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now moot, and It is hereby being withdrawn.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
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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.
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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
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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
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