BATON ROUGE — Louisiana officials filed three lawsuits against CVS Health on Tuesday, including one over its sending texts to residents in an effort to kill a bill that would have undermined its business in the state.

The other lawsuits allege CVS abused the pharmacy benefit manager system and that it harmed independent pharmacies in Louisiana. The lawsuits were filed in Opelousas. It was not immediately clear why this court was chosen.

Louisiana lawmakers tried to pass a bill in the closing days of the legislative session this month that would have barred pharmacy benefit managers like CVS from owning retail drug stores in the state. CVS said it would have forced it to close more than 100 stores.

One of the lawsuits says that the texts were "inaccurate, misleading and deceptive. 

"They were clearly intended to incite fear among vulnerable people regarding their medical needs to garner their support to lobby the legislature against pending legislation that CVS opposed," Murrill's office said, adding that it was a "violation of public policy and established standards of decency."

The second lawsuit alleges that CVS's control of "multiple, interlocking stages of the pharmaceutical supply and reimbursement chain" gives the company the "market power not just horizontally but vertically across multiple tiers of the healthcare system."

The third lawsuit alleges that CVS' opposition to the bill through the texts would cause harm to the state's independent pharmacies. 

"CVS’s business practices with the independent pharmacies of Louisiana constitute unfair competition, and are deceptive and substantially harmful to the public," Murrill's office said about the lawsuit.

The lawsuit says that the multinational pharmacy brand abuses its market power to impose unethical and exceedingly high fees onto independent pharmacies under threat of expulsion from the CVS network in a way that "amounts to unfair competition and unfair trade practice."

At a Tuesday news conference, Murrill said that, since 2022, over 100 independent pharmacies have closed across the state. 

"Those numbers continue to rise because of the tactics that are used to drive them out of business," Murrill said. "CVS has, in my opinion... has deliberately avoided compliance with Title 22 restrictions in the insurance code that prohibit them from undercutting the prices they have to pay when they acquire a drug."

A conference committee inserted the anti-PBM language into a bill at such a late date that there was no time to hold public hearings or receive public comment about it. CVS said the maneuvering forced it to reach out to Louisiana consumers directly.

CVS said its communications were legal, noting that the company did not use its customer database to select who would receive its messages. 

"Our focus is and remains serving the people of Louisiana: lowering drug costs, providing access to care, and helping to improve health," spokeswoman Amy Thibault said. It said looked forward to working with policymakers on a path forward. 

It also said the lawsuit alleging it unfairly benefits from the PBM system were unwarranted. It also said that an independent pharmacy group operating in Louisiana has added more than 30 pharmacies recently and negotiated an increase its its reimbursement rates.

"We believe the claims are without merit and will defend ourselves vigorously," Thibault said.

The state issued a cease and desist order to CVS over the texts, alleging CVS' use of phone number collection to send the text was "unsolicited and unwanted text messages" sent for "political reasons." It also said the text contained "inaccurate and deceptive statements regarding (HB 358)". Texts about the bill went to CVS customers and non-customers.

"The use of personal and sensitive contact information of Louisiana citizens in such a manner is inappropriate and in violation of Louisiana law," the letter said.

While HB 358 failed when the state Senate declined to take it up, a separate bill passed requiring more transparency from those pharmacies rather than outright banning them.

A separate lawsuit was filed last week, alleging that CVS crossed legal and ethical boundaries when sending the messages.