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CVS Accused of Illegal Opioid Dispensing in Federal Suit

A CVS pharmacy in Miami, Florida, US, on Tuesday, Oct. 1, 2024. CVS Health Corp. plans to cut roughly 2,900 jobs to reduce costs, the health-care company said, as it conducts a strategic review of its operations that includes a possible breakup. Photographer: Eva Marie Uzcategui/Bloomberg (Eva Marie Uzcategui/Bloomberg)

(Bloomberg) -- CVS Health Corp. pharmacies illegally dispensed controlled substances including opioids, fueling an overdose crisis as short-staffed stores ignored red flags, the US Department of Justice alleged in a lawsuit unsealed Wednesday.

The largest US pharmacy chain deliberately set staffing levels at drugstores too low to safely dispense the prescription medications, according to the complaint filed in federal court in Rhode Island. The company “prioritized profits over safety in dispensing controlled substances,” the civil complaint alleges.

CVS disputed the Justice Department’s allegations. The company has cooperated with the investigation for more than four years, a spokesperson said. Similar litigation by state and local governments was resolved in a 2022 settlement agreement. The federal lawsuit “seeks to impose a shifting standard for pharmacy practice,” the company said in an email.

The federal government is intervening in a case originally filed under seal by a former CVS employee. Hillary Estright, a pharmacist and former CVS pharmacy manager in Tennessee, filed the lawsuit under the False Claims Act, which allows whistleblowers who expose fraud against the government to get a share of money recovered.

The government’s complaint alleges that corporate performance metrics, incentives and staffing created conditions for reckless dispensing of controlled substances. Workers raised alarms through an internal ethics line that the company ignored, according to the complaint. Workers at CVS and other retail pharmacy chains have walked off the job to protest working conditions. 

When store pharmacists did reject prescriptions in instances where they suspected abuse, they had no way to warn other pharmacists at different CVS stores, according to the lawsuit. 

One effort to flag problem prescriptions was watered down, according to the lawsuit. And prescriptions from known “pill mill” practices were routinely dispensed, the Justice Department alleges.

In the case of one Texas pain doctor, Howard Diamond, CVS staff escalated his prescriptions for internal review 13 times between 2014 and 2017. In one instance, the doctor wrote controlled substance prescriptions for a patient after the patient’s death. 

Despite a yearslong trail of warning signs and internal reports of problematic prescribing, CVS continued to let pharmacists fill his prescriptions, even after he was indicted for controlled substance violations, the complaint said. Diamond pleaded guilty to charges related to controlled substances and health-care fraud in 2018.

(Updates with additional information starting in paragraph four)

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