A legal battle between Florida hospitals and the nation’s biggest pharmacy chains came to a sudden end May 26, when a judge ruled that “no reasonable jury” could conclude that the retailers violated the state’s anti-racketeering statute.
The lawsuit was brought by a coalition of hospitals serving 15 Florida counties, alleging that between 2006 and 2018 the residents of those counties had been dispensed over 2.1 billion prescription opioid pills by CVS, Walgreens and Walmart. They argued that the pharmacy chains had violated not only the federal Controlled Substances Act, but Florida’s Racketeer Influenced and Corrupt Organization (RICO) Act by conspiring to drive up prescription opioid use—which, they claimed, drove up costs for hospitals. The lawsuit claimed the hospitals had incurred more than $500 million in unpaid bills from treating injuries related to opioid use specifically, and $1.5 billion in damages from providing other care to patients who used opioids.
“We are very disappointed with the judge’s ruling,” plaintiffs’ attorney Warren Burns told Filter. “The court previously took the exact opposite view at least three times.”
The case began in September 2025 and went to trial later that year. But in December, after two weeks of deliberations during which one of the jurors was dismissed, the jury was still unable to reach a verdict. Broward County Chief Judge Carol-Lisa Phillips ultimately declared a mistrial.
Now, rather than the case moving forward to a new trial with a new jury, Phillips has ended it with a directed verdict. This refers to when judges issue the ruling themselves, on the grounds that the case is legally unambiguous and therefore “no reasonable jury” would come to a different conclusion.
“We’re pleased to prevail in this case,” a CVS representative stated to Filter. “[T]he Court rejected this meritless claim and granted our motion for a directed verdict.”
The plaintiffs had argued that OUD patients require “very complicated” care.
This isn’t the first time RICO violations have come up during opioid litigation, but racketeering is a very difficult allegation to prove in this context. All RICO law including Florida’s has a “proximate cause” requirement, which in this case means the evidence would have to show the hospitals were injured by the pharmacy chains directly.
“[A]bsent harm to patients with opioid use disorder, Plaintiffs would have suffered no injury,” Phillips wrote in her May 26 verdict. “Plaintiffs cannot suffer harm from Defendants’ alleged predicate acts unless OUD patients are first injured—the harm to OUD patients is a necessary prerequisite to any injury suffered by Plaintiffs.”
The plaintiffs had claimed that OUD patients require “very complicated” care, which compared to other patients involves longer stays, more resources, more staff, more social workers and more medication. Their argument, as summarized by Phillips, was that “the additional resources and length of stay for these patients translated into increased costs—harms that only hospitals suffer.”
A Walmart representative stated to Filter that the verdict “confirms what we have said from the beginning; we aren’t responsible for causing any injuries to Florida hospitals.” Walgreens did not respond to Filter‘s request for comment.
Meanwhile, chronic pain patients have become increasingly disenfranchised from health care.
The lawsuit had also alleged that the pharmacy chains’ internal policies, which pushed pharmacists to fill prescriptions quickly, resulted in ignoring so-called red flags that the DEA uses to investigate potentially unlawful prescriptions.
“If it stands, this ruling will give the chain pharmacies a get out of jail free card, notwithstanding their role in creating a drug epidemic that shattered lives and robbed the hospitals of hundreds of millions of dollars,” Burns said. “That’s not justice.”
Amid the ongoing, disproportionate preoccupation with the role prescription opioids have played in the overdose crisis, major litigation has looked beyond just manufacturers like Purdue Pharma (which dissolved earlier in May when its long-awaited bankruptcy finally went into effect; it’s now a nonprofit-run public benefit corporation called Knoa Pharma). In December 2024 and January 2025 the Department of Justice sued CVS and Walgreens, respectively, for unlawful prescribing as well as fraud. Other litigation has targeted pharmacy benefit managers, including CVS Caremark.
Meanwhile, chronic pain patients have become increasingly surveilled, stigmatized and disenfranchised from health care, while opioid settlement payouts keep somehow missing syringe service programs and finding their way to law enforcement.
Image via Congresswoman Ashley Hinson
