Texas AG Paxton investigates military healthcare contractor over denied claims

Texas Attorney General Ken Paxton has opened an investigation into a major military healthcare contractor over wrongfully denied medical claims.

Paxton’s office said in a release this week that complaints have surged against TriWest Healthcare Alliance because the company is denying claims due to errors that incorrectly listed some beneficiaries as having “Other Health Insurance,” or OHI.

“Health insurance companies cannot promise health care coverage and then wrongfully deny patients the benefits they are entitled to receive,” Paxton said in the release. The investigation will examine whether TriWest’s handling of the claims violated Texas consumer protection law.

TriWest is one of the contractors that administers TRICARE, the military’s healthcare program for active-duty service members, retirees and their families.

In May, NBC News reported on persistent problems beneficiaries have faced since 2025, when TRICARE transitioned its contract from Health Net Federal Services to TriWest. The reporting included the case of Guy Shoemaker, 65, of Fort Worth Texas, who said he had tens of thousands of dollars in previously approved claims overturned and money clawed back from paid providers because of an OHI error.

Shoemaker, a retired Army sergeant first class and recruiter who spent a year in Afghanistan, was diagnosed with…

Original source: https://www.nbcnews.com/health