{"id":426991,"date":"2026-09-05T08:30:23","date_gmt":"2026-09-05T08:30:23","guid":{"rendered":"https:\/\/www.newsbeep.com\/us-tx\/426991\/"},"modified":"2026-09-05T08:30:23","modified_gmt":"2026-09-05T08:30:23","slug":"texas-ag-paxton-investigates-military-healthcare-contractor-over-denied-claims","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us-tx\/426991\/","title":{"rendered":"Texas AG Paxton investigates military healthcare contractor over denied claims"},"content":{"rendered":"

Texas Attorney General Ken Paxton has opened an investigation into a major military healthcare contractor over wrongfully denied medical claims.<\/p>\n

Paxton\u2019s office said in a release this week<\/a> that complaints have surged against TriWest Healthcare Alliance because the company is denying claims due to errors that incorrectly listed some beneficiaries as having \u201cOther Health Insurance,\u201d or OHI. <\/p>\n

\u201cHealth insurance companies cannot promise health care coverage and then wrongfully deny patients the benefits they are entitled to receive,\u201d Paxton said in the release. The investigation will examine whether TriWest\u2019s handling of the claims violated Texas consumer protection law.<\/p>\n

TriWest is one of the contractors that administers TRICARE, the military\u2019s healthcare program for active-duty service members, retirees and their families.<\/p>\n

In May, NBC News reported on persistent problems beneficiaries have faced since<\/a> 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. <\/p>\n

Shoemaker, a retired Army sergeant first class and recruiter who spent a year in Afghanistan, was diagnosed with Stage 2 throat cancer in 2021 and has since needed ongoing therapy to ensure he can speak and swallow safely. The lull in coverage led to serious deterioration of his condition. Another 13 beneficiaries also spoke to NBC News, describing problems with their TRICARE coverage following the transition to TriWest.<\/p>\n

Paxton, who is currently running for Senate as a Republican against Democrat James Talarico, mentioned Shoemaker in his press release. <\/p>\n

\u201cMr. Shoemaker tried to correct the issue with TriWest for almost two years. He only received relief after NBC aired a news story covering his situation,\u201d the press release said. \u201cThe Shoemakers\u2019 situation is not unique and TriWest has acknowledged the OHI denials are [a] problem.\u201d<\/p>\n

Shortly after NBC News\u2019 story on Shoemaker aired, TriWest President and CEO David McIntyre Jr. apologized<\/a> to those who had experienced problems with OHI errors under the company\u2019s watch.<\/p>\n

\u201cI want to personally take this opportunity to apologize to those of you who have experienced challenges with Other Health Insurance on our watch,\u201d McIntyre wrote in a letter to beneficiaries in May.<\/p>\n

In an emailed statement Friday, TriWest said the company is reviewing Paxton\u2019s investigative demand.<\/p>\n

\u201cWe and the 146,000 providers in our Texas network are committed to military families, helping ensure they receive the care they have earned,\u201d the statement said.<\/p>\n

In an interview Friday, Shoemaker, who is now covered by Medicare, said the Texas investigation is \u201cnice to see,\u201d but believes the issue should be addressed nationally. For him, however, \u201cthe damage is done\u201d \u2014 even though his coverage problems were resolved, his condition is \u201cgoing to progressively get worse,\u201d Shoemaker said. <\/p>\n

\u201cI know the issue still exists for other veterans,\u201d Shoemaker said. \u201cI\u2019ll give Ken Paxton credit. I appreciate the fact that he\u2019s taking it up, but again, it should be more than just state level.\u201d <\/p>\n

Paxton\u2019s office said it had issued civil investigative demands to TriWest seeking information from the company and plans to interview consumers and employees. The investigation will determine whether TriWest violated the Texas Deceptive Trade Practices Act.<\/p>\n","protected":false},"excerpt":{"rendered":"Texas Attorney General Ken Paxton has opened an investigation into a major military healthcare contractor over wrongfully denied…\n","protected":false},"author":2,"featured_media":426992,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[27,29,28],"class_list":["post-426991","post","type-post","status-publish","format-standard","has-post-thumbnail","category-texas","tag-texas","tag-texas-headlines","tag-texas-news"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/posts\/426991","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/comments?post=426991"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/posts\/426991\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/media\/426992"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/media?parent=426991"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/categories?post=426991"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-tx\/wp-json\/wp\/v2\/tags?post=426991"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}