Texas AG investigates UnitedHealth for alleged deceptive insurance practices
Texas Attorney General Ken Paxton has launched an investigation into UnitedHealth Group, Inc., focusing on allegations of deceptive and unlawful practices that may have denied or delayed medically necessary care for Texas patients. The probe will examine UnitedHealth’s administration of health insurance benefits, coverage decisions, and prior-authorization practices, with concerns raised under the Texas Deceptive Trade Practices Act and other state laws. Civil Investigative Demands have been issued to UnitedHealth to gather evidence related to these allegations.
Among the concerns are reports that UnitedHealth may have bribed nursing homes to delay hospitalizing patients requiring medical care. Additionally, a case involving a Texas patient highlights potential issues with coverage determinations, where UnitedHealth allegedly approved a prior-authorization request for a procedure only to revoke it afterward, leaving the patient with a substantial medical bill. The investigation will also explore whether UnitedHealth’s coverage decisions could constitute the corporate practice of medicine, potentially overriding physicians’ medical judgments.
Paxton criticized UnitedHealth’s practices, stating, "Alarming reports keep piling up about how United treats Texas consumers. I will not tolerate any insurance company putting illegal corporate greed over the people of Texas." He emphasized that no Texan should be denied necessary care, subjected to endless appeals, or left with unexpected medical bills. The investigation is ongoing, and no determination of law violations has been made.
The UnitedHealth inquiry is part of a broader series of investigations by Paxton’s office into health insurance claims and coverage decisions. Separate investigations involve TriWest Healthcare Alliance Corp., which administers healthcare programs for military personnel and veterans, and Blue Cross and Blue Shield of Texas, which faces allegations of delaying or denying urgent medical care. Each investigation aims to determine whether the companies violated Texas law, with Civil Investigative Demands issued to gather relevant information.