Texas Attorney General Ken Paxton announced Monday that AstraZeneca Pharmaceuticals LP will pay nearly $34 million to resolve state claims that it pushed Medicaid-paid prescriptions through an unlawful kickback scheme. According to the state, the drugmaker relied on third parties, including so-called “white coat” nurses, and offered free nursing and reimbursement-support programs that nudged prescribers toward AstraZeneca medicines. Under an agreement announced June 29, AstraZeneca will pay $33,998,000 under the Texas Health Care Program Fraud Prevention Act to put those claims to rest.
In a press release, the Texas Attorney General's Office described programs that “provided free nursing services and reimbursement support to prescribers and paid third-parties to deploy nurses and other healthcare professionals” to recommend AstraZeneca drugs to providers, according to FOX 26 Houston. The office said many of the prescriptions at issue were covered by Texas Medicaid, generating millions in claims the state now labels as tainted.
What the state alleges
“I will not allow Big Pharma to misuse taxpayer dollars to put profit ahead of Texans’ health,” Paxton said in the statement. His office alleges the inducements were packaged as non-branded patient counseling but in practice steered providers toward AstraZeneca medicines, with Medicaid picking up the tab for many of those prescriptions.
How the case reached court
The dispute traces back to a 2022 qui tam complaint that accused AstraZeneca of three kickback schemes: deployment of white-coat nurses, free nurse services, and reimbursement support, as described in court records. A 2025 appellate opinion details the procedural fights over where the suit should be heard and tracks how the case moved through Texas courts before the state negotiated the resolution; see the 15th Court of Appeals opinion for the blow-by-blow.
Company response and sealed records
Bloomberg Law reported that the settlement surfaced in sealed court records and that an AstraZeneca spokesperson told the outlet the company denies the allegations. That reporting says the parties reached a resolution earlier in June and that the Attorney General's Office formalized the agreement on June 29, 2026.
Why it matters for Texans
The payment will return nearly $34 million to the state and marks another headline-grabbing recovery in Paxton’s broader campaign against alleged Medicaid fraud by drugmakers. Reporting by The Texas Tribune and the Dallas Morning News has chronicled the Attorney General’s recent string of high-profile suits against pharmaceutical companies, a pattern legal experts say could reshape how manufacturers design and run patient-support programs in Texas.
