Texas Attorney General Ken Paxton is going after two of the country's biggest health insurers. He's launched formal investigations into UnitedHealth Group and Blue Cross Blue Shield of Texas (BCBSTX), accusing both of engaging in "deceptive and unlawful practices" that block Texans from getting the care they need. Paxton has issued civil investigative demands to both companies, seeking evidence of violations of the state's Deceptive Trade Practices Act and other Texas laws.

The allegations against UnitedHealth are particularly pointed — Paxton claims the insurer paid kickbacks to skilled nursing facilities to discourage hospital transfers, and that its prior authorization practices amount to the "corporate practice of medicine" by overriding physician judgment. In one cited case, UnitedHealth approved a procedure at an Austin surgical center, then withdrew approval after it was completed, leaving the patient with the bill. UnitedHealth has denied the nursing home kickback allegations and did not respond to requests for comment on the investigation.

Key Takeaways:

• Paxton issued civil investigative demands to UnitedHealth Group and BCBSTX under Texas's Deceptive Trade Practices Act
• UnitedHealth is accused of paying nursing homes to reduce hospital transfers and overriding physician care decisions via prior authorization
• BCBSTX is accused of delaying care for a newborn by denying a medically necessary hospital transfer
• UnitedHealth is already under scrutiny from the DOJ, federal watchdogs, and Congress over Medicare billing and nursing home care denials

Why it matters: These investigations reflect a growing national reckoning with health insurer practices around care denials and prior authorization. With public frustration running high, state-level enforcement actions like these could pressure insurers to reform how they make coverage decisions — and signal that more states may follow suit.