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While the long-term care industry continues seeking internal solutions to stem drug diversion and over-prescribing of powerful painkillers and opioids, federal and state law enforcement agencies are beginning to raise the heat on sources like physicians and pharmacists. The latest high-profile case recently ended with national pharmacy behemoth CVS agreeing to pay a $22 million fine to settle allegations that two of its Florida pharmacies violated the Controlled Substances Act by filling bogus oxycodone prescriptions over a three-year period.

CVS last week announced it will purchase Omnicare, the nation’s largest provider of pharmaceutical services to nursing homes and other long-term care providers, for $10.4 billion.

The $22 million fine capped a lengthy Justice Department investigation into so-called Florida “pill mills,” which are typically operated by prescription drug addicts who finding physicians willing to write scripts for powerful pain medications without regard to medical need, the Department stated. Federal investigators noted that providers such as the two CVS pharmacies dispensed the drugs “despite red flags that they were illegitimate.” DEA licenses for the two CVS stores in Stanford, FL, were revoked in June 2012.

In a prepared statement, CVS said it “is committed to the highest standards of ethics and business practices, including complying with all federal and state laws governing the dispensing of prescriptions and related record-keeping requirements, and is dedicated to reducing prescription drug abuse and diversion while ensuring access to appropriate, effective pain medication for patients with a legitimate need.”

Meanwhile, the escalating scrutiny on painkillers in a state dubbed the nation’s “pill mill epicenter” has made it increasingly difficult for many older and disabled people in Florida to obtain certain painkilling medications, including opioids, according to published reports. Long-term care providers have long been challenged by drug diversion and other medication management issues, while also trying to preserve a vital flow of pain management medications for their seriously ill patients.

On May 20, the DEA and federal prosecutors capped a 15-month pharmaceutical trafficking sting across Arkansas, Alabama, Louisiana and Mississippi, arresting 280 people, including 22 physicians and pharmacists, the agency recently announced.