California settles lawsuit against mail-order birth control whistleblowers
California authorities have agreed to an $18 million settlement in a lawsuit brought by two whistleblowers who accused a health care company of overbilling health insurers for birth control prescriptions that were dispensed without the necessary monitoring by doctors.
The settlement 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 $15 million to be paid to the state Department of Justice and $3.275 million to the Department of State Insurance, attorneys said in a statement. Michael Hurst of Davis and Anderson Berry of Sacramento.
The settlement calls for the whistleblowers — Cindy Swintelski Schwartz and Happy Baumann — and their attorneys to share $4.59 million from the settlement, which does not include an admission of liability Club pills.
Pill Club did not immediately comment on an emailed request for a settlement on Tuesday.
The lawsuit, filed under seal under California’s False Claims Act, alleged that The Pill Club and its affiliates “engaged in a scheme that defrauded Medi-Cal and private health insurance providers of millions of dollars in at least 38 states, including California “.
“Defendants knowingly and routinely billed Medi-Cal and private health insurers for patients who were prescribed birth control pills and related products by nurse practitioners who were not properly supervised by physicians under California law,” the lawsuit states.
The lawsuit alleged that nurse practitioners who prescribe birth control rarely talk to patients in person or on the phone, instead using text messages or email.
“A nurse practitioner (‘NP’) spends approximately 15 seconds to several minutes assessing and diagnosing a patient before prescribing birth control,” the lawsuit states. “NPs are advised to fill a staggering 120 prescriptions a day and some claim they can fill 600 a day.
“Thus, in California alone, defendant NPs may write thousands of prescriptions each day. Pharmaceuticals and other products are then delivered by mail with no delivery charge and, depending on the health insurer, no co-pay. Supplies also come with “chocolate and sample gifts”.
In a statement, Hearst said Pill Club officials ignored whistleblower complaints that they were pressured to prescribe contraceptives without a doctor’s supervision.
“At the same time, The Pill Club was forcing them to write more prescriptions per day on a daily basis,” Hurst said in a statement. “We are proud of whistleblowers for their courage to come forward to stop behavior they knew was wrong.
“If more people did this, there would be a lot less waste, fraud and abuse in our health care system.”