WASHINGTON — A former CVS employee named Hillary Estright started the whistleblower lawsuit that ended Tuesday with CVS agreeing to pay $315 million, and the Justice Department says what she will receive has not been decided.
The Justice Department said CVS Pharmacy Inc. and related companies will pay to resolve allegations that their pharmacies filled opioid and other controlled-substance prescriptions that had no legitimate medical purpose, then sought payment from federal health programs for many of them. The settlement covers October 17, 2013 through December 2, 2025. The department stressed that the claims are allegations only and that there has been no determination of liability.
The department alleges that pharmacists filled dangerous quantities of opioids, filled them too early, and dispensed “trinity” combinations of an opioid, a benzodiazepine and a muscle relaxant, including on prescriptions from so-called pill mills, despite clear red flags. It blames corporate performance metrics, incentive pay and staffing policies that it says put profit ahead of patient safety, and it alleges CVS policies kept pharmacists from warning one another about problem prescribers.
Under a memorandum of agreement with the Drug Enforcement Administration, CVS must set up a hotline for employees and the public to report suspected illegal dispensing, monitor dispensing patterns across its pharmacies and create a process for evaluating prescribers suspected of illegal prescribing, according to the Justice Department’s release. Brett Shumate, who leads the department’s Civil Division, pointed to “proactive monitoring of opioid prescribing patterns.” Stanley Woodward Jr., the associate attorney general, said the settlement holds “bad actors accountable” and that “Americans are safer because of it.”
The government filed its own complaint on December 13, 2024, in federal court in Rhode Island, after intervening in Estright’s case, United States ex rel. Hillary Estright v. CVS Health Corporation, No. 22-cv-00222. Under the False Claims Act’s whistleblower provisions, a private party can sue on the government’s behalf. Her share of the recovery, the release says, has not been determined.
The release does not say how the $315 million divides between False Claims Act recoveries and Controlled Substances Act claims, or when CVS must pay. It carries no statement from CVS.
Of everyone the release names, the person who started the case is the one with no figure attached.
