the people involved in the private suit refused to release it publicly (which is standard, and part and parcel of many settlements)

But what did not happen was an actual review of the evidence, only an indication that the evidence wasn't available for review:a huge difference, and a very poor basis to declare no wrong doing

 

[sangha]

Actually, no, it made no mention of actual evidence, only that the people involved in the private suit refused to release it publicly (which is standard, and part and parcel of many settlements)

But what did not happen was an actual review of the evidence, only an indication that the evidence wasn't available for review:a huge difference, and a very poor basis to declare no wrong doing

Actually, it did mention "actual" evidence

 

[Dr. Chuckles]

Actually, it did mention "actual" evidence

then feel free to list it

 

[SassySmartie]

If they got part of it dismissed, why not the whole thing?

I posted the judge's dismissal and opinion. You can read it yourself.

 

[SassySmartie]

the fact that you keep pushing the idea that a settlement is some how a clear distinction that no wrong doing was done ...




then you should try to be more honest




Yes, I am aware of that, but such isn't proof against wrong doing




And sometimes it's an easier means in dealing with their wrong doing




really? Because you originally tried to deflect from the issue, then you started attacking the AG on some irrelevant point. But the one thing I don't recall you doing, is offering an actual analysis of the case or the evidence against PP

Can you post a link?

I've already posted several including actual pleadings. Try reading.

 

[Dr. Chuckles]

I've already posted several including actual pleadings. Try reading.

I went back and read the thread in it's entirety before posting that, and nowhere did I see you address the actual evidence or the nature of the case. What I did see were plenty attempts to attack various peoples character and conflate a settlement with a state of innocence.

But it's hardly a position I feel invested in, so feel free to cite the actual documents you mention above

 

[SassySmartie]

Actually, no, it made no mention of actual evidence, only that the people involved in the private suit refused to release it publicly (which is standard, and part and parcel of many settlements)

But what did not happen was an actual review of the evidence, only an indication that the evidence wasn't available for review:a huge difference, and a very poor basis to declare no wrong doing

The judge's opinion dismissing part of the claim says specifically that Reynolds did not present any specific or in the judge's words "particular" evidence, no dates, no specific patient records. Instead Reynolds alleged a billing scam. There wasn't a "review" of evidence because none was provided. There was also no investigation by the AG's office nor the Federal DOJ. The opinion clearly states that both offices opted not to investigate or take any action on Reynold's original complaint following her disciplinary action at PP, where she quit after being written up with the possibility of losing her job if she didn't improve on the job. Suddenly after this mishap, after working from 1997-2009 and participating (by her own admission) in alleged fraudulent billing, suddenly, she's offered a job with a pro-life group and brings this suit... That almost exactly matches Abby Johnson's suit, who has been documented as being a liar and only joined the pro-life group and suit following her own firing from PP.

Furthermore, I didn't ever once "declare no wrong doing" I simply pointed out that a settlement does not = judgment.

 

[SassySmartie]

I went back and read the thread in it's entirety before posting that, and nowhere did I see you address the actual evidence or the nature of the case. What I did see were plenty attempts to attack various peoples character and conflate a settlement with a state of innocence.

But it's hardly a position I feel invested in, so feel free to cite the actual documents you mention above

Page 10, post #91 the urls linked are actual pleadings:

Secondly, the neither the US Dept of Justice nor the State of Texas bothered to investigate any of Karen Reynold's complaints. Furthermore, as a whistleblower, in Texas, Reynolds gets a share of any settlement or fees collected. Her complaints were originally filed in 2009, neither Texas nor the US DOJ pursued charges. Karen Reynolds then sued PP on behalf of the DOJ and the State of Texas. A large portion of her complaints were dismissed outright because of the lack of action taken by both gov't agencies and because she did not provide specific evidence of frauds. IOW, she alleged a billing scheme but did not provide specific cases or patient charts where the alleged fraud took place. Furthermore, the judge limited her complaint to post 2007 as too much time had elapsed.

PP has been dealing with this since 2009. Taking a case like this to trial is extremely expensive. How much do you think it costs to copy every single patient record from 2007-2009? During the discovery phase of a trial, PP would be required to produce all patient charts in that time period, box and ship them to the plaintiff, with copies to the court, they also have to pay their legal team to sort through, organize and investigate their defense and answer various other pleadings and motions moving towards the trial. It is quite common in civil actions like this for the Defendant to settle because the costs of going to trial are burdensome and time consuming. Further, for PP in particular, which will be participating in numerous legal actions as a result of new legislation to sue states to reverse these ridiculous laws, they had to weigh whether they want to tie up time and funding in fighting this case, or cut their losses to focus on upcoming legal battles.

AGAIN, there was not a JUDGEMENT of guilt. You keep writing as if you think that the US Dist Court Eastern District Lufkin Division has RULED on this case. They have NOT. The parties [i.e. Reynolds and PP] instead chose to agree on a dollar amount to settle and drop the case. Which if Reynolds had real, substantial evidence, why would she settle? She'd stand to get a cut of the alleged $30 million in alleged fraud money. Instead she settled for a cut of the $1.4 million that will be paid to Texas. Wonder why that is? A settlement Agreement must be agreed on by all parties involved and the monetary amount must be agreed on by all parties. A defendant cannot offer to settle to the judge and unilaterally drop the case. The parties make a settlement arrangement in lieu of going to trial, the defendant admits no wrongdoing, and parties agree to the amount of money to be paid and how it will be dispersed.

