The state of California has announced an $18.3 million settlement with The Pill Club (TPC) to resolve allegations that TPC improperly billed Medi-Cal between January 2016 and October 2022. TPC agreed to pay the California Department of Justice (DOJ) $15 million to resolve allegations brought under the state’s False Claims Act (Cal. Gov’t Code § 12650(b)(3)) and the California Department of Insurance (DOI) $3.3 million to resolve allegations brought under the state Insurance Fraud Prevention Act (Cal. Ins. Code § 1871.1) (ICPA). The whistleblowers will split a total of $4.6 million from the state’s settlements.
TPC is a Silicon Valley-based online-only pharmacy providing prescription and delivery services for reproductive health and birth-control-related products. According to its website, TPC serves approximately three million people who menstruate (regardless of gender identity) throughout 49 states and the District of Columbia by combining “telemedicine and direct-to-consumer pharmacy” services. TPC advertises auto-refills and acceptance of most insurance plans, including Medicaid. Accordingly, TPC claims that most patients will pay $0 for women’s health products; if a patient does not have insurance, TPC starts its pricing as low as $8.95 per product.
On March 28, 2019, two nurse practitioners (NPs) formerly employed by TPC filed a qui tam complaint under seal against the digital pharmacy alleging that it had submitted tens of thousands of false claims for reimbursement...
Patricia White, 70, of Old Greenwich, received a nine-month prison sentence for submitting false claims for unclaimed properties to around 30 state treasuries. HARRISBURG, Pa. — Months after her br...