June 29, 2004

Lieutenant Governor Amy Tuck
President Pro Tempore Travis Little

Dear Governor Tuck and President Pro Tempore Little:

You have asked us for an opinion as to the legal authority of the Governor or the Division of Medicaid to delay the deletion of the 65,000 PLADs (Poverty Level Aged or Disabled persons) from Medicaid eligibility until September 15, 2004.

House Bill 1434 deletes the eligibility paragraph for the PLADs category that are contained in Section 43 13-115, Mississippi Code of 1972. However the Division of Medicaid is charged with the statutory responsibility of carrying out the administrative functions of determining eligibility, and under Section 43-13-121(1)(a), the division has the additional authority to adopt and promulgate reasonable rules and regulations for the proper and efficient administration of the agency's functions. Under both state law (Section 43-13-116(3)(e)) and federal regulation (Sections 431.200, 201, 211, 221, 222, and 244), the Division of Medicaid must grant opportunity for a hearing to any recipient who requests one because of his/her belief that the agency has taken an action erroneously. The division must allow the recipient a reasonable time, not to exceed ninety (90) days, from the date that notice of the adverse action was mailed, to request a hearing. In accordance with these mandates, the Governor has directed the Division to extend the PLAD coverage for ninety (90) days to allow recipients an opportunity to appeal their designation as a PLAD enrollee. During this transitional period, the division has State General Fund spending authority to continue to cover services for the PLAD category under the Division of Medicaid appropriation bill, House Bill 1734, which contains no prohibition against spending state or federal funds for the PLAD category.

I have discussed the Governor's legal foundation for extending these benefits with the Governor's legal staff, and it is our opinion that the Governor's actions were lawful. Thus the conclusions I discussed with you earlier this week have not changed, and it is my continued belief that the Governor's extension of Medicaid benefits through September 15 for PLAD recipients is valid under both state and federal law.

Sincerely,

Robert Davidson
Chief Counsel, Mississippi Senate
cc/ Governor Haley Barbour

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