On Tuesday a federal judge delayed the removal of Planned Parenthood from the state’s Medicaid program for the second time this year, again citing a lack of evidence from state attorneys.

Tuesday’s temporary injunction is the second block since U.S. District Judge Sam Sparks issued the first in January after a three-day trial. The state has attempted to defund Planned Parenthood since 2015 following accusations the health provider profited from fetal tissue donation. The health provider received a final notice of termination in December.

In 2015 anti-abortion rights group Center for Medical Progress released a video of Planned Parenthood Gulf Coast employees allegedly discussing the sale of fetal tissue. The group’s members went undercover in the video, disguising themselves as employees from a tissue procurement company and speaking with Melissa Farrell, PP Gulf Coast employee.

Sparks wrote in his decision that the video may have been altered and state attorneys lacked evidence the health provider profited from any fetal tissue procurement.

“The Inspector General had no evidence any PPGC doctor altered an abortion procedure, and the video he relied upon, the CMP Video, features unclear and ambiguous dialogue by Ms. Farrell, who had no personal knowledge of abortion procedures and conversations exploring theoretical possibilities,” Sparks wrote.

Sparks said the case warrants a full trial, which will be scheduled after attorneys provide more evidence within the next 30 days. State Attorney General Ken Paxton said in a prepared statement the video was enough to prove the health provider engaged in unethical behavior.

“The raw, unedited footage from undercover videos exposed a brazen willingness by Planned Parenthood officials to traffic in fetal body parts, as well as manipulate the timing and method of an abortion,” Paxton said in the satement.

Sparks also wrote that removing the health provider would deprive about 12,500 patients of service. Sparks said the state cannot argue there are more alternative providers to use because people have the right to choose which one they want.

“The declarations collectively show the Individual Plaintiffs do not know where they would get the same kind and quality of care,” Sparks wrote. “Each citing the nonjudgemental service the Provider Plaintiffs offer, the flexible hours, and the short wait times.”

State attorneys used an orthopedic surgeon to interpret and decide if the video showed unethical behavior, to which Sparks said the surgeon’s opinion was unreliable and irrelevant.

“While the Chief Medical Officer did provide the Inspector General with his opinion, that opinion was only offered as an analysis of what the CMP video showed, not whether a violation occured,” Sparks wrote.

Ken Lambrecht, the president and CEO of Planned Parenthood of Greater Texas, said in a statement that Texans may continue using the health provider’s other services.

“This ruling ensures that Medicaid patients can continue to receive birth control, cancer screenings, HIV tests, STD treatment and other essential healthcare services at Planned Parenthood’s health centers throughout Texas,” Lambrecht said.

UT law professor John Robertson, who testified for Planned Parenthood during the hearing in January, told the Daily Texan procedures can only be changed after an abortion and health providers cannot profit from, but may donate, fetal tissue.

“Donation of tissue is fine after the consent for the abortion,” Robertson said. “Money beyond expenses of procuring tissue cannot be paid.”