CVS sued under False Claims Act for submitting false claims to Medicare

An insurance company has filed a lawsuit against CVS Pharmacy alleging that it sought coverage from insurance plans for invalid prescriptions of controlled substances that would inevitably land on the black market.

The allegations include that in 18 states claim CVS violated the False Claim Act by submitting claims to Medicare for controlled substances such as codeine and oxycodone. Those prescriptions require a registration number issued by the Drug Enforcement Agency, but between January 2008 and 2010, Fox claims, one out of every five of the claims submitted by CVS for the drugs lacked such a number.

The company filing the case, Fox Rx is asking that CVS pay treble damages for what the federal government lost, which it estimates to be hundreds of millions of dollars, plus up to $11,000 for each prescription that was issued without a DEA number. In April 2013, CVS agreed to pay $11 million to the federal government to settle a lawsuit accusing it of failing to keep proper records of the controlled substances it distributes. In December 2013, it agreed to pay $4.25 million to settle accusations that it failed to reimburse Medicaid for prescription drugs.