Untitled Texas Attorney General Opinion ( 1968 )

THE .L%TJXBRNEY GENERAL At?STlN. TwAn 78711 c%AvvF"yIu c. in-TIN Ax-rORNlcY OIMERAI- 'February 13, 1968 Hon. Burton G. Hackney Opinion No. M-200 Commissioner State Department of Public Welfare Re: Medical assistance pay- John H. Reagan Building ments for public assistance Austin, Texas by State Department of Public Welfare. Dear Mr. Hackney: In your letter of February 1, 1968, you call our atten- tion to the fact that since the issuance of our Opinion No. M-173, that the Congress of the United States has enacted H. R. 12080, which is Public Law 90-248, becoming effective January 2, 1968, and that our Opinion Is therefore moot. We agree with your statement that Opinion No. M-173, is now moot, and It is hereby being withdrawn. You have asked as to whether or not, under existing State and Federal statutes, you have the authority to make payments for medical assistance on behalf of such recipients (OAA, AH, APTD, and AFDC) to the recipients of the service or only to the provider of the services. Section 5la of Article III of the Texas Constitution reads, in part,as follows: 11 . . . "The Legislature shall have authority to enact appropriate legislation which will enable the State of Texas to cooperate with the Govern- ment of-the United States in providing assistance to and/or medical care on behalf of needy persons, and in providing rehabilitation and any other services included in the Federal legislation pro- viding matching funds to help such families and individuals attain or retain capability for in- dependence or self-care, and to accept and expend funds from the Government of the United States for -961- Hon. Burton G. Hackney, page 2 (M-200) such purposes in accordance with the laws of the United States as they now are or as thee may hereafter be amended, and to make appropria- tions out of State funds for such purposes; pro- vided that the maximum amount oaid out of State funds to or on behalf of any individual recipient shall not exceed the amount that is matchable out of Federal funds; provided that the total amount of such assistance payments and/or medical assis- tance payments out of State funds on behalf of such reciaients shall not exceed the amount that be expended per fiscal year out of State funds for assistance payments only to recipients of Old Age Assistance, Aid to the Permanently and Totally Disabled, Aid to thenBlind, and Aid to Families with Dependent Children shall never exceed Sixty M+ll~ionDoilars ($6o,OoO,OOoj.” (Emphasis added.) In your original request you submitted the same question as above quoted, except in your original request the question was predicated 'on the assumption that there is no Federal barrier, either in law or Federal rules and regulations." In answering your original request, we therefore assumed that the Federal Social Security Act did not require medical assistance payments to be ven- dor payments to the providers of medical services. You now inform us that the Federal Government, by rules and regulations, made in pursuance to the Federal Social Security Act, requires medical assistance payments to be vendor payments to the providers of med- ical services. You also state in your letter that your department has construed Section 51a of Article III of the Texas Constitution to require medical assistance payments to be vendor payments only, as the wording, 'on behalf of needy persons" as used in our Con- stitution parallels the language used in the Federal Social Security Act. -962- Hon. Burton G. Hackney, page 3 (M-200) The Texas Legislature which submltted Section 51a of Article III, in enacting enabling legislation pursuant thereto, has also construed~our Constitution to require medical assistance payments to be made to the vendors of such services, as reflected by S.B. No. 79, 57th Leg., and by S.B. No. 2 and S.B. No. 454, 60th Leg. S.B. No. 79, Acts 57th Leg., R.S. 1961, Ch. 380, p. 858, states in part: "Section 1. The following definitions shall apply to words and terms used in this Act: "(a) The term 'Medical Assistance' means monetary assistance paid to a vendor of medical services and/or vendor of hospital services or a vendor of nursing care rendered on behalf of a recipient of public assistance. 'Medical Assistance' shall be in addition to and separate from the grants of public atsistance made pavable directly to the recipients. (Emphasis added;) S.B. No. 454, Acts 60th Leg., R.S. 1967, Ch. 348, p. 822, contains the following statement: ,, . . .and payments to vendors of Medical Assistance on behalf of such recipients, . . . ' '(i3nphasis added;. Your construction of Section 51a of Article III, together with the legislative construction thereof, as shown by the quoted portions of S.B. No. 79, S.B. No. 2 and S.B. No. 454 are both en- titled to great weight. 12 Tex.Jur.2d 366, Constitutional Law, Sec. 20. As the Federal Social Security Act, as construed by such rules and regulaticns, require vendor payments for medical services, it follows that your department can only make vendor payments, as the construction of the Federal Act controls the method of payments. This is so, by virtue of the fact that the Federal matching fund, appropriated by Congress, goes into and becomes a part of the same fund for medical care. SUMMARY Construction of existing Federal statutes and present state statutes require the State Department of Public Welfare to make payments for medical assistance on behaif of recipients - 963 - Hon. Burton 0. Hackney, page 4 (M-200) (OAA, AB, APTD, and AFDC) under Title XIX in the form of vendor payments payable to the provider of services. Y 9 very truly, H Prepared by W. V. Geppert Assistant Attorney General APPROVED: OPINION COMMITTEE Hawthorne Phillips, Chairman Kerns Taylor, Co-Chairman John Reeves Bill Craig Houghton Brownlee, Jr. Sam Kelley A. J. CARUBBI, JR. Executive Assistant -964-