CVS Faces Legal Action Over Filling Unlawful Prescriptions

In a civil lawsuit unsealed today, the U.S. Department of Justice has accused CVS Pharmacy Inc. and its subsidiaries of filling unlawful prescriptions in violation of the Controlled Substances Act (CSA) and seeking reimbursement for those prescriptions from federal healthcare programs, violating the False Claims Act (FCA). CVS, the nation's largest pharmacy chain with over 9,000 locations, stands accused of contributing to the opioid crisis by filling prescriptions for controlled substances that lacked medical legitimacy.

Unlawful Prescriptions Alleged

The government’s complaint claims that, from October 17, 2013, to the present, CVS knowingly filled prescriptions for dangerous and excessive quantities of opioids, early refills, and "trinity" prescriptions—an especially harmful combination of an opioid, benzodiazepine, and muscle relaxant. CVS also allegedly dispensed large quantities of controlled substances prescribed by "pill mill" doctors, who issued prescriptions without any legitimate medical purpose.

The lawsuit asserts that CVS ignored internal data and reports from its pharmacists indicating that it was filling unlawful prescriptions. These actions allegedly led to opioid overdoses and deaths, contributing to the ongoing crisis.

Corporate Practices Under Scrutiny

The government claims that CVS’s violations were driven by corporate performance metrics and staffing policies that prioritized profits over patient safety. According to the complaint, CVS set unrealistic staffing levels that left pharmacists unable to properly verify the legitimacy of prescriptions, even as they were under pressure to meet performance targets. The company allegedly prevented pharmacists from sharing crucial information with each other about certain prescribers, making it more difficult to identify suspicious prescriptions.

As a result, the lawsuit asserts, CVS played a significant role in enabling the illegal distribution of opioids, fueling addiction, and exacerbating the opioid crisis.

Legal and Financial Consequences

The Justice Department’s complaint seeks civil penalties for each unlawful prescription filled in violation of the CSA, as well as damages and penalties for prescriptions reimbursed by federal healthcare programs in violation of the FCA. The court could also impose injunctive relief, requiring CVS to reform its corporate practices and compliance policies to prevent further violations.

Principal Deputy Assistant Attorney General Brian M. Boynton stated, “CVS repeatedly filled controlled substance prescriptions that were unlawful and pressured its pharmacists to fill them without confirming their validity. These practices contributed to the opioid crisis and opioid-related deaths.”

National Impact and Ongoing Investigations

This legal action reflects the government's commitment to holding entities accountable for their role in the opioid epidemic. U.S. Attorney Zachary A. Cunha emphasized the importance of holding corporations responsible when they prioritize profits over patient safety.

Whistleblower Hillary Estright, a former CVS employee, originally filed the lawsuit under the qui tam provisions of the False Claims Act, allowing private citizens to sue on behalf of the government for fraud. The case has drawn support from numerous law enforcement agencies, including the DEA, HHS, and the Department of Defense, highlighting the severity of the allegations and the ongoing effort to combat opioid-related harm across the country.

As the case continues to develop, CVS faces significant legal and financial consequences. The claims against the company are currently allegations, with no determination of liability yet made. However, if found guilty, CVS could face substantial penalties and be required to implement major changes to its operations.

Conclusion

The allegations against CVS underscore the critical role pharmacies play in ensuring the safe and lawful distribution of prescription medications. With the opioid epidemic continuing to devastate communities, this lawsuit serves as a reminder that corporations must prioritize patient safety over profits. The outcome of this case could set an important precedent for how large pharmacy chains are held accountable for their role in the ongoing crisis.