Texas

Abbott expands call for stronger anti-fraud investigations to include Texas Medicaid

KERA | By Abigail Ruhman

Published January 20, 2026 at 6:00 AM CST

Texas Gov. Greg Abbott on Friday directed state officials to increase anti-fraud measures and investigate potential fraud in the Medicaid program. He said the Trump administration has identified some services that are susceptible to fraud.

Gov. Greg Abbott directed state officials to investigate potential Medicaid fraud in Texas and implement additional anti-fraud measures.

In a letter sent Friday, Abbott directs the head of the Texas Health and Human Services Commission and the Health and Human Services Office of Inspector General to "proactively address fraud, waste and abuse" in Medicaid programs after the Trump administration identified potential fraud in other states.

The letter outlines actions for the agencies to take – including additional reviews of services identified by the Trump administration.

Several of the measures focus on the insurance companies that facilitate Medicaid programs – known as Managed Care Organizations, or MCOs. Abbott instructs HHSC the OIG to ensure the organizations have a fully staffed Special Investigations Unit to complete legally required investigations into fraud. The state will also provide training to those investigative units to improve their ability to find and prevent fraud.

MCO policies for services that are considered at a higher risk for fraud will go through a targeted review by the state.

Abbott also directs state officials to "complete a targeted utilization review of autism services" and provide a report in June.

"During my tenure as Governor, Texas has policed the Medicaid program and proactively combatted fraud," Abbott wrote in the letter. "But we will strengthen our efforts to further protect taxpayers, preserve access for eligible Texans, and maintain the integrity of Texas' Medicaid Program."

The letter was sent less than two weeks after Abbott sent a letter to the heads of the Texas Workforce Commission and HHSC, directing them to implement anti-fraud measures in a program designed to help low-income families pay for childcare. That letter was sent after the Trump Administration choose to freeze federal funding to Child Care Services programs due to a viral video claiming widespread fraud in Minnesota.

State agencies are expected to provide a progress report to Abbott by March 15.

Abigail Ruhman is KERA's health reporter. Got a tip? Email Abigail at aruhman@kera.org.

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