The US Department of Justice (DOJ) filed a complaint Monday against Rite Aid claiming the corporation and its state branches filled prescriptions for controlled substances that were not medically necessary, did not have a valid prescription or were issued by prescribers acting outside their usual areas of practice.
The Controlled Substances Act categorizes prescription drugs into schedules, based on factors including their likelihood for abuse, and regulates how pharmacies can provide drugs. Pharmacies cannot provide Schedule II, III, and IV drugs without a prescription, and pharmacies can only provide Schedule V drugs to customers if medically necessary. The DOJ alleges Rite Aid knowingly filled unlawful prescriptions over a five-year time span, claiming pharmacists prescribed medically unnecessary drugs by ignoring red flags, such as filling prescriptions for “excessive quantities” of scheduled drugs.
Another claim against Rite Aid concerns the False Claims Act, which criminalizes knowingly presenting a false claim for payment and knowingly using a false record when making a fraudulent claim. Specifically, the DOJ alleges that Rite Aid provided controlled substances without a valid prescription, which were medically unnecessary uses in violation of Medicare and Medicaid program procedures. These federal health care programs require valid prescriptions when reimbursing pharmacies for the cost of the drug. Department of Health and Human Services Special Agent in Charge Maureen Dixon explained, “Prescriptions which are not medically necessary, and not for a medically accepted indication, will not be paid for by Medicare and Medicaid.”
Some of the prescription drugs cited in the lawsuit include trinities (a combination of an opioid, muscle relaxer, and benzodiazepine), fentanyl, and oxycodone.
This lawsuit comes just months after Walgreens settled a complaint by West Virginia, where the state’s attorney general claimed the pharmacy’s lack of regulation led to the oversupply of opioids in the state.