Texas AG Ken Paxton Investigates Blue Cross Blue Shield Over Care Delays
- Texas Attorney General Ken Paxton has launched an investigation into Blue Cross Blue Shield of Texas, its parent company Health Care Service Corporation, and related entities over allegations...
- As part of the official inquiry, Attorney General Paxton issued a Civil Investigative Demand seeking information.
- The investigation follows reports submitted to the Office of the Attorney General alleging that administrative hurdles delayed urgent medical treatments.
Texas Attorney General Ken Paxton has launched an investigation into Blue Cross Blue Shield of Texas, its parent company Health Care Service Corporation, and related entities over allegations that the insurer denied or delayed coverage for medically necessary and urgent care. The inquiry centers on prior authorization and utilization review procedures that allegedly created delays in approving treatment.
Civil Investigative Demand Issued Over Prior Authorization Practices
As part of the official inquiry, Attorney General Paxton issued a Civil Investigative Demand seeking information. The investigation aims to determine whether Blue Cross Blue Shield of Texas, Health Care Service Corporation, or related entities violated Texas law, specifically examining potential breaches of the Texas Deceptive Trade Practices Act. Investigators will scrutinize how the insurer represents its claims approval process and whether claims were rejected without adequate review.
Reported Administrative Denials Involving Urgent Newborn Care
The investigation follows reports submitted to the Office of the Attorney General alleging that administrative hurdles delayed urgent medical treatments. One specific case highlighted in the state’s inquiry involved a newborn baby who required urgent medical care. According to the attorney general’s office, administrative denials delayed the infant’s transfer to a facility equipped to treat the baby, even though the procedure was allegedly covered under the family’s health plan.
Potential Health Risks and Official Statements
The attorney general’s office warned that delays in urgent medical situations can worsen patient conditions, increase complication risks, allow diseases to progress, and potentially result in disability or death. Paxton emphasized that insurance providers must prioritize patient health over financial outcomes.