The Pill Club is seeking $18.3 million in damages for alleged Medicaid fraud in California.

Online pharmacy of contraceptives The Pill Club has reached an $18.3 million settlement with California authorities for alleged fraud under the state Medicaid program.

The company billed Medi-Cal for services it did not provide, allegedly requesting 30-minute face-to-face consultations when its nurse practitioners had no direct or real-time contact, according to the California Department of Justice. with patients. The California Insurance Department said a contraceptive provider would bill for in-person visits when nurses only review patient forms.

The state Department of Justice also said that The Pill Club distributed female condoms to beneficiaries who did not want or did not request contraceptives, billing Medi-Cal well above the retail price.

The settlement requires $15 million to be paid to the Justice Department and $3.3 million to go to CDI. It comes just days after a state court uncovered a whistleblower complaint against The Pill Club, where former nurse practitioners also alleged the company defrauded private insurers in at least 38 states, including California.

According to According to their lawyers, the whistleblowers will receive nearly $5 million from the settlement.

“The Pill Club unacceptably siphoned off Medi-Cal funding designed to help vulnerable populations access essential health services,” California Attorney General Rob Bonta said in a statement. “I am grateful to the whistleblowers and our investigators who were instrumental in bringing The Pill Club to justice.

“At the California Department of Justice, we fight every day to protect and expand access to healthcare. We will not tolerate companies that try to illegally get rich off Medi-Cal.”

A spokesperson for The Pill Club stated that it is not required to control or change any business practices as part of the settlement, and they noted that this is not regulated in any other states. However, the company plans to improve its billing practices, update measures to ensure patients only get the medications and contraceptives they request, and introduce new patient informed consent methods.

“When I joined The Pill Club just over two years ago, I was drawn to the challenge of strengthening our operations to align with our mission. I am pleased that I have the opportunity to address these issues and once again focus our attention on expanding access to contraceptives for all who need them,” Liz Meyerdirk, CEO of The Pill Club, said in a statement.

BIG TREND

The Pill Club, launched in 2016, has collected Series B at $51 million three years later and another $41.9 million in 2021.

The company briefly changed its name to Favor to highlight its non-contraceptive services, but reverted to his old branding following a lawsuit from a restaurant and retail delivery company that also used the name.

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texasstandard.news contributed to this report.

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