The Justice Department reached a $315 million settlement with CVS Pharmacy on Tuesday over allegations that the chain improperly filled prescriptions for opioids and other controlled substances, then sought reimbursement for many of those prescriptions from federal healthcare programs.
The settlement resolves a lawsuit filed by the government in 2024 on behalf of former CVS employee Hillary Estright. The lawsuit alleged CVS violated the Controlled Substances Act and the False Claims Act by dispensing prescriptions that lacked a legitimate medical purpose.
The government alleged that CVS filled prescriptions for “excessive quantities of opioids,” as well as filling prescriptions early and selling often abused “trinity” prescriptions, which combine an opioid, a benzodiazepine, and a muscle relaxant. The complaint also accused the company of filling prescriptions from “pill mill” providers who would sell the substances without a prescription or medical purpose.
CVS pharmacists allegedly filled prescriptions despite clear warning signs that they were invalid or medically unnecessary, with many being billed to and reimbursed by federal healthcare programs.
“Today’s settlement is a significant milestone in the Justice Department’s efforts to combat the opioid epidemic by cracking down on pharmacies who unlawfully fulfill prescriptions for controlled substances,” Associate Attorney General Stanley Woodward Jr. said.
The lawsuit further alleged that CVS imposed performance metrics, incentive compensation, and staffing policies that prioritized corporate profits over patient safety. The government said the company failed to employ enough pharmacists to meet patient needs and comply with its legal obligations, while policies prevented pharmacists from warning colleagues about certain problematic prescribers.
The agreement requires CVS to implement additional safeguards to ensure prescriptions for opioids and other controlled substances are dispensed only when medically appropriate, Assistant Attorney General Brett Shumate said. The measures include proactive monitoring of opioid prescribing patterns.
CVS said that the settlement does not indicate any admission of wrongdoing.
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“We strongly disagree with the claims made in this case, and our settlement with the DOJ admits no wrongdoing,” a CVS spokesperson told the Washington Examiner. “We’re pleased to move forward and put this litigation behind us.”
“Our more than 27,000 CVS pharmacists do their part to help keep America healthy and are highly trained in the safe and appropriate use of all medications,” the spokesperson added. “We’ve implemented best-in-class and first-of-their-kind programs to help our pharmacists make the best decisions on behalf of patients.”