Abortion

LePage Administration Goes After Family Planning Group

The Family Planning Association of Maine (FPAM) asked a judge to overturn a Maine state government order that the organization repay more than $180,000 the government claims it overpaid the nonprofit.

The Family Planning Association of Maine (FPAM) asked a judge to overturn a Maine state government order that the organization repay more than $180,000 the government claims it overpaid the nonprofit. Shutterstock

The Family Planning Association of Maine (FPAM) asked a judge to overturn a Maine state government order that the organization repay more than $180,000 the government claims it overpaid the nonprofit.

FPAM was reimbursed $184,000 for reproductive health-care services that the Maine Department of Health and Human Services (DHHS) claims were related to abortion services. The reimbursements were made through MaineCare, the state’s Medicaid program, from January 2006 through August 2010.

DHHS claims that any health care provided to women on the same day that they had an abortion constitutes abortion related services, regardless of whether the services are directly related to an abortion procedure.

Federal law prohibits Medicaid reimbursements for abortion services, with limited exceptions.

Maine DHHS commissioner Mary Mayhew said in a statement Wednesday that the state Medicaid regulations prohibit reimbursement for “any services ancillary to a non-covered service.”

Maine state law prohibits state funding of abortion care through MaineCare unless a physician certifies that the procedure is necessary to preserve the woman’s life or the pregnancy is the result of rape or incest. The physician must provide written justification as to the necessity of the abortion procedure.

The MaineCare benefits manual does not specify if abortion services include anything other than the abortion procedure.

The DHHS “consistently interpreted MaineCare rules to cover reimbursement for clinically necessary reproductive healthcare services provided to pregnant women regardless whether those women subsequently had abortions,” according to the appeal filed in Kennebec County Superior Court.

“We got some direction from the department more than 10 years ago for what services would be reimbursable, and they said we were not allowed to bill them that way anymore,” Kathleen Brogan, vice president for public affairs at Maine Family Planning, told the Kennebec Journal. “They just changed their interpretation of what was appropriate and never let us know. We think it’s very interesting that we billed that way through two administrations, and very soon after the current administration took over, it became unacceptable.

FPAM claims that the state in recent years has reimbursed the organization for those services, but that the policy was changed by Republican Gov. Paul LePage’s administration without notifying the FPAM of the change.

FPAM officials say they discontinued billing the state for those services after the change became apparent.

DHHS spokesman David Sorensen told the Kennebec Journal that the department had conducted an audit of FPAM that revealed it “had been improperly billing Maine’s taxpayer-funded Medicaid program for abortion-related services in violation of Medicaid law.”

“The department has taken appropriate action to enforce the law, treating Maine Family Planning’s case as it would any other audit of a MaineCare provider,” Sorensen said.

LePage, first elected in the massive Republican gains of the 2010 midterms, is staunchly anti-choice, and this year commended the goal of trying “to repeal and eliminate the heinous act of abortion,” reported the Kennebec Journal.

LePage has refused to expand Medicaid under the Affordable Care Act, like many GOP governors nationwide. Expansion would provide an estimated 70,000 low-income residents in the state with access to health care. Maine remains one of 19 states that have not expanded the program.

A bill that would have ensured access to preventive health services for nearly 14,000 low-income women in Maine was vetoed by LePage in May 2014, despite being passed with broad bipartisan support.

The proposal would have expanded family planning services for low-income women under MaineCare, and included coverage for cancer screenings, well-woman exams, birth control, and testing and treatment for sexually transmitted diseases, along with sexual health information.

FPAM’s appeal to the Maine Superior Court comes after the organization appealed audit findings and requested an administrative appeal hearing, which was held April 16.

“We are confident in our case and look forward to the opportunity to present it to the court,” Mayhew said.