Pro-choice protester holds a sign outside the Bank of America building in Austin: "I asked God, She's pro-choice."
Alexa Garcia-Ditta

State: Two Planned Parenthood Affiliates Guilty by Association

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Above: Controversy over Planned Parenthood's fetal tissue donation practices brought supporters and detractors of the health care provider to downtown Austin in October.

The state has formally begun the process of ousting two more Texas Planned Parenthood affiliates from the joint state-federal Medicaid program, though it hasn’t yet wrapped up investigations into some of the health care providers’ tissue donation practices.

In letters received by Planned Parenthood Greater Texas (PPGT) and Planned Parenthood South Texas (PPST) on Wednesday, the Texas health commission’s Office of Inspector General (OIG) wrote that those two affiliates’ connections with Houston’s Planned Parenthood Gulf Coast, which once provided fetal tissue to university researchers, signals that they are in violation of Medicaid policy and federal law.

“Our rules provide that if you are affiliated with a provider that commits program violations subjecting it to enrollment termination, then you, as an affiliate, are subject to the same enrollment termination,” wrote Health and Human Services Commission Inspector General Stuart Bowen. The letter came two days after Bowen’s office informed the Gulf Coast affiliate that the state intended to terminate its Medicaid participation.

Together, the three groups serve approximately 13,000 Texas Medicaid patients per year.

Neither the Greater Texas nor the South Texas affiliates — which serve Dallas-Fort Worth, Central Texas and the Rio Grande Valley — are featured in a recent series of heavily edited videos created by activists who say Planned Parenthood is profiting illegally from the sale of “baby parts” obtained from legal abortion procedures. However, members of the anti-abortion group Center for Medical Progress, posing as tissue procurement professionals, did secretly film conversations about tissue donation with employees at Planned Parenthood Gulf Coast and other Planned Parenthood locations nationwide.

The videos sparked two separate Texas investigations into the health care provider’s fetal tissue donation practices — one from the attorney general’s office, the other from the Legislature’s Senate Health and Human Services Committee — both of which are ongoing. Neither PPST nor PPGT participate in fetal tissue donation. Similar investigations in other states have turned up no evidence of civil or criminal misconduct.

Nevertheless, the HHSC Office of the Inspector General stated its intent to boot the affiliates from participation in Medicaid in three letters addressed to top-ranking leaders at PPST and PPGT Wednesday.

Jeffrey Hons, president and CEO of PPST, told the Observer Wednesday that his affiliate “will fight this with every tool at our disposal, including legal action.”

“We’ve never participated in fetal tissue donation for research, we have not had the kinds of things that the letter says about Medicaid billing matters,” Hons said. “For [the OIG] to say that those things apply to San Antonio, Harlingen, and Brownsville, this doesn’t pass the smell test.”

Neither the attorney general’s office nor Senate committee investigators have so far released any evidence of wrongdoing, or brought any civil or criminal charges against a Texas Planned Parenthood employee or affiliate.

The organizations have 30 days to respond to the inspector general. Among the three Texas affiliates, five Planned Parenthood health centers provide abortion services, while another 30 provide cancer screenings, contraception and other preventive care services.

As the Observer reported Monday, a state cannot exclude a qualified provider from participating in the federal Medicaid program simply because it opposes certain services it provides, but must show that a provider has committed program policy or law violations. Neither the attorney general’s office nor Senate committee investigators have so far released any evidence of wrongdoing, or brought any civil or criminal charges against a Texas Planned Parenthood employee or affiliate.

Texas’ latest efforts at a Planned Parenthood Medicaid ban mirror those in other states, similarly motivated by their opposition to abortion. In 2013, Arizona and Indiana unsuccessfully tried to kick Planned Parenthood out of their Medicaid programs. Most recently, Louisiana Governor Bobby Jindal tried to boot the provider, but a federal judge ruled Monday that Louisiana must continue to fund the organization while Planned Parenthood’s lawsuit against the state winds it way through the courts.

Under the federal Social Security Act, Medicaid-eligible patients have the right to receive services at the qualified health care provider of their choice, and Texas has already grappled with the federal government over Planned Parenthood and Medicaid dollars once before. In 2012, Texas forfeited a 9-to-1 federal match in funds when it kicked Planned Parenthood out of what was then called the Medicaid Women’s Health Program, which provided cancer screenings and contraception to low-income Texans. The federal government pulled its match, saying Texas was in violation of the Social Security Act, and the state rebuilt the program, which now sees fewer clients than the original, with its own funds.

In 2015, the state also booted Planned Parenthood from providing services through the Breast and Cervical Cancer Services program, and last week, the Texas Tribune reported that the state has blocked Planned Parenthood from the state’s Abstinence Education Services program.