In a civil complaint unsealed in federal court in Providence, Rhode Island, the Justice Department has alleged that CVS Pharmacy, Inc., along with its subsidiaries, violated the Controlled Substances Act (CSA) and the False Claims Act (FCA). The lawsuit claims that CVS filled unlawful prescriptions and sought reimbursements from federal healthcare programs for these prescriptions.
The complaint alleges that since October 17, 2013, CVS knowingly filled prescriptions for controlled substances without legitimate medical purposes. Among these were large quantities of opioids and "trinity" prescriptions—a combination of an opioid, benzodiazepine, and muscle relaxant—often linked to prescribers known for "pill mill practices." It is claimed that CVS ignored evidence indicating their stores dispensed unlawful prescriptions.
According to the allegations, corporate policies at CVS prioritized profits over patient safety by imposing performance metrics on pharmacists without adequate staffing or information. This allegedly contributed to the opioid crisis and resulted in some patients dying after overdosing on unlawfully obtained opioids.
Zachary A. Cunha, U.S. Attorney for the District of Rhode Island stated: “Opioid deaths remain a scourge on communities across Rhode Island and the nation... This lawsuit alleges that CVS failed to exercise its critical role as gatekeeper of dangerous prescription opioids.”
Principal Deputy Assistant Attorney General Brian M. Boynton commented: “Our complaint alleges that CVS repeatedly filled controlled substance prescriptions that were unlawful... The practices alleged contributed to the opioid crisis.”
If found liable, CVS could face civil penalties under both acts and potential changes to its compliance programs may be ordered by the court.
Jessica D. Aber, U.S. Attorney for the Eastern District of Virginia remarked: “When lives are destroyed or lost to opioid abuse... Our laws regarding distribution... are clear and apply to everyone.”
DEA Administrator Anne Milgram said: “CVS is alleged to have dispensed large amounts of highly addictive opioid medications... Simply put, they put profits over their obligation to keep their customers safe.”
Deputy Inspector General Christian J. Schrank stated: “Pharmacies and pharmacists are critical partners... HHS-OIG is committed to holding individuals and entities accountable.”
Patrick J. Hegarty from DCIS added: “Today’s filing demonstrates DCIS’ ongoing commitment... investigate health care providers that submit false claims."
The case was initiated by whistleblower Hillary Estright under FCA's qui tam provisions which allow private parties to sue on behalf of the United States.
The litigation involves attorneys from multiple districts including Rhode Island, Virginia, Hawaii, Texas alongside divisions within Justice Department such as Civil Division’s Consumer Protection Branch.
This intervention underscores government efforts against healthcare fraud with reliance on tools like FCA allowing tips about potential fraud reported through designated channels.