Deerfield-based drug store giant Walgreens has agreed to settle a civil lawsuit with the federal government by paying $300 million for allegedly filling millions of invalid prescriptions for opioids and other controlled substances, and submitting false bills to state and federal Medicare programs and private insurers.

The settlement was announced Monday by U.S. Attorney for Northern Illinois Andrew Boutros. He said related agreements between Walgreens and the Drug Enforcement Agency and the Department of Health and Human Services Office of Inspector General will “provide swift relief in the form of monitoring and claims review that will improve Walgreens’s practices immediately.”

“Our office will continue to work with our law enforcement partners to ensure that opioids are properly dispensed and that taxpayer funds are only spent on legitimate pharmacy claims,” Boutros said.

Under terms of the agreement, Walgreens will have the option of paying the $300 million upfront, or over six years – into 2031. If the company is sold before 2031, it will incur another $50 million in liability.

In its lawsuit, filed Jan. 16, the government alleged that Walgreens management pressured and even intimidated pharmacists to fill millions of prescriptions for such drugs as Oxycodone, Hydrocodone and Hydrocodone/Acetaminophen, despite numerous red flags commonly recognized by the DEA and pharmacies.

The government also alleged that Walgreens regularly submitted billing for prescriptions it knew were illegal and invalid. Walgreens, the government said, “even intentionally deprived its own pharmacists of crucial information, including by refusing to share internal data regarding prescribers with pharmacists and preventing pharmacists from warning one another about certain problematic prescribers.”

The settlement of the civil suit resolves four cases brought under the “qui tam,” or whistle blower, provisions of the FCA by former Walgreens employees.

In 2018, Walgreens pharmacist T.J. Novak filed suit. That lawsuit was eventually combined with three other whistle blower lawsuits.

Walgreens denies it did anything wrong. In its announcement the government noted that its allegations against Walgreens “are allegations only and there has been no determination of liability.”

A Walgreens spokesperson told Axios that the company “strongly disagrees with the government’s legal theory.”

“Our pharmacists are dedicated healthcare professionals who care deeply about patient safety and continue to play a critical role in providing education and resources to help combat opioid misuse and abuse across our country,” the spokesperson said.

However, neither the whistle blowers nor the government have alleged that any pharmacists intended to act illegally. The allegations made by the whistle blowers and the government were that Walgreens management routinely pressured their pharmacists to fill prescriptions, despite the prescriptions raising “egregious red flags” on their own system’s computers.

Government lawyers allege that “Walgreens fostered “a corporate culture wherein pharmacists who diligently observed their responsibility to verify the legitimacy of controlled-substance prescriptions were subject to reprimand.”

Novak, a registered pharmacist for 43 years, said that Walgreen routinely pressured pharmacists to fill prescriptions despite suspicions about falsified prescriptions.

“Despite the fact that Walgreens knew that it was unlawful for its pharmacists to dispense controlled substances without the use of sound professional judgment,” Novak said, “Walgreens discouraged its pharmacists from using (their) judgment and encouraged its pharmacists to dispense controlled substances even when factors were present indicating that the controlled substances could not be dispensed (with) sound professional judgment because the prescriptions were doubtful, questionable, or suspicious.”

Walgreens, the government alleged, “did all of this even after previously acknowledging that it failed to comply with the Controlled Substances Act and reaching a settlement with the Department of Justice and the Drug Enforcement Administration in 2013.”

The government alleged that Walgreens paid lip service to compliance with DEA guidelines and took numerous other steps to circumvent compliance.

“At the same time that Walgreens issued paper compliance policies that reflected its understanding of its legal obligations, Walgreens took other corporate actions that Walgreens knew prevented its pharmacists from complying with those policies.”

Walgreens knew that prescriptions with “morphine milligram equivalents” over 300 “were highly likely to be invalid,” the complaint stated,

From 2012 on, Walgreens’ “Good Faith Dispensing” Policy“specifically acknowledged that a prescription for an unusually high dosage of a controlled substance “should alert a pharmacist to questionable circumstances.”

Despite the GFD Policy, Walgreens filled 827 high MME prescriptions for a single person, and 823 such prescriptions for another, according to the government complaint. Several other individuals had between 197 and 742 high MME scripts filled, the government said.

Walgreens allegedly filled one person’s prescription multiple times despite a warning posted on Its system on Jan. 21, 2015 that stated in all caps, “DO NOT ACCEPT ANY CONTROLS FROM THIS PATIENT!!!, RUNNING PHONEY RXS FOR MULTIPLE PATIENTS ON STOLEN BLANKS!!!”

Another type of prescription both the DEA and Walgreens GFD Policy recognized as “a particularly significant red flag because it is widely acknowledged to be highly abused and dangerous” were what are called “trinities,” prescriptions, singly or collectively, of opioids, benzodiazepines, and muscle relaxants that are exceedingly potent and addictive. Walgreens, the government alleged, filled 560 prescriptions for one person, and between 371 and 495 for four other individuals.

In 2017, the director of Walgreens’s pharmacy compliance department responded to a pharmacist’s question about filling controlled-substance prescriptions more than three days early with, “early refills are a huge red flag with the DEA.”

Walgreens’ nationwide system automatically flagged prescriptions presented for refilling four days or more early, with a cautionary message.

Still, the government alleged, Walgreens filled prescriptions “significantly early” for five individuals repeatedly, on between 134 and 153 occasions each.

“The presence of any one of these egregious red flags indicates that a prescription is highly likely to be invalid,” the government said in its complaint.