### THE .L%TJXBRNEY GENERAL

c%AvvF"yIu c.in-TIN At?STlN. TwAn 78711 Ax-rORNlcYOIMERAI- 'February

### 13,1968

Hon. Burton G. Hackney Commissioner Opinion No. M-200 State Department of PublicWelfare Re: Medical assistance payJohn H. Reagan Building ments for public assistance Austin, Texas by State Department of PublicWelfare. Dear Mr. Hackney:

In your letter of February 1, 1968,you call our attention to the fact that since the issuance of our Opinion No. M-173, that the Congress of the United Stateshas enactedH. R. 12080, which is PublicLaw 90-248, becoming effective January 2, 1968, and that our Opinion Is thereforemoot.

We agree with your statement that Opinion No. M-173, is now moot, and It is hereby being withdrawn.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 suchrecipients (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 Constitutionreads, in part,as follows:

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. . . "TheLegislature shallhave authority to enact appropriate legislationwhich will enable the State of Texas to cooperatewith the Government of-theUnited States in providing assistance to and/ormedical care on behalf of needy persons, and in providing rehabilitation and any other services included in the Federal legislationprovidingmatching funds to help such families and individuals attain or retain capability for independence 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 accordancewith the laws of the United States as they now are or as thee may hereafterbe amended, and tomake appropriations out of State funds for such purposes; provided that themaximum amount oaid out of State funds to or on behalf of any individualrecipient shall not exceed the amount that ismatchable out of Federal funds; provided that the total amount of such assistancepayments and/ormedical assistance 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 assistancepayments only to recipients of Old Age Assistance,Aid to the Permanentlyand Totally Disabled, Aid to then Blind, and Aid to Families with Dependent Children shallnever exceed Sixty M+ll~ion Doilars ($6o,OoO,OOoj.” (Emphasisadded.) In your original request you submitted the same question as above quoted, except in your originalrequest the questionwas predicated 'on the assumption that there is no Federal barrier, either in law or Federal rules and regulations." In answering your originalrequest, we therefore assumed that the Federal Social SecurityAct did not requiremedical assistance payments to be vendor payments to the providers ofmedical services. You now inform us that the Federal Government,by rules and regulations,made in pursuance to the Federal Social SecurityAct, requiresmedical assistance payments to be vendorpayments to the providers of medical services. You also state in your letter that your department has construed Section 51a of Article III of the Texas Constitution to requiremedical assistancepayments to be vendorpayments only, as thewording, 'onbehalf of needy persons" as used in our Constitutionparallels the languageused in the Federal Social Security Act. -962-Hon. Burton G. Hackney, page 3 (M-200)

The Texas Legislaturewhich submltted Section 51a of Article III, in enacting enabling legislationpursuant 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 'MedicalAssistance'means monetary assistancepaid to a vendor ofmedical services and/or vendor of hospital services or a vendor of nursing care rendered on behalf of a recipient of public assistance. 'Medical Assistance' shallbe in addition to and separate from the grants of public atsistancemade pavable directly to the recipients. (Emphasisadded;) S.B.No. 454, Acts 60th Leg., R.S. 1967, Ch. 348, p. 822, contains the following statement:

,,

. . .andpayments 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 shownby the quoted portions of S.B.No. 79, S.B. No. 2 and S.B. No. 454 are both entitled to great weight. 12 Tex.Jur.2d 366, ConstitutionalLaw, Sec. 20. As the Federal Social Security Act, as construedby such rules and regulaticns, require vendorpayments formedical services, it follows that your department can onlymake vendor payments, as the construction of the Federal Act controls the method of payments. This is so,by virtue of the fact that the Federalmatching fund, appropriatedby Congress, goes into and becomes a part of the same fund for medical care. SUMMARY Construction of existing Federal statutes and present state statutesrequire the State Department of PublicWelfare to make payments formedical 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 vendorpayments payable to the provider of services. Y H 9 very truly,

Preparedby 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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