Drug diversion settlements and fines at hospitals and pharmacies

Headline totals

• Organizations have paid a documented $27,092,098 across 35 matters in this registry.
• The largest organizational matter is $4,500,000 (University of Texas Southwestern Medical Center, 2018); the smallest catalogued is $15,000 (Mid-Valley Hospital and Clinic, 2024).
• Amounts paid by individuals are tracked separately and are not included in the organizational total above. Individuals in this registry have paid or been ordered to pay a documented $10,689,912 across 51 matters.

Organizational settlements and fines, largest first

These are amounts a hospital, health system or pharmacy itself agreed or was ordered to pay — civil settlements, assessed civil penalties, and criminal fines. A settlement resolves allegations; it is not a finding or admission of liability, and the underlying conduct may still be described only as "alleged" in the source documents linked below.

Organizational drug diversion settlements, civil penalties and criminal fines (n = 35 matters). Each title links to its case record; the amount paid sits beneath it.

Some settlements were structured to be credited against related restitution, so the same underlying loss can appear in more than one figure on this page. See the individual case record for the full settlement or plea agreement before citing a figure.

What drives the size of a penalty

The matters catalogued above span civil penalty, civil settlement, criminal fine, forfeiture, restitution, and the amounts vary by roughly two orders of magnitude between the smallest and largest entries. A few patterns recur across the underlying case documents:

• Duration and scale of the conduct. Diversion that continued for months or years, or that touched a large volume of doses, tends to produce a larger settlement than a single isolated incident.
• Whether reporting obligations were met. Cases that combine the underlying diversion with a failure to report losses or suspicious activity to the DEA or a state board carry additional exposure beyond the diversion itself.
• Whether a death or patient harm occurred. Matters tied to a patient injury or fatality — for example a diluted or substituted medication reaching a patient — are documented at the higher end of the range.
• Whether the facility self-reported. Organizations that identified and disclosed the problem themselves, versus those where a regulator or law enforcement agency made the discovery, are treated differently in how a matter is resolved.

These are patterns visible across the registry's case documents, not a formula — every matter is negotiated or adjudicated on its own facts. See the statistics page for how these 716 cases break down by drug, setting and outcome.

Methodology

Penalty figures are drawn from the same public registry that backs the diversion statistics page: 716 documented cases spanning 1983-2026 across 52 states, with Maryland contributing the most case records. Only cases with a specific, sourced dollar amount are included here; a case can appear in the broader registry without contributing a figure to this page.

Amounts paid by an organization are kept separate from amounts paid by an individual, and from restitution ordered as part of a criminal sentence, so the organizational total is not inflated by money that a person, rather than the organization, was ordered to pay. A settlement or agreed penalty is not a court finding of liability or guilt.

Frequently asked questions

What is the largest drug diversion settlement paid by a hospital or pharmacy?

In this registry, University of Texas Southwestern Medical Center paid $4,500,000 in 2018, the largest organizational civil settlement currently catalogued.

How much have healthcare organizations paid overall in diversion cases?

A documented $27,092,098 across 35 matters in this registry. That figure covers civil settlements, civil penalties and criminal fines paid by the organization itself; it does not include money paid by individuals.

Is a settlement the same as an admission of wrongdoing?

No. A civil settlement resolves allegations without a trial and typically states explicitly that it is not an admission of liability. A civil penalty or criminal fine follows a formal finding or plea. This page reports what was agreed or ordered to be paid, not a legal conclusion about guilt.

Do individuals who divert drugs also pay fines, separate from the organization?

Yes. This registry documents $10,689,912 in fines and restitution ordered against individuals, tracked separately from the $27,092,098 paid by organizations, because the two are not owed by the same party and should not be added together.

Where do these settlement and fine amounts come from?

Each figure is sourced from a public document — a Department of Justice or U.S. Attorney press release, a consent judgment, a plea agreement, or a state attorney general announcement. The source link for each matter is attached to its row in the table above and to its full case record.