Gov. Greg Abbott directed the Texas Health and Human Services Commission to investigate a second Rio Grande Valley hospital over alleged birth tourism practices.

The two hospitals are Mission Regional Medical Center and Knapp Medical Center in Weslaco. Both are owned by Prime Healthcare.

Birth tourism refers to pregnant women traveling to the U.S. to give birth so their child receives U.S. citizenship.

Abbott said Mission Regional appeared to be advertising birth packages in South Texas in foreign countries and targeting foreign nationals. In a letter, he directed the HHSC to investigate whether any laws were broken.

"Birth tourism is an illegal practice that exploits the extraordinary hospitality that the United States and Texas offer to millions of foreign travelers each year," Abbott said in a statement. "Thousands of foreign travelers come to the United States under false pretenses to give birth and secure citizenship for their children. HHSC must investigate the hospital, a facility it regulates, for any violations of state law and contractual obligations."

The investigation follows a social media post made in April by former Valley Congresswoman Mayra Flores. She shared photos she said she took of a billboard in Reynosa that appeared to advertise childbirth packages at Mission Regional Medical Center.

The day after Abbott's directive, the HHSC submitted a referral to the attorney general's office based on publicly available evidence connecting the two hospitals to a birth tourism scheme advertised at "havemybabyinTEXAS.com."

Channel 5 News reached out to Mission Regional. A spokesperson said a limited marketing campaign caused a misunderstanding and was discontinued.

The hospital said the campaign was meant to highlight services, not encourage unlawful activity, and that it remains committed to following the law.

"I am pleased that HHSC took decisive action based on my directive last week," Abbott said. "Regardless of what the Supreme Court of the United States may have said, U.S. citizenship is not for sale in Texas. Texas will not tolerate the exploitation of our health care system as a pathway to skirt federal immigration laws."

Channel 5 News also reached out to the Hidalgo County District Attorney's Office and was told the office was not notified about the referral.

Channel 5 News reached out to Knapp Medical Center for comment and is waiting to hear back.

Check out the full statement from Mission Regional below:

"Mission Regional Medical Center is an award-winning, nonprofit community hospital that has served the Rio Grande Valley since 1954 with a mission to provide high-quality, compassionate healthcare to the communities we serve. We recognize that a very limited marketing campaign may have caused unintended misunderstanding and was immediately discontinued. The campaign was meant to highlight services available to the communities we serve and was never intended to encourage any unlawful activity. Mission Regional Medical Center does not support or facilitate any unlawful activity and remains committed to serving the Rio Grande Valley with integrity, compassion, transparency, and full compliance with all applicable laws.

We are aware of the Governor's request that this matter be reviewed and are cooperating fully and transparently with state officials.

The very limited campaign consisted of only two billboards located near the hospital and a website that generated very little patient volume, produced no financial benefit to the hospital, and was only intended as a service for the community, which is one of the most medically underserved regions of Texas, where approximately 30% of residents are uninsured and access to maternity care continues to decline. The advertisements at issue originated as part of a local marketing effort to share information regarding services for the community and consisted of only two billboards located within approximately 15 miles of our hospital near a legal U.S. port of entry frequently used by residents who live and work in the Rio Grande Valley, along with a website, which is no longer active, and was accessible to all to provide information about obstetric services.

The hospital does not support or facilitate unlawful activity and has never operated its obstetric program with the intent of attracting individuals who are unlawfully present in the United States, promoting birth tourism, or encouraging travel to the United States for the purpose of obtaining U.S. citizenship for a child.

Self-pay obstetric services represented only a very small portion of the hospital's operations, with only 63 elective cases this year and 97% of patients providing home addresses in the United States. Self-pay prices were set at rates below the hospital's cost of care at approximately Texas Medicaid reimbursement rates, meaning every self-pay obstetric delivery was provided at a financial loss but services were offered as a community benefit to expand access to affordable maternity care, consistent with the nonprofit mission of Mission Regional Medical Center. Self-pay packages are commonly offered by hospitals nationwide and within the region, similar packages were offered at higher costs.

Mission Regional Medical Center serves one of the most medically underserved regions of Texas and communities across South Texas continue to face significant challenges accessing obstetrical care due to physician shortages and the closure or reduction of maternity services. Rather than reducing access, Mission Regional Medical Center has remained committed to maintaining obstetrical services, including a Level III Neonatal Intensive Care Unit, because improving maternal and infant health outcomes is central to our nonprofit mission. Knapp Medical Center, the only other nonprofit hospital in the Rio Grande Valley did not actively participate in this marketing campaign with no involvement since 2024.

Beyond maternity services, Mission Regional Medical Center provides more than $12 million annually in charity care and community benefit, and our Emergency Department cares for more than 3,000 patients each month, more than 100 patients every day, including a significant number of uninsured individuals. The hospital was saved from financial distress and converted to a nonprofit status in 2017, ensuring continued access to essential, quality healthcare services for the Rio Grande Valley and recently named among the nation's best by Forbes as a Top Hospital by State. "