PROVIDENCE, R.I. (WPRI) — The U.S. Department of Justice has filed a lawsuit against CVS Health, accusing the drugstore giant of filling prescriptions for controlled substances that "lacked a legitimate medical purpose," according to U.S. Attorney Zachary Cunha.

The civil complaint, unsealed Wednesday in federal court, alleges Woonsocket-based CVS violated the Controlled Substances Act by knowingly filling prescriptions for controlled substances that were invalid or not issued in the usual course of medical practice.

"If you go into a pharmacy with a prescription that says, 'Give me 50 pills of smack,' and that's actually what's written on the prescription pad, the pharmacist has a legal obligation not to fill that prescription," Cunha told reporters during a news conference.

"CVS as a corporation ignored repeated red flags that a large number of opioid prescriptions were not legitimate and should not have been filled," he added.

Prosecutors alleged CVS, which is the country's largest pharmacy chain, unlawfully filled prescriptions beginning in October 2013 through present day, according to the complaint, which fits within the statute of limitations under the federal law.

Federal prosecutors accuse CVS of filling "dangerous and excessive quantities of opioids, early fills of opioids, and 'trinity' prescriptions, an especially dangerous and abused combination of drugs made up of an opioid, a benzodiazepine and a muscle relaxant."

"They did so in the face of doctors who were known pill-mill prescribers, they did so in the face of doctors who were known to be responsible for overdoses and they did so in response to prescription patterns that are known in the industry as inherently suspicious," Cunha said.

CVS spokesperson Kara Page pushed back at the allegations, calling the lawsuit a "false narrative," and noting that the company has been cooperating with the DOJ's investigation for more than four years.

"We will defend ourselves vigorously against this misguided federal lawsuit, which follows on the heels of years of litigation over these issues by state and local governments—claims that already have been largely resolved by a global agreement with the participating state Attorneys General," Page said in a statement.

Federal prosecutors, however, alleged CVS ignored substantial evidence — including from its own pharmacists and internal data — that indicated its stores were dispensing unlawful prescriptions.

In the complaint, the DOJ blames CVS's violations on "corporate-mandated performance metrics, incentive compensation and staffing policies that prioritized corporate profits over patient safety."

Specifically, the complaint accuses CVS of short-staffing its pharmacies to a point where its pharmacists couldn't properly vet each prescription. CVS also reportedly deprived its pharmacists of crucial information that could have refused the number of unlawful prescriptions filled, such as by preventing them from warning each other about certain prescribers, according to the lawsuit.

Page pushed blame back on the federal government, saying the government had "declined to provide guidance" on many of the issues it now alleges were unlawful.

"Each of the prescriptions in question was for an FDA-approved opioid medication prescribed by a practitioner who the government itself licensed, authorized, and empowered to write controlled-substance prescriptions," Page added.

Page also pointed out that CVS has a program to "block controlled-substance prescriptions written by doctors of potential concern," which has resulted in lawsuits claiming the company went too far in some instances.

Cunha fired back, saying the Controlled Substances Act makes it clear the company is responsible for making sure the prescriptions are legitimate, and he said they should have taken note of the many red flags employees raised over the years.

"They were not subtle red flags," Cunha said. "They were overt, they were repeated, and they were repeatedly raised by CVS's own expert pharmacy staff. This notion that there is some sort of regulatory ambiguity here, I reject that."

Cunha also highlighted the human toll the opioid epidemic has had on Rhode Islanders and people across the country. He called opioids a "scourge on communities," and CVS played a role in the practice that "has taken so many lives."

"The failure to step in and prevent the issuance of prescriptions that should not go out the door for dangerous and potentially fatal opioids puts lives at risk," he said.

CVS is also accused of violating the False Claims Act by seeking reimbursement from federal health care programs for some of the unlawfully filled prescriptions.

If CVS is found liable, Cunha said it could face civil penalties for each unlawfully filled prescription, plus triple damages and penalties for each one that was illegally reimbursed. Prosecutors included a sample size of 10,000 claims in the lawsuit, saying the number would inevitably grow once the lawsuit goes through the process of discovery and they get more insight into CVS's operations.

At this point, Cunha said the lawsuit is focused on the company and its subsidiaries, but that once the lawsuit goes through the discovery process they will "determine who is responsible."

Asked specifically whether CVS executives were aware of the allegations outlined in the complaint, Cunha said, "there was a sufficient number of individuals at a sufficient level of accountability within the corporation that were aware."

But at this point he said they are only accusing the corporation of being liable.

"We're not making specific allegations as to any individuals at this time," he said.