A Texan who wants to know which Medicaid health plan the state has fined, and for what, can go to the page the Health and Human Services Commission built for exactly that purpose. Twenty spreadsheets sit there, one for each plan. Every one of them ends at Nov. 30, 2022.
State law does not treat the reporting as optional. Texas Government Code §540.0210 orders the commission to keep a record of every enforcement action that ends in a penalty against a Medicaid managed care organization — the private insurers the state pays to run Medicaid — and to post it “in English and Spanish,” “in a format that is readily accessible to and understandable by the public,” and to “update the list of records on the website at least quarterly.” The provision was added by House Bill 4611 in 2023 and took effect April 1, 2025. It has not been amended since.
The commission’s own page says the same thing in its own words: “Enforcement actions are posted quarterly.” It still cites the statute by its old number, §533.0072, which was repealed when the Legislature reorganized the Medicaid managed care code.
Roughly fifteen consecutive quarters are missing. Every one of the twenty workbooks carries a server timestamp, and each contains the same four tabs and no others, covering the state fiscal quarters from March 2022 through November 2022. The four posted quarters record $3,193,300 in penalties across all twenty plans. The largest single line in the last quarter Texas ever published is a $220,000 penalty against UnitedHealthcare, and the commission’s own entry explains it: “OIG requested United’s contracts in support of United’s rationale that it reported affiliate expenses at fair market value. The initial deadline for this information was January 20, 2022. Both United and its affiliates refused to provide unredacted contracts.” The commission counted 88 days of noncompliance.
What makes the gap hard to read as simple neglect is that somebody was working on that page on Sept. 9. That day the commission repaired two broken links — the files for Texas Children’s Health Plan and UnitedHealthcare had been returning errors — and uploaded corrective action plans for June and July 2026, both of which had been late. It updated everything on the page except the one thing the statute names.
Those corrective action plans show the commission is watching its plans closely and in real time. The July 2026 document, which runs 19 pages, records that Aetna “failed to document needs identified in the service planning documents for the STAR Kids non-Medically Dependent Children Program population and failed to conduct required Service Coordination visits.” STAR Kids is the Medicaid program for children and young adults with disabilities. Parkland Community Health Plan “failed to meet the performance standard to resolve Member Appeals within 72 hours” in STAR, and separately “failed to meet the performance standard to adjudicate Behavioral Health claims within 30 days” in the Children’s Health Insurance Program. Wellpoint “failed to meet the call hold rate performance standard for the Behavioral Health Hotline” in STAR Kids. Cook Children’s “failed to provide administrative services by failing to complete the four-week call.” Scott and White was cited over a pharmacy benefit manager arrangement that did not reflect what was actually paid.
So the state publishes, month by month, which plans are failing its members. What it stops short of publishing is what it charged them for it.
The statute contains one escape hatch, and it is narrow. Subsection (d) says the commission “may not post information under this section that relates to a sanction while the sanction is the subject of an administrative appeal or judicial review.” That exemption runs sanction by sanction. On its face it cannot account for fifteen quarters in which nothing at all was posted. The commission has not said publicly how many of the unposted penalties are under appeal, or whether penalties were assessed at all.
The Dispatch has reported this year on Texas hospitals losing $27 million a day while Washington withheld Medicaid payments, on the state’s falling children’s coverage, and on a proposal to strike the pay floor for home-care attendants. Each of those turns on money moving between the state and a contractor. The sanctions list is the ledger for the other direction, and nothing has been added to it in nearly four years.
Two things could force the question soon. The commission’s Executive Council meets Sept. 17, and the Sunset Advisory Commission’s staff review of the agency — the periodic audit that can rewrite how a state agency operates — is expected in October.