Arkansas has once again cut off Medicaid funding to Planned Parenthood following a recent court ruling.

The state’s Department of Human Services said it terminated Planned Parenthood’s status as a Medicaid provider last week when the court’s ruling formally took effect, according to The Associated Press.

{mosads}A federal appeals court in August vacated an earlier injunction that prevented the state from stopping Medicaid payments to Planned Parenthood and said earlier this month it would not reconsider its decision. 

Four circuit courts and numerous district courts in other states have ruled that states can’t block Medicaid funds to Planned Parenthood. 

Planned Parenthood has not said whether it will appeal the Missouri case to the Supreme Court. 

“Planned Parenthood Great Plains remains committed to serving our patients regardless of their ability to pay while we continue fighting to protect the right of Arkansas women and families to access critical health care services,” Aaron Samulcek, interim president and CEO of Planned Parenthood Great Plains, said in a statement.

“Every individual ought to have the freedom to choose their health care provider and for many in Arkansas, that choice is Planned Parenthood Great Plains.”

Arkansas blocked Medicaid funding in 2015 in response to undercover videos released by an anti-abortion group.