California Fines Online Health Provider $3.2M over Claims Practices

The Pill Club Holdings Inc. (dba The Pill Club) paid $3.2 million after the California Department of Insurance alleged it violated the California Insurance Frauds Prevention Act by submitting false claims to insurance companies for reimbursement for telehealth visits and prescribing and dispensing FC2 female condoms that were not medically necessary.

The Pill Club is an online health company that offers hormonal birth control, emergency contraceptives, and female condoms to patients through telehealth appointments.

Nurse practitioners employed by The Pill Club review the online questionnaires filled out by patients and prescribe hormonal birth control or FC2 female condoms based on a patient’s answers. The Pill Club is reported to have falsely billed for the nurse practitioners’ review of the questionnaires by claiming it was an in-person visit lasting 16-30 minutes.

The Pill Club also allegedly submitted false claims to health insurers for reimbursement for FC2 female condoms that patients did not want and were not medically necessary. The Pill Club then dispensed the FC2 female condoms from in-house pharmacies based out of California and Texas.

The CDI began an investigation after receiving a complaint alleging The Pill Club violated California law and had a pattern of submitting fraudulent insurance claims. The California Attorney General separately also reached a settlement with The Pill Club for alleged violations under the California False Claims Act.

Medical Professional Liability

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