Texas Attorney General Ken Paxton
AUSTIN — Texas Attorney General Ken Paxton has announced his office is investigating UnitedHealth Group, Inc. for allegedly engaging in deceptive and unlawful practices that have denied Texans access to medically necessary healthcare.
According to the Office of the Attorney General, reports indicate that United has engaged in numerous unlawful practices in administering health insurance benefits and making patient-care decisions.
The reports include allegations that United bribed nursing homes to delay hospitalizing patients who needed medical care.
In one case, a Texas patient received a letter from United approving a prior-authorization request for a procedure at RedBud Surgery Center in Austin. After the procedure, United sent a second letter withdrawing approval and leaving the patient with a large medical bill.
“Alarming reports keep piling up about how United treats Texas consumers,” said Paxton. “I will not tolerate any insurance company putting illegal corporate greed over the people of Texas. No Texan should be denied medically necessary care, dragged through endless appeals, or stuck with devastating bills after trusting their insurer’s word.
“My office will gather the evidence, stand up to this multinational conglomerate, and make sure Texans get the coverage they pay for.”
According to the OAG, United’s “coverage determinations” may also amount to the corporate practice of medicine — overriding physicians’ medical judgment and directing patient care. By denying care that treating physicians have determined is medically necessary, United delays treatment and harms patients. The longer the delay, the greater the risk that care comes too late.
Paxton has issued Civil Investigative Demands to United to collect evidence of the company’s potential violations of the DTPA and other Texas laws.
Just a week earlier, Paxton launched an investigation into Blue Cross Blue Shield of Texas based on its alleged procedures for denying and delaying urgent and medically necessary care and its potentially burdensome prior authorization requirements.
