Should dentists provide family-planning services?

With the debate about Planned Parenthood raging, Louisiana attorneys set out to put together a list of health care providers that could provide equivalent family-planning care should Planned Parenthood be defunded. However, the list included some unconventional options – options that left many people skeptical and scratching their heads.

In response to the contentious videos reportedly depicting Planned Parenthood employees selling fetal parts in August, Louisiana Governor Bobby Jindal moved to cut off $730,000 in Medicaid reimbursements received by the two Planned Parenthood clinics in the state. Planned Parenthood requested an injunction from federal court to block Jindal’s movement. According to a recent report by Mother Jones, the clinics in Louisiana do not provide abortions, but offer STD and cancer screenings, contraceptives and pap smears to low-income women on Medicaid.

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Attorneys representing the Louisiana Department of Health and Hospitals, looking to get a ruling on the legality of ending Planned Parenthood’s Medicaid contracts, presented a federal court judge with a list of over 2,000 family-planning providers in the state that could accommodate patients previously utilizing the clinics’ services. However, the judge found that the list included hundreds of specialists not usually associated with family planning, such as dentists, ophthalmologists, cosmetic surgeons and ear, nose and throat doctors.

Dentists providing family-planning services? The judge was skeptical. “It strikes me as extremely odd that you have a dermatologist, an audiologist, a dentist who are billing for family-planning services,” said Judge John deGravelles. “You’re telling me they can provide family planning and related services?”

Attorneys for Planned Parenthood were also skeptical. "The list the defendent [Louisiana Department of Health and Hospitals] provided appears to be a list of all enrolled Medicaid providers," said Carrie Flaxman, attorney for Planned Parenthood. "There are numerous examples of ... providers that would not provide the care that Planned Parenthood provides, including dentists, radiologists, nursing homes, places that are not going to do breast cancer screenings or give out birth control."

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But the state did not withdraw the list without a fight. A Louisiana attorney stood by the list, saying that dentists could indeed provide family-planning services. According to court transcripts, Judge DeGravelles asked the attorney “We have dentists on there, sir. There are dentists listed ... You’re telling me that they can provide family planning and related services?”

“They have,” said the attorney. “That what I’m telling you, Judge."

The attorney acknowledged that the dentists had been included on the list because "what they did was pull a code run and they matched the codes that are typically billed ... codes that were typically family-planning codes," implying that these dental practices on the list had at one time billed an ICD code that fell within a loose collection of codes the state associated with family planning.

Under the judge's scrutiny, the state ultimately submitted a new list of health care providers that could legitimately offer the services. 

The Louisiana Department of Health and Hospitals conceded in the amended list submission that “ dentists should not have been included in” the list. The revised list consisted of just 29 providers, down from the initial list of over 2,000. 

"There are huge needs in the state for [Planned Parenthood] services," said Flaxman. "If the patients could find other providers to provide the care the defendent will be paying for those services under its obligations anyway under Medicaid."