ORDER GRANTING IN PART DEFENDANT’S MOTION TO DISMISS

After the dismissal linked above, Reynolds filed this:

THIRD AMENDED COMPLAINT
AND DEMAND FOR JURY TRIAL

Where on page 17 you can see the alleged fraudulent charges. Though, ya know, I find it hard to see how a complete STD screen isn't 'necessary' or appropriate when a patient comes in suspecting she has a particular STD, since, if she's at-risk and having symptoms of one STD, she'd be at-risk for others. I also find it completely plausible that Self-Pay clients would opt not to have extra services, since 'self-pay' means they're paying completely out of pocket for services and probably can't afford a full panel of tests. It seems to me that these 'unnecessary' procedures are part of women's health and in the ideal scenario and best case scenario, women would have affordable, equal access to all of these procedures. Would you really argue that if a woman comes into a health clinic for a pregnancy test, that she does not also need contraceptive counseling and contraceptives? Since the fact that she may be pregnant means her contraception may not be the right contraception and/or might not be the most effective, or maybe she needs more education on the appropriate use of that method?

In both the Johnson and Reynolds cases, we see a disgruntled employee [in Johnson's case FIRED and LIED about what she saw] [in Reynold's case had been written up as disciplinary action at work, and in a position to lose her job] that worked for many years, according to their own testimonies, participated in alleged falsifications, yet waited until they were fired or in trouble to suddenly decide to report these alleged abuses. They also both stand to gain financially from such action. In Johnson's case, she became famous and a renowned speaker on the pro-life circuit. Both reek of retaliation and dishonesty. Neither can state specific cases of fraud.

 

[nota bene]

Planned Parenthood Gulf Coast didn't settle because it did no wrong. And the DOJ maintains that it did, as does Texas. From the settlement document itself:

Page 2

D. The United States contends that PPGC submitted false claims and made false statements to the United States in connection with claims that PPGC submitted to the United States under the Social security Block Grant, Title XX of the Social Security Act, 42 U.S.C. FF1397 et. seq. (SSBF), the Medicaid Program, Title XIX of the Social Security Act, 31 U.S.C. §§ 1296 et seq. (Medicaid Program), and the Women’s Health Program (WHP), a Medicaid research and demonstration waiver created under Section 1115(a) of the Social Security Act, 42 U.S.C. § 1315(a), and implemented by Texas under former Tex. Hum. Res. Cod § 32.0148.

Page 7

E. Office of the Inspector General for the United States Department of Health and Human services expressly reserves all rights to institute or to maintain any administrative action seeking exclusion against PPGC.

4. Nothing in this Agreement shall constitute a waiver of the rights of the Government to audit, examine, or re-examine PPGC’s books and records….

Planned Parenthood Gulf Coast $4.3 Million Settlement Agreement with Government

 

[mac]

I posted the judge's dismissal and opinion. You can read it yourself.

Right, and then settled on the rest.

 

[sangha]

then feel free to list it

Feel free to read it

 

[mac]

The false charges allegations in the Catholic Healthcare link that yeat2late posted and I reposted took place in 1990s and they finally settled in 2011.

And? So what?

 

[sangha]

I've already posted several including actual pleadings. Try reading.

The abortion banners seem to think that pretending that facts haven't been posted, will make them go away and that our refusal to repost things they didn't read to begin with (or pretending they didn't read them) means that they weren't posted.

 

[Dr. Chuckles]

The abortion banners seem to think that pretending that facts haven't been posted, will make them go away and that our refusal to repost things they didn't read to begin with (or pretending they didn't read them) means that they weren't posted.

besides be very pro-abortion, it isn't my fault that her posts are so filled with irrelevant character attacks that people may miss her addressing something of actual substance.

***I write "may" because I haven't had a chance to read the links provided above***

 

[nota bene]

I have posted facts, Sangha. I posted the Texas Attorney General's website link that summarizes, and I also posted the actual settlement document's link.

 

[sangha]

besides be very pro-abortion, it isn't my fault that her posts are so filled with irrelevant character attacks that people may miss her addressing something of actual substance.

***I write "may" because I haven't had a chance to read the links provided above***

I am not at all surprised that you won't take responsibility for not seeing or recognizing the facts about the evidence that SS posted.

 

[sangha]

I have posted facts, Sangha. I posted the Texas Attorney General's website link that summarizes, and I also posted the actual settlement document's link.

No, their statement was nothing more than a dishonest and politically motivated claim.

 

[Dr. Chuckles]

I am not at all surprised that you won't take responsibility for not seeing or recognizing the facts about the evidence that SS posted.

Yeah, I'm not responsible for someone's inability or poorly thought out attempt to communicate something

 

[sangha]

Yeah, I'm not responsible for someone's inability or poorly thought out attempt to communicate something

I had no problem recognizing the facts she posted. If you had a problem, maybe it's not her fault.

 

[SassySmartie]

Right, and then settled on the rest.

Even the judge was concerned with the spending going on in this case. Especially since it was Reynolds and not the DOJ nor the Texas AG bringing or paying for the case.

You can read here in the Transcript of the Case Management Conference, where the judge asks about the lengthy list of witnesses, questions Reynold's attorney about the expenses and the rationale behind their choices in this case. Reynold's legal team wanted to use the discovery phase of this case to find proof of Reynold's allegations, they were casting a wide net, hoping that discovery would provide proof, when the fact of the matter is that it is the burden of the plaintiff to show cause and proof that there was wrong doing by PP. Reynolds did not do this. That is why neither the State of Texas [even though Abbott who is the state AG and running for Governor next year, posted that press release as if HE secured this settlement when he did not] nor the US DOJ bothered to investigate Reynold's complaints in 2009. Further, the complaint was sealed until 2011, once the State and DOJ opted not to pursue an investigation or case when Reynolds was free to bring this suit herself on behalf of the state and DOJ. Clearly both offices didn't feel they had enough information or evidence to launch and investigation, or enough to warrant spending money on taking the case to trial.