Texas Attorney General Ken Paxton launched an investigation into TriWest Healthcare Alliance Corp. over wrongful denials of health insurance claims. The company is contracted by the U.S. government to administer the U.S. Department of Veterans Affairs Community Care Network and serves as the support contractor for the Defense Health Agency's TRICARE West Region.
Complaints have surged against TriWest claiming the company is incorrectly denying healthcare claims by falsely claiming beneficiaries have other health insurance. The company has acknowledged the problem. The Office of the Attorney General has issued Civil Investigative Demands to the company and plans to conduct interviews with consumers and employees.
One case involved a Texas couple who served over 20 years. The husband was battling cancer when TriWest falsely read his vision plan as other health insurance, resulting in denial of claims for necessary treatments and appointments. He attempted to correct the issue for almost two years before receiving relief after NBC aired a news story about his situation.
The investigation seeks to determine whether TriWest violated the Texas Deceptive Trade Practices Act, according to the attorney general's office.