United States Attorney Clare E Connors | U.S. Department of Justice
In a civil complaint unsealed in Providence, Rhode Island, the Justice Department has accused CVS Pharmacy Inc. and its subsidiaries of violating the Controlled Substances Act (CSA) and the False Claims Act (FCA). The lawsuit alleges that CVS filled unlawful prescriptions for controlled substances and sought reimbursement from federal healthcare programs for these prescriptions.
The complaint claims that from October 17, 2013, to the present, CVS knowingly dispensed prescriptions lacking legitimate medical purpose. This includes dangerous quantities of opioids and "trinity" prescriptions, a combination of drugs prone to abuse. CVS is also accused of filling prescriptions from prescribers involved in "pill mill practices."
According to the government, CVS's corporate policies prioritized profits over patient safety by imposing performance metrics on pharmacists without providing necessary resources or information. This allegedly contributed to the opioid crisis and related deaths.
Principal Deputy Assistant Attorney General Brian M. Boynton stated, "Our complaint alleges that CVS repeatedly filled controlled substance prescriptions that were unlawful and pressured its pharmacists to fill such prescriptions without taking the time needed to confirm their validity."
U.S. Attorney Zachary A. Cunha for the District of Rhode Island emphasized that opioid deaths continue to devastate communities, asserting that "this lawsuit alleges that CVS failed to exercise its critical role as gatekeeper of dangerous prescription opioids."
If found liable, CVS could face civil penalties under the CSA and treble damages under the FCA. The court may also order changes to prevent further violations.
U.S. Attorney Jessica D. Aber for the Eastern District of Virginia remarked on the importance of enforcing laws regarding opioid dispensing: "We will pursue whatever legal action is necessary to stop any enterprise...that places profit over the safety of our citizens."
DEA Administrator Anne Milgram criticized CVS for prioritizing profits over customer safety: "A pharmacy is...in place to keep customers safe." The DEA vows continued enforcement against those who violate drug laws.
Deputy Inspector General Christian J. Schrank highlighted pharmacies' role in ensuring lawful dispensing: "HHS-OIG is committed to holding individuals and entities...accountable."
Special Agent Patrick J. Hegarty stressed protecting TRICARE beneficiaries as a priority for DCIS: "Today’s filing demonstrates DCIS’ ongoing commitment...to investigate health care providers that submit false claims."
Whistleblower Hillary Estright initiated an action under FCA provisions allowing private parties to sue on behalf of the United States.
The case underscores government efforts against healthcare fraud using tools like FCA. Allegations remain unproven at this stage.
