Texas Attorney General Ken Paxton opened an investigation into TriWest Healthcare Alliance Corp., the U.S. government contractor that administers the VA Community Care Network and the Defense Health Agency's TRICARE West Region, over reports that it wrongfully denied health care claims by falsely treating insureds as having other health insurance (OHI). The OAG has issued Civil Investigative Demands (CIDs) and plans to interview consumers and employees to determine whether TriWest violated the Texas Deceptive Trade Practices Act. No findings or penalties have been imposed yet.
No penalties or remedies have been imposed yet. As part of the ongoing investigation, the OAG has issued Civil Investigative Demands (CIDs) to TriWest and plans to conduct interviews with consumers and employees.
Organizations that use third-party administrators (TPAs) or health benefit contractors should review their administrator and vendor agreements for claims-processing accuracy standards, coordination-of-benefits (COB) and 'other health insurance' (OHI) data-matching provisions, and data-quality warranties covering eligibility and enrollment data feeds (the alleged violation arose from a vision plan being misread as OHI). Key clauses to scrutinize include: representations that the vendor will accurately classify coverage and promptly correct misclassifications; member appeal, grievance, and complaint-escalation requirements with defined response times; audit and reporting rights over claim denial rates and denial reasons; cooperation obligations for regulatory investigations and Civil Investigative Demands; and indemnification/hold-harmless provisions for deceptive trade practices or wrongful-claim-denial liability. Customer-facing health plan agreements should also be checked to ensure denial notices and coverage representations align with what is contractually promised to avoid DTPA exposure.
Entity
TriWest Healthcare Alliance Corp.
Industry
Insurance"TriWest Healthcare Alliance Corp."
"Attorney General Ken Paxton launched an investigation into TRICARE Insurance’s TriWest Healthcare Alliance Corp."
"This investigation stems from reports and admission that the company wrongfully denied health care claims."
"falsely claiming that the insured has other health insurance (“OHI”)"
"The investigation seeks to determine whether TriWest violated the Texas Deceptive Trade Practices Act (“DTPA”)."
"the Office of the Attorney General has issued Civil Investigative Demands (“CIDs”) to the company"
$7.5M
Texas Attorney General Ken Paxton announced a $7.5 million settlement with Tris Pharmaceuticals over alleged misrepresentations about the efficacy of Dyanavel XR, an ADHD drug marketed for children. The release says the company overstated the drug’s efficacy and directed sales representatives to make misleading claims to doctors, including Medicaid providers.
Texas Attorney General Ken Paxton announced an agreement with Plum Organics requiring stronger testing and limits for heavy metals in covered baby food products, along with publicly accessible testing results. The release does not state a monetary penalty; the agreement follows an ongoing investigation into baby food manufacturers.
Texas Attorney General Ken Paxton opened an investigation into Blue Cross and Blue Shield of Texas, its parent Health Care Service Corporation, and related entities over alleged denials or delays of urgent and medically necessary care and potentially burdensome prior authorization requirements. The investigation is ongoing; the Attorney General issued a Civil Investigative Demand to obtain information and assess potential violations of Texas law.
Texas Attorney General Ken Paxton issued a consumer alert warning Texas businesses and nonprofits about a surge of demand letters alleging California Invasion of Privacy Act (CIPA) violations based on common website technologies such as cookies, pixels, and analytics tools. The AG cautions that some letters may exaggerate or misrepresent violations and may be fraudulent, noting serial CIPA plaintiff Vivek Shah has been declared a vexatious litigant. Recipients are advised not to pay or respond directly, to consult privacy counsel, and to report suspected fraud to the Consumer Protection Division.
A Texas state district court (Judge Cory Liu) has found TikTok liable for lying to parents about the safety of its platform and for exposing children to inappropriate and explicit content, making Texas the first state in the nation to hold TikTok liable on these claims. The court found that although TikTok claimed it would remove graphic videos depicting drugs, nudity, alcohol, injuries, and profanity, such videos remained accessible to minors, even under 'Restricted Mode.' No penalty has been imposed yet; Attorney General Paxton will proceed to trial, expected next month, where relief and penalties will be determined.
Texas Attorney General Ken Paxton sued Amazon.com, Inc. on August 31, 2026, alleging Amazon deceived advertisers by claiming to run second-price auctions while secretly applying hidden surcharges and undisclosed 'soft reserve' prices that pushed winners' costs up by roughly 17% on ordinary days and more than 25% during peak events like Prime Day. The hidden surcharges generated roughly $4.5 billion in additional nationwide revenue in 2024, and more than 18,000 Texas sellers and vendors advertise on the platform. The State brings claims under the Texas Deceptive Trade Practices Act, seeking civil penalties of up to $10,000 per violation, an injunction against inaccurate auction descriptions, and per-auction pricing records for every Texas advertiser; the FTC and a coalition of other states filed a parallel federal action the same day.