Untitled Texas Attorney General Opinion

Hon. Preston Smith Opinion No. M-23 Lieutenant Governor State of Texas Re: Whether chiropractic services Austin, Texas afe Included in the provisions of Section 2 of Senate Bill 2, Acta 60th Leglelature. (Med- Dear Governor Smith: lcal Aaalstance Act of 1967.) You have requested the opinion of this office as to whether ~chlropractlc'eervlceeare Included In the pro- visions of Section 2 of Senate Bill 2, Acta of the 60th Legislature, the proposed Medical Assistance Act of 1967. Section 2~of Senate Bill 2, the proposed Medical Assistance.Act of 1967, provides, In part, that: !'It .itithe.lntent of the Leglalature to make statutory ~provlrrlon which will enable the State of Texas to provide Medical Assistance on behalf of needy lndivlduale of this State and to enable the State to obtain all benefits provided by the Federal Social Security Act as it now reads or as It may hereafter be amended, or by any other Federal Act now In effect or which may hereafter b;eenacted wlthln'the~llmlts of fundeavallable for such puz@se~si...:Wherever used:in this Act the term 'MedIcal Aaslstance.~..~shall~lnclude~~all~ofthe health care, aervices;:aasistance and:beneflts,authorlzed or provided -for.,lnsuch Federal.I.e~lslatlon." (Emphasis added .) The proposed Medical Aselstance.Act of 1967, Senate Bill 2, Is enabling legislation to authorize the State of Texasi acting through the State'Department of Public Welfare, to 'receive grants, pursuant to Title XIX of the Social Security Act, enacted by the Social Security Amendments of 1065 (Public Law 83-97) for medical assistance programs. Section 1902 of the Social Security Act (42 U.S.C.A. R 1396a) provides, In part, that: - 96 - Hon. Preston Sm$th, page 2, (M-23) “(a) A State plan for medical assistance must. . . , “(1) provide that. . . . I, . . . . ” (10) provide for making medical assistance available to all lndlvlduals receiving aid or assistance under State plans approved under titles I, IV, X, XIV, and XVI; and. . . . fyi) . . .provide that the medical assistance made available to Individuals ,receivlng aid or assistance under any such State plan. . . : “(I> “(13) provide for Inclusion of some Institutional and some non-institutional care and services, and effective July 1, 1967 provide (A) for ~nClUslOn of at least the care and services listed In clauses 1 throu 5 of Section 1905(a.. L . . (Ghasis $dAd!) Section 1905 of the Social Security Act (42 U.S.C.A. 8 139sd) provides, In part, that: “(a) The term ‘medical assistance’ means payment ‘.ofpart or all of the cost of the following care and services. . . . I, . . . . - 97 - Hon. Preston Smith, page 3, ~(M-23) "(1) Inpatient hospital services (other than services In an Institution for tuberculosis or mental diseases); “(2) outpatient hospital services; “(3) other laboratory and x-ray services; “(4) skilled nursing home services (other -than services in an Institution for tUberCUlO8is or mental diseases) for Individuals 21 years of age.or older: “(5) 4 hyslclans' services, whether furnished n- the office, the patlentls home, a hospital, dr a^'skillednurslnu home, or elsewhere; “(6) .medlcal care',or any other type of remedial care recognized under State law, furnished by licensed practitioners within the scope of their practice.as defined by State law; ,“(7). . . .. .” (Emphas1s.added.j The Handbook of Public Assistance Administration, Supplement D, Medical Assistance Programs, prepared~by the U. S. Department of Health, Education, and Welfare, sets forth,.at page 3 of Section D-5141, certain definitions applicable to-Section 1905(a)(5) and,Section 1505(a) (6) of the Social Security Act. In connect%% with the physicians' services provided for In Section 1905(a).(5), the following definition is aet:forth: "The..term. ~physlclans'~servlceet Is defined as those servlces.provlded, wlthln theascope of practice of his profession as defined by State law, by or under the personal.supervlslon of an,lndlvldual licensed under State la$ to.practlce'medicine or osteopathy." (Emphasis adaed.) In connection with the medical care or other type remedial care provided for In Section 1905(a) (6), the following definition Is set forth: - 98 - Hon. Preston Smith, page.4, (M-23). “This term Is defihed as any services other than physicians’ services, provided ulthi th scope of practice as deffned by State law” b an Individual licensed as a practitioner un ’ k er State law. ‘I (Emphasis added. ) Pursuant to the foregoing provisions of Title XIX of the Social Security Act (Public La* 89-97), and the applicable definitions found In the Bandbook of Public Assistance Administration, a State desiring to avail it- self of the medical assistance program benefits provided for in Title XIX of the Social Security Act must, in its plan, provide the medical assistance services set forth In Section 1905(a)(l) through (5). The remainder of the medical assistance services set forth in Section 1905(a)(6) through (15) are merely services which the State plan may provide If it so desires, unless they are presently being provided by the State under an existing medical a$ElEtance program, in which event such medical assistance services must be continued. Pursuant to the provisions of Article 695j, Vernon’s Civil Statutes, the State of Texas presently has in operation a program providing for certain medical benefits to recipients of uublic asEiEtance. Section 1 of Article 6953 provides In part that: “(a) The term ‘Medical Assistance’ means monetary assistance paid to a vendor of medical service8 and/or vendor of hospital services or a vendor of nursing car& rendered on behalf of a recipient of public assistance. (Medical Assistance ’ shall be in addition to and separate from the grants of public assistance payable directly to the recipients. “0’) !Cheterm .