CVS to pay $315M after settlement in DOJ lawsuit over controlled prescriptions
A CVS pharmacy in Pinole, California, US, on Tuesday, July 18, 2023. CVS Health Corp. is scheduled to release earnings figures on August 2. Photographer: David Paul Morris/Bloomberg via Getty Images
CVS Pharmacy will pay $315 million to settle federal allegations that the company illegally filled thousands of opioid prescriptions and then sought reimbursement from Medicare and other government health programs.
What we know:
Federal prosecutors said CVS filled prescriptions for excessive quantities of opioids, combinations of drugs known as "trinity" prescriptions, and orders written by suspected "pill-mill" providers, all without verifying whether the medications were medically necessary. Many prescriptions were filled despite clear red flags, according to the government complaint.
Big picture view:
The settlement covers conduct from 2013 to 2025 and resolves claims that CVS violated both the Controlled Substances Act and the False Claims Act by dispensing unlawful prescriptions and billing federal programs for them.
What they're saying:
Associated Attorney General Stanley E. Woodward Jr. said the agreement marks "a significant milestone" in efforts to curb the opioid epidemic by holding pharmacies accountable for improper dispensing practices.
"Today’s settlement requires CVS to implement additional safeguards to ensure that prescriptions for opioids and other controlled substances are dispensed only when medically appropriate," said Assistant Attorney General Brett A. Shumate of the Justice Department’s Civil Division. "The remedial measures in this agreement — including proactive monitoring of opioid prescribing patterns — will provide critical protections for patients and federal healthcare programs. The Department of Justice will continue to take steps to prevent the unlawful dispensing of opioids."
The other side:
Prosecutors also say that corporate pressure, including performance metrics, incentive pay and staffing shortages contributed to the violations by prioritizing speed and profits over patient safety.
As part of the settlement, CVS agreed to a memorandum of agreement with the Drug Enforcement Administration requiring the company to create a hotline for reporting suspected illegal dispensing, monitoring pharmacy-level dispensing patterns and reviewing prescribers flagged for questionable activity.
The backstory:
The case originated from a whistleblower lawsuit filed by former CVS employee Hillary Estright. The Department of Justice intervened in 2024. Estright’s share of the recovery has not yet been determined.
The resolved claims are only allegations and no determination of liability has been made.
The Source: This story was written with information provided by the Department of Justice. This story was reported from Orlando.