Nearly six months after Gov. Mary Fallin asked the Oklahoma Health Care Authority to end its Medicaid contracts with Oklahoma’s Planned Parenthood groups over “alarming” billing-error rates, the agency has terminated the contracts “without cause,” according to an agency press statement.
While OHCA refused interviews Thursday and will not say whether the decision was made related to the reproductive care providers’ previous 14.2 percent and 20.3 percent billing-error rates, NonDoc has been investigating Gov. Fallin’s request and SoonerCare error rates for months.
The results show other providers with billing-error rates four to six times higher than the Planned Parenthood groups.
In addition, OHCA officials have said they cannot provide comparative “rate” data for providers like hospitals because their audit contracts treat those organizations differently.
Of the rates provided to NonDoc, Success Vision Express of Tulsa LLC had an 88.5 percent error rate, Nanda Orthodontics in Edmond had a 72.1 percent error rate, and Ocean Dental in Stillwater had a 60.7 percent error rate. No one with any of those organizations replied to requests for comment as of this report’s publication.
OHCA silent on contract termination
OHCA CEO Nico Gomez told NonDoc in January that terminating a provider contract is “a CEO decision” that does not require board action.
“The end of the day, that decision lies with me — termination or whatever remedy we choose to do — and I look at it on a case-by-case basis,” Gomez said, adding that, at the time, the Planned Parenthood audit and remediation plan were ongoing. “Obviously, I’ll have to respond to whatever action we take or don’t take.”
But Thursday, OHCA communications director Jo Kilgore said Gomez would not do an interview about his decision.
Angie Remington, public relations manager for Planned Parenthood of the Heartland, which operates the group’s Eastern Oklahoma clinic, did an interview with NonDoc in March while OHCA continued to say review of the audit was ongoing.
“It definitely feels like Planned Parenthood has been singled out,” she said. “This is a process that other Medicaid providers go through. I don’t know what the error rates are for other Medicaid providers, but you certainly don’t see the governor coming out and calling out other providers for their billing-error rates at step one in the process, especially.”
In response to records requests, the agency provided NonDoc with billing error rates for nine dentists and optometrists that were higher than Planned Parenthood’s rates.
Agency representatives said they could not provide NonDoc with billing-error rates for federally qualified health centers or hospitals, and they reportedly have not responded to records requests from the Associated Press for similar information.
The AP reported Thursday that Gomez said he informed the organizations in February that their contracts would be terminated.
Planned Parenthood’s ‘doors remain open’
Reached Thursday, Remington said she no longer works for Planned Parenthood, and she directed comment to Susan Allen, the organization’s marketing and communications director.
“Our doors remain open for the people who choose Planned Parenthood for their health care, including patients who are covered by Medicaid,” Allen said, referring to the OHCA’s announcement that the contracts would run through June 29.
Allen declined further comment, but Remington had noted in March that the organization filed a lawsuit in Arkansas over a similar situation. Kansas is also taking action to defund the organization, and Planned Parenthood filed a lawsuit Wednesday in response.
“I can just say that this is part of a political move to end access to care and abortions. This is something that has been happening increasingly in the past five years,” Remington said. “I think the governor knows that we do not provide abortion in Oklahoma, but I think this being part of a broader political attack across the nation, she’s not taking that into consideration.”
Conversations with stakeholders have indicated broad belief that Gov. Fallin’s request for Planned Parenthood contract termination came as a political response to controversial videos that purported to show Planned Parenthood staff selling aborted fetuses for research, but a call to the governor’s press secretary Thursday went unreturned.
“They basically asked us to do an investigation of Planned Parenthood, and that was to go out and do a clinical audit, and that’s what we did,” OHCA director of program integrity and accountability Kelly Shropshire told NonDoc in February. “[Planned Parenthood] did request an informal reconsideration, so we took the information they asked us to look at in rebuttal to some of the questioned items.”
Shropshire gave a lengthy explanation of OHCA audit processes and noted that data is reviewed and compared to a larger universe of claims.
“It’ll be done real soon,” Shropshire said of the review in February.
NonDoc made multiple requests for the results of that review over the following months but was not provided with further information. As a result, the 14.2 percent and 20.3 percent error rates for Tulsa and OKC Planned Parenthood locations, respectively, may have gone either up or down owing to the audit results.
In January and February, OHCA officials said the agency had never terminated a SoonerCare contract based on billing-error rates.
Kilgore declined to answer whether Thursday’s contract termination was related to the billing-error rates.
“The decision was made without cause,” she said.