Texas Attorney General Ken Paxton has launched an investigation into TriWest Healthcare Alliance, a military healthcare contractor, over allegations that it wrongfully denied medical claims due to errors listing beneficiaries as having "Other Health Insurance". The investigation will examine whether TriWest's handling of the claims violated Texas consumer protection law. Complaints against TriWest have surged since 2025, when it took over TRICARE contracts from Health Net Federal Services. So far, at least one beneficiary has had tens of thousands of dollars in previously approved claims overturned due to these errors.
Written by the local model on 2026-09-04,
using this article's own text rather than the other coverage of the
same event (that is the story summary below).
Story summary
Texas Attorney General Ken Paxton has launched an investigation into TriWest Healthcare Alliance, a major military healthcare contractor, over allegations that it is wrongfully denying medical claims. The company is administering TRICARE, the military's healthcare program for active-duty service members, retirees, and their families. Complaints against TriWest have surged due to errors in its system, which incorrectly lists some beneficiaries as having "Other Health Insurance" (OHI), leading to denied claims. As a result of these errors, some patients, like Guy Shoemaker, a 65-year-old retired Army sergeant from Fort Worth, Texas, have had tens of thousands of dollars in previously approved claims overturned and money clawed back from their paid providers. The investigation will determine if TriWest's handling of the claims violated Texas consumer protection law. This issue has been ongoing since at least 2025, when TRICARE transitioned its contract from Health Net Federal Services to TriWest, with problems persisting until now.
Written for “Military Healthcare Contract Scandal” on 2026-09-05,
grounded in this article and the 0 other(s) covering the same event.
Why this leaning score
The model judged this article politically coded and scored it -0.35, but none of the 1 quote(s) it offered could be found in the article text, so the score is not published.
Written under an earlier scoring contract, which gave a paragraph
rather than checkable quotes. Re-analysing this article replaces it.
Leaning score withheld for article 4040: no verified evidence · logged 2026-09-04
Texas Attorney General Ken Paxton has opened an investigation into a major military healthcare contractor over wrongfully denied medical claims.
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Paxton → open → 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.
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that → say → Insurance
“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.
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Paxton → promise → release
The investigation will examine whether TriWest’s handling of the claims violated Texas consumer protection law.
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handling → examine → law
TriWest is one of the contractors that administers TRICARE, the military’s healthcare program for active-duty service members, retirees and their families.
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that → administer → members
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.
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TRICARE → report → 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.
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thousands → include → error
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.
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he → retire → therapy
The lull in coverage led to serious deterioration of his condition.
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lull → lead → condition
Another 13 beneficiaries also spoke to NBC News, describing problems with their TRICARE coverage following the transition to TriWest.
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beneficiaries → speak → TriWest
Paxton, who is currently running for Senate as a Republican against Democrat James Talarico, mentioned Shoemaker in his press release.
“Mr. Shoemaker tried to correct the issue with TriWest for almost two years.
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Shoemaker → run → years
He only received relief after NBC aired a news story covering his situation,” the press release said.
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release → receive → situation
“The Shoemakers’ situation is not unique and TriWest has acknowledged the OHI denials are [a] problem.”
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denials → acknowledge → ?
Shortly after NBC News’ story on Shoemaker aired, TriWest President and CEO David McIntyre Jr. apologized to those who had experienced problems with OHI errors under the company’s watch.
“I want to personally take this opportunity to apologize to those of you who have experienced challenges with Other Health Insurance on our watch,” McIntyre wrote in a letter to beneficiaries in May.
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McIntyre → air → May
In an emailed statement Friday, TriWest said the company is reviewing Paxton’s investigative demand.
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company → email → demand
“We and the 146,000 providers in our Texas network are committed to military families, helping ensure they receive the care they have earned,” the statement said.
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statement → commit → care
In an interview Friday, Shoemaker, who is now covered by Medicare, said the Texas investigation is “nice to see,” but believes the issue should be addressed nationally.
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issue → cover → Medicare
For him, however, “the damage is done” — even though his coverage problems were resolved, his condition is “going to progressively get worse,” Shoemaker said.
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Shoemaker → do → him
“I know the issue still exists for other veterans,” Shoemaker said.
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Shoemaker → know → veterans
“I’ll give Ken Paxton credit.
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I → give → credit
I appreciate the fact that he’s taking it up, but again, it should be more than just state level.”
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it → appreciate → level
Paxton’s office said it had issued civil investigative demands to TriWest seeking information from the company and plans to interview consumers and employees.
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it → say → consumers
The investigation will determine whether TriWest violated the Texas Deceptive Trade Practices Act.
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TriWest → determine → Act