Attorney General Ken Paxton has opened an investigation into UnitedHealth Group over allegations that it used deceptive and unlawful practices to deny Texans medically necessary care. His office announced October 5 that it has issued Civil Investigative Demands to collect evidence of possible violations of the Texas Deceptive Trade Practices Act “and other Texas laws.”
It is the second major insurer Texas has put under investigation in a week. Paxton opened a similar probe of Blue Cross Blue Shield of Texas on September 28.
The release cites reports that include “allegations that United bribed nursing homes to delay hospitalizing patients who needed medical care.” The same allegation was the subject of a May 2025 Guardian investigation, which reported that UnitedHealth paid nursing homes bonuses to cut hospital transfers for residents on its Medicare Advantage plans, based on internal records, more than 20 current and former employees and two whistleblower declarations to Congress. UnitedHealth told the Guardian that the suggestion its employees prevented hospital transfers “is verifiably false,” and that its payments help prevent unnecessary hospitalizations. The company also said the Justice Department had investigated the allegations and declined to pursue them.
The release also describes a Texas case. A patient received a letter from United approving prior authorization for a procedure at RedBud Surgery Center in Austin. After the procedure, United sent a second letter withdrawing the approval, leaving the patient with a large medical bill, according to the attorney general’s office.
Paxton’s office is also examining whether United’s “coverage determinations” amount to the corporate practice of medicine, “overriding physicians’ medical judgment and directing patient care.”
“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. “My office will gather the evidence, stand up to this multinational conglomerate, and make sure Texans get the coverage they pay for.”
UnitedHealth told KXAN it did not have a response to share.
The demands rest on Texas law, enforced by Texas’s own attorney general, for Texans who paid for their coverage.
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