US Accuses CVS of Filling and Billing for Illegal Opioid Prescriptions.
The United States Department of Justice announced on Wednesday that it has filed a lawsuit against the pharmacy chain CVS, alleging that the company filled illegal opioid prescriptions and billed federal health insurance programs, thereby contributing to a widespread epidemic of opioid addiction and overdose.
The recently unsealed complaint in federal court in Providence, Rhode Island, claims that from October 2013 to the present, CVS breached the federal Controlled Substances Act by dispensing prescriptions for excessive amounts of opioids and hazardous drug combinations. The complaint asserts that the company routinely filled prescriptions from physicians operating so-called pill mills, providing large quantities of opioids without any legitimate medical justification.
The Justice Department indicated that these violations were influenced by company-imposed performance metrics that resulted in the neglect of warning signs, and in some instances, patients succumbed to overdoses shortly after receiving illegal prescriptions. In a statement, CVS expressed its disagreement with the allegations and the misleading narrative presented in the complaint, noting that it has cooperated with the DOJ's investigation for over four years. In 2022, CVS reached an agreement to pay nearly $5 billion over a decade to resolve thousands of similar claims from state, local, and Native American tribal governments, without admitting any wrongdoing.
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This settlement was part of a broader series of nationwide agreements involving pharmacies, drug manufacturers, and distributors, amounting to approximately $46 billion. The lawsuit, which was unsealed on Wednesday, originated from a whistleblower complaint filed by a former CVS employee. The lawsuit alleges that CVS operated with insufficient staffing and pressured its pharmacists to process prescriptions rapidly without verifying their legitimacy, while disregarding alerts from its own staff. One employee reportedly stated, “Safety issues arise when one is dealing with medication and also being rushed to fulfill an order like McDonald’s. CVS has concocted an assembly-line style of medication preparation and only cares about profits.”
The company persisted in processing hundreds of prescriptions for a physician in Alabama, even after receiving multiple internal alerts in 2015 indicating that he was under investigation, as stated in the complaint. This physician was subsequently arrested in 2016. Additionally, the company dispensed thousands of prescriptions for a doctor in Pennsylvania, despite internal warnings and online patient feedback indicating that he “issues prescriptions without examining the patient” and is characterized as “a pill pusher and a drunk,” according to the Justice Department.
The complaint detailed ten specific patients who reportedly died after obtaining illegal prescriptions for opioids and other substances at CVS. From 1999 to 2023, over 800,000 individuals in the United States succumbed to opioid overdoses, as reported by the U.S. Centers for Disease Control and Prevention. Preliminary data suggests that overdose rates began to decline last year.
The lawsuit filed by the U.S. Department of Justice against CVS highlights the ongoing struggle to combat the opioid crisis, with the pharmacy chain accused of contributing to the epidemic by filling illegal prescriptions and billing federal health programs. The allegations suggest that CVS ignored critical warning signs and operated under a performance-driven model that prioritized speed over safety. With over 800,000 lives lost to opioid overdoses in recent decades, this case could have significant repercussions for both CVS and the broader healthcare industry, as it underscores the importance of responsible drug distribution and oversight to prevent further harm.
