Texas Attorney General Ken Paxton has opened an investigation into UnitedHealth Group over allegations that the healthcare company engaged in deceptive and unlawful practices that denied or delayed medically necessary care for Texas patients.
Paxton announced the investigation on Oct. 5, saying his office had issued Civil Investigative Demands to UnitedHealth to obtain evidence of potential violations of the Texas Deceptive Trade Practices Act and other state laws.
“NEW: I am investigating UnitedHealth Group for denying patients the coverage they need and for engaging in deceptive practices,” Paxton said in a post on X.
READ: UnitedHealth Group under criminal investigation by DOJ for Medicare fraud (May 15, 2025)
The attorney general’s office said reports it is examining include allegations that UnitedHealth paid nursing homes to delay hospitalizations for patients who required medical care.
It also cited the case of a Texas patient who received a letter approving prior authorization for a procedure at RedBud Surgery Center in Austin. After the procedure was completed, United allegedly sent another letter withdrawing the approval, leaving the patient with a large medical bill, according to Paxton’s office. The investigation will also examine whether UnitedHealth’s coverage determinations improperly interfere with physicians’ medical judgment. Paxton’s office said denying treatment that a patient’s physician has determined to be medically necessary could delay care and potentially harm patients.
“Alarming reports keep piling up about how United treats Texas consumers,” Paxton said. “No Texan should be denied medically necessary care, dragged through endless appeals, or stuck with devastating bills after trusting their insurer’s word.”
The investigation does not establish that UnitedHealth violated Texas law. The Civil Investigative Demands are intended to gather evidence before the state determines whether further legal action is warranted.
The inquiry comes shortly after Paxton’s office opened a separate investigation into Blue Cross Blue Shield of Texas and its parent company, Health Care Service Corporation, over alleged denials and delays involving urgent and medically necessary care and prior authorization requirements.
UnitedHealth had not publicly responded to requests for comment cited by media reports as of publication
Paxton’s Senate campaign
The UnitedHealth investigation comes as Paxton is campaigning for the Republican nomination in the 2026 Texas Senate race.
READ: FTC to bring lawsuit against CVS, Cigna, and UnitedHealth Group (January 16, 2025)
On Oct. 5, Paxton’s campaign also announced that he raised more than $18 million during the third quarter, from July 1 through Sept. 30, according to reporting by The Texas Tribune. The amount was more than double his second-quarter haul of $9 million and represented his strongest quarterly fundraising total.
The fundraising announcement is separate from the UnitedHealth investigation, which was issued by the Texas Attorney General’s office. Paxton’s office said the UnitedHealth investigation will focus on gathering evidence concerning the insurer’s practices and potential violations of Texas law.