THE .L%TJXBRNEY GENERAL 

c%AvvF"yIu c. in-TIN At?STlN. TwAn 78711 

Ax-rORNlcY OIMERAI- 

'February 13, 1968 

Hon. Burton G. Hackney 

Commissioner 

Opinion No. M-200 

State Department of Public Welfare Re: Medical assistance payJohn 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 attention 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now moot, and It is hereby being withdrawn.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 Government 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 providing matching 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 

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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 appropriations out of State funds for such purposes; provided 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 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 assistance payments only to recipients of 

Old Age Assistance, Aid to the Permanently and 

Totally Disabled, Aid to then Blind, and Aid to 

Families with Dependent Children shall never 

exceed Sixty M+ll~ion Doilars ($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 vendor 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 medical 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 Constitution 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 entitled 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 

H 

9 very truly, 

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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