AUSTIN, Texas - Texas wants Planned Parenthood to give back millions of dollars in Medicaid reimbursements - and pay far more in fines on top of that - in a lawsuit that appears to be the first of its kind brought by a state against the largest abortion provider in the U.S.

A hearing was set for Tuesday in front of U.S. District Judge Matthew Kacsmaryk, who earlier this year put access to the most common method of abortion in the U.S. in limbo with a ruling that invalidated approval of the abortion pill mifepristone.

The case now before him in America’s biggest red state does not surround abortion, which has been banned in Texas since the U.S. Supreme Court overturned Roe v. Wade last year. But Planned Parenthood argues the attempt to recoup at least $17 million in Medicaid payments for health services, including cancer screenings, is a new effort to weaken the organization after years of Republican-led laws that stripped funding and imposed restrictions on how its clinics operate.

At issue is money Planned Parenthood received for health services before Texas removed the organization from the state’s Medicaid program in 2021. Texas had begun trying to oust Planned Parenthood four years earlier and is seeking repayment for services billed during that time.

“This baseless case is an active effort to shut down Planned Parenthood health centers,” said Alexis McGill Johnson, president of Planned Parenthood Federation of America.

Texas brought the lawsuit under the federal False Claims Act, which allows fines for every alleged improper payment. Planned Parenthood says that could result in a judgment in excess of $1 billion.

It is not clear when Kacsmaryk will rule.

The lawsuit was announced last year by Republican Texas Attorney General Ken Paxton, who is now temporarily suspended from office pending the outcome of his impeachment trial next month over accusations of bribery and abuse of office.