Texas Attorney General Ken Paxton announced on Monday that he would launch an investigation into industry giant UnitedHealth Group for "engaging in deceptive and unlawful practices" that may have denied care to Texans.
In the announcement, Paxton said he issued investigative demands to the company for any evidence that it violated Lone Star State laws, including the Deceptive Trade Practices Act (DTPA). He points to multiple reports that indicate UHG "has engaged in numerous unlawful practices in administering health insurance benefits and making patient-care decisions."
For example, he notes reporting from the Guardian that alleges UnitedHealth paid kickbacks to skilled nursing facilities to reduce transfers to hospitals. The company has consistently denied those allegations.
Paxton also alleges that coverage determinations made by the insurer—such as prior authorization—may "amount to the corporate practice of medicine" by overriding physician decisions.
"No Texan should be denied medically necessary care, dragged through endless appeals, or stuck with devastating bills after trusting their insurer’s word," Paxton said in a statement. "My office will gather the evidence, stand up to this multinational conglomerate and make sure Texans get the coverage they pay for."
UnitedHealth Group did not respond to a request for comment before publication time.
The attorney general kicked off a similar investigation into Blue Cross Blue Shield of Texas and its parent company, Health Care Services Corporation, last week. In an announcement, Paxton said his office would "procedures for denying and delaying urgent and medically necessary care and its potentially burdensome prior authorization requirements."
He also sent letters to BCBSTX seeking evidence of any violation of Texas law, including DTPA.
Paxton said that his office had received reports that BCBSTX had denied or delayed coverage for services that were medically necessary, including in the case of a newborn who had their transfer to the appropriate medical facility delayed by "administrative denials and potentially improper utilization review procedures."
"Blue Cross Blue Shield has a responsibility to put patients before profits and ensure that Texans receive the care they need," Paxton said. "When a newborn baby or any other Texan urgently needs medical treatment, an insurance company’s priority should be helping provide that care to the best of its ability—not searching for ways to delay or deny it."
"I will wage a relentless legal battle against any insurance company that fails to protect health and safety of Texans," he continued.
BCBSTX told Fierce Healthcare it does not comment on investigations.
Paxton is currently running for a Texas Senate seat in a tight contest with Democrat James Talarico, with the race garnering national attention.