‘vendorof medical services’ means any person as defined under Sub- section (i) f thl S tl iding medical services tz ae~ec&%?of public assistance. I, . . * . “(I) The term tphyslcianl means a person licensed by the Texas State Board of Medical Examiners. 11 . . . .‘I (~hasls added.) - 99 - Hon. Preston Smith, page 5, (M-23) Section 4 of Senate Bill 2, the proposed Medical Assistance Act of 1967, provides, In part, that: "The State Department Is hereby authorized and empowered to determine the scope of the services to be covered. . . . "Medical AESiStanCe provided for these groups Shall be not less In scope, duration, or amount than Is currently ~furnlshed such croups, and In addition, shall Include at least the m&lmkn~servlces required under Federal Laws and rules and regulatlone. . . . "The State Department Is authorlzed and empowered, at such times as the State Department may determine feasible and.wlthln the limits of appropriated funds, to extend the scope, duration, and amount of Medical Assistance on behalf of these groups of public asslst- ante recipients and related groups as are mandatory so as to Include, In whole or In part, the optional medical services authorized under Federal Laws and rules and regulations. . . .'I (Emphasis added.) Senate.Blll 2, the proposed Medical Assistance Act of 1967, authorizes ~the State :Department.of Publlc Welfare to engage In a medlcal assistance program whereby the State of Texas will be able to receive Federal matching funds pursuant to Title XIX of.the.Social Security Act. The scope of medical services to be made available to public assistance recipients is left to .the discretion of the State Department of Public Welfare wlthin the limits of available fLUIdS. However, to qualify for Federal matching funds pursuant to Title XIX of .the Social Security Act, the State Department of Public Welfare must lncl.ude.lnits medical assistance program the services set forth In Section 1505(a)(l) through (5) of:the Social Security Act. Such being the case the "phyElClaXIS'services" provided for In Section 1905(a)(5) of the Social Security Act must be made available to public assistance recipients, However, such "phySiClanE services" must be supplied by individuals licensed In Texas to practice medicine or osteopathy. Consequently, we are of the opinion that In view of the fact a chiropractor offering chiropractic service Is not licensed.to practice medlclne or osteopathy in the State of Texas pursuant to the provisions of Articles 44o5-4512, Vernon's Civil Statutes, but Is licensed to - 100 - Hon. Preston Smith, page 6, (M-23) ractlce chiropractic pursuant to the provisions of Article fi 512b, Vernon's Clvll Statutes, such chiropractic services are not Included within the terms of "physicians' services" set forth In Section 1905(a)(5) of the Social Security Act. Also, as chiropractic services are presently not available to public assistance recipients by virtue of Article 6$5j, it Is not mandatory that Such services be made available under the provisions of the propOSed Medical Assistance Act of 1957, Senate Bill 2, to comply with the requirements of Title XIX of the Social Security Act; However, In this connection, should the State Department of PublIcWelfare elect to extend the medical~beneflts .avallablepursuant to thm.Medlcal Assistance Act of 1967 to those services re- ferred to In Section 1905(a)(6) of ,the Social Security Act, then, In such event, chiropractic services could be made available to public assistance recipients. SUMMARY --w-m-- To comply with the provisions of Title XIX of the Social Security Act, whereby Federal matching funds can be obtained, Senate Bill 2, the proposed Nedlcal AESiEt- ante Act of 1967, must make available the medical assistance benefits set forth in Section 1905(a)(l) through (5) of the Social Security Act (42 U.S.C.A. ",l;z5d) to public assistance recipients. benefits do not include, however, chlro- practic services. The State Department of Public Welfare is given the authority under Senate Bill 2, the Medical Assistance Act of 1967, to extend at its discretion, the scope of benefits available to reCiplent.6of public assistance to Include those services set forth in Section 1905 (a)(s) through (15 of the Social Security Act (42 U.S.C.A. 13osd). Should the State Department of Public Welfare elect to extend medical - 101 - Hon. Preston Smith, page 7, (M-23) assistance benefits tc those services referred to In Section l$C5(a)(j) of the Social Security Act, then, In such event, chiropractic services could be made avall- able to public assistance recipients. -Preparea-byPat Bailey Assistant Attorney General PB:Eck:dh APPROVED: OPINION COMMITTEE Haxthorne Phillips, Chairman W. V. Ceppert, Co-Chalrman John Reeves W. 0. Shultz John Grace Ro&er Tyler STAFF LEGAL ASSISTANT A. J. CDRUBBI, JR. - 102 -