Summary
ADF represents Susan Thayer, a former director of two Iowa Planned Parenthood clinics, in a False Claims Act lawsuit seeking to hold her former employer responsible for nearly $28 million in “repeated false, fraudulent, and/or ineligible claims for reimbursements” to Medicaid.
The complaint alleges that Planned Parenthood billed Medicaid for ineligible abortion-related expenses, billed excessive amounts of birth control pills through an automatic “C-Mail” (contraceptive mail) renewal program, re-billed some pills that were returned undeliverable, overbilled for services not performed by qualified health care professionals, and billed for prescriptions not properly prescribed by a physician.
The complaint also alleges that Planned Parenthood coerced partial payments from low income patients and yet counted those payments as voluntary contributions so that it could bill the full amount of those services to Medicaid. Thayer also alleges that Planned Parenthood caused area hospitals to unknowingly submit false claims to Medicaid by encouraging women to report to an emergency room with any abortion complications and to tell the E.R. that they were experiencing a miscarriage – causing the E.R. to seek reimbursement from Medicaid for services that were ineligible completions of abortions.
Case timeline
- March 2011: Sue filed her original complaint as a qui tam plaintiff under the federal False Claims Act (FCA), which allows a private party to bring a claim on behalf of the government and gives the government an opportunity to intervene. Neither the federal government nor the state of Iowa chose to intervene, and the court ordered the case to be unsealed.
- July 2012: Sue filed her unsealed complaint, in which she alleged four schemes in which Planned Parenthood of the Heartland fraudulently obtained and retained millions of dollars of Medicaid reimbursements.
- December 2012: The district court granted Planned Parenthood’s motion to dismiss Sue’s complaint.
- March 2013: ADF filed an appeal with the U.S. Court of Appeals for the 8th Circuit.
- August 2014: The 8th Circuit upheld the district court’s dismissal of two claims. However, it reversed and remanded its decision on the other two claims: first, that Planned Parenthood filed fraudulent claims for reimbursement for unprescribed contraceptives that Planned Parenthood’s staff illegally dispensed without a physician’s order. And second, that Planned Parenthood illegally billed Medicaid for routine, abortion-related follow-up visits.
- June 2016: The district court ruled in Planned Parenthood’s favor on both these claims based on the limited evidence Planned Parenthood had agreed to turn over during discovery, and ADF appealed that ruling back up to the 8th Circuit, representing Sue at oral argument in May 2021.
- October 2020: Planned Parenthood tried to punish Sue for taking a stand by filing a motion to collect more than $2 million in attorney’s fees from Sue and her attorneys. An award that large would have bankrupted Sue, and ADF vigorously opposed it. Thankfully, the district court denied the motion.
- September 2021: Unfortunately, the 8th Circuit upheld the district court’s summary judgment ruling, ending Sue’s lawsuit to hold Planned Parenthood accountable for endangering women and defrauding taxpayers.
