Missouri withholds Medicaid payments to Planned Parenthood for second year

The state of Missouri, in a legal battle with Planned Parenthood to restrict abortions, has also withheld more than $1 million in Medicaid payments since mid-2018 for cancer screenings, sexually transmitted disease (STD) testing and birth control that the organization’s clinics provide to low-income patients.

Hearings before the state’s administrative hearing commission have been scheduled for early December after the two Planned Parenthood affiliates that operate clinics around the state lodged separate complaints against the Department of Social Services.(DSS)

Medicaid dollars cannot be used to pay for abortions. The only clinic in the state that performs abortions in Missouri is Planned Parenthood’s St. Louis facility. The organization’s other clinics provide non-abortion-related services.

DSS cited a change in the state budget, passed by the Missouri legislature in May, as the reason it began to withhold Medicaid reimbursements beginning July 1. It bars payments to any clinic—or an affiliate or associate of that clinic—other than a hospital.

““[N]o funds shall be expended to any clinic, physician’s office, or any other place or facility in which abortions are performed or induced other than a hospital, or any affiliate or associate of any such clinic, physician’s office, or place or facility in which abortions are performed or induced other than a hospital,” the appropriation bill reads.

The intention was to improve upon language inserted into the state budget last year that also prohibited funds from going to abortion providers and their affiliates, according to Missouri House Budget Chair Cody Smith, R-Carthage.

The revision to last year’s budget was overturned by a St. Louis circuit court judge, who said lawmakers couldn’t legislate multiple subjects under one bill and had to use plain language in appropriations bills.

“Because of the (court) decision that we should not reference statute in (budget) language, we took that out and then rewrote it, trying to preserve the spirit of the original intent of that language,” Smith said.

Last year’s attempt is still in litigation. The Missouri Supreme Court announced last month that it will hear the state’s appeal of the circuit court decision Dec. 10.

“We are not saying women can’t go to these facilities -- this is not a prohibition of women going to these facilities,” Smith said. “This is a prohibition of taxpayer dollars from going to these facilities.”

Because of the ongoing litigation, Planned Parenthood clinics across the state have not been reimbursed for those services since July of 2018.

Planned Parenthood of the Great Plains, which includes clinics in Kansas City and Columbia, said it is owed between $600,000 and $800,000 in services to Medicaid patients over the two budget years.

“Because of the case status, the claims haven’t been going through the normal adjudication process,” Mandy Culbertson, the affiliate’s spokesperson, wrote in an email. “We won’t have a specific number until all claims are filed, and reviewed for approval/denial.”

Planned Parenthood of the St. Louis Region and Southwest Missouri, which includes clinics in St. Louis, Springfield, St. Peters and Joplin, is waiting on $407,000 in Medicaid payments for services provided between July 1, 2018 and June 30 of this year, it said.

Since July 1, they have provided about $125,000 in uncompensated care.

“We will continue to have our doors open to provide care for anyone who needs it,” Jesse Lawder, PPSLR’s spokesperson, said.

The dispute over Medicaid payments is only the latest front in Planned Parenthood’s struggle with the state.

It has contested the Department of Health and Senior Services’ decision to yank its license to perform abortions in its S. Louis clinic, a move that would leave Missouri the only state without an abortion provider. An administrative hearing commissioner is expected to make a decision after February.

Planned Parenthood has also battled with the state in in federal court, challenging a recently passed Missouri law that criminalizes abortions after 8 weeks of pregnancy. While a majority of the law has been stayed by a federal judge, the issue will eventually be considered by the Eighth Circuit Court of Appeals.

Missouri has drawn national attention for its stringent abortion laws and regulations. A DHSS rule requiring physicians to perform a pelvic exam three days prior to the procedure was rolled back after Planned Parenthood called it ‘invasive’ and ‘dehumanizing.’

The same director, Dr. Randall Williams, was again under scrutiny last month after it was revealed that the health department kept a spreadsheet which tracked the periods of some Planned Parenthood patients in an attempt to find post-abortion complications.

The protracted battles in Missouri have drawn the attention of Congress; on Thursday, the House Oversight Committee will host a majority-Missouri panel to discuss restrictions on access to abortion.

This story was originally published November 14, 2019 at 1:07 PM.