California officials have agreed to an $18 million settlement in a lawsuit brought by two whistleblowers who accused a medical company of overbilling medical insurers for birth control prescriptions doled out without the required oversight by physicians.
The agreement comes in a previously secret lawsuit filed in Sacramento Superior Court in 2019 by two former nurse practitioners who worked for a company called The Pill Club.
The settlement calls for the state Justice Department to be paid $15 million and the state Insurance Department to receive $3.275 million, according to an announcement by attorneys Michael Hirst of Davis and Anderson Berry of Sacramento.
The agreement calls for the whistleblowers — Cindy Swintelski Schwartz and Happy Baumann — and their lawyers to share $4.59 million from the settlement, which does not include an admission of liability by The Pill Club.
The Pill Club did not immediately provide comment Tuesday to an email query about the settlement.
The lawsuit, filed under seal through the California False Claims Act, alleged that The Pill Club and affiliates “participated in a scheme that defrauded millions of dollars from Medi-Cal and private health care insurance providers in at least 38 states, including California.”
“Defendants knowingly and routinely presented bills to Medi-Cal and private health care insurers for patients prescribed birth control pills and related products by nurse practitioners that were not properly supervised under...
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