This article is a section taken from Minnesota Health Care Programs (MHCP), a part of the revisions and additions to the Minnesota Health Care Program Eligibility Policy Manual.
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Minnesota Health Care Programs (MHCP) applicants and enrollees may designate an authorized representative at the time of application or at any other time. An authorized representative is a person or organization authorized by an applicant or enrollee to apply for a MHCP and to perform the duties required to establish and maintain eligibility.
Responsibilities of an Authorized Representative
In most cases, authorized representatives have the same responsibilities and rights as applicants or enrollees.
Authorized representatives have the responsibility and right to:
Contact the county, tribal or state servicing agency, including talking with the worker without additional consent
Contact the help desks, without additional consent
Have access to eligibility information in the applicant’s or enrollee’s case file
Complete and sign forms, such as applications and renewals, for the applicant or enrollee
Appeal agency decisions
Receive forms and notices
Act on behalf of the applicant or enrollee in all other matters with the county, tribal or state servicing agency
- Maintain the confidentiality of any information regarding the applicant or enrollee provided by the county, tribal or state servicing agency
Who Can Be an Authorized Representative?
Authorized representatives must:
be at least 18 years old,
have access to required information and ability to verify eligibility requirements, and
- agree in writing to accept the responsibilities of an authorized representative.
Who Cannot Be an Authorized Representative?
The following people cannot be an authorized representative for a client on their caseload:
County, tribal or state servicing agency employees who determine eligibility
Regional Treatment Center (RTC) reimbursement officers for MA enrollees
- Certified assisters (navigators)
An incarcerated individual can have an authorized representative, but the authorized representative cannot enroll the inmate without his or her consent.
Designating an Authorized Representative
Applicants or enrollees can designate an authorized representative. Only an applicant or enrollee can choose who they want as their authorized representative. An applicant or enrollee with a court-appointed guardian or conservator cannot appoint an authorized representative, however, the guardian or conservator can appoint an authorized representative.
Applicants and enrollees can:
Fill in the authorized representative’s name, address, and phone number in the appropriate place on a paper application
The authorized representative and the applicant must both sign the application unless the applicant is unable to sign. Legal documentation of authority to act on behalf of an applicant/enrollee can serve in place of the applicant/enrollee’s signature.
- Submit an externally created statement that clearly indicates the person is giving permission for someone to act on their behalf in the healthcare application or eligibility process, including the name, address, and phone number of the authorized representative
Submit a court order establishing legal guardianship
Submit a Power of Attorney with language that explicitly lists the right to represent the applicant or enrollee in the healthcare application or eligibility process.
A Power of Attorney is a legally binding document that authorizes a person or corporation to act on another person’s behalf in financial matters. The powers granted can be limited to certain activities and to a specific period, or they can be general and wide in scope.
- The Power of Attorney must be dated, signed by the applicant or enrollee, and include the name of the person or corporation who is being appointed to act on the applicant’s or enrollee’s behalf.
- Submit a Durable Power of Attorney that explicitly includes the right to represent the applicant or enrollee in healthcare application or eligibility process. A Power of Attorney is durable if it contains language such as, “This power of attorney shall not be affected by the incapacity or incompetence of the principal,” or similar words showing the intent to allow the authority to continue even if the person becomes incapacitated.
Servicing Agency Designation of an Authorized Representative
The county, tribal or state servicing agency must appoint an authorized representative if the client is not able to do so and is not able to provide information necessary to determine eligibility. This could be a relative or friend who is able to provide the necessary information.
The agency must appoint a social service professional as the applicant or enrollee’s authorized representative if no qualified person is available to act as an authorized representative.
Potential authorized representatives for children in foster care or pre-adoptive placement include, but are not limited to, social workers or other representatives of the agency that has legal custody and control of the child.
How Long Does the Designation Last?
The authorized representative designation remains in place until:
Revoked by the applicant or enrollee
Revoked by the authorized representative
The legal authority to act on the applicant or enrollee’s behalf changes
- The authorized representative is disqualified
Disqualification of an Authorized Representative
Servicing agencies may disqualify authorized representatives who:
Knowingly provide false information
Are unable to provide required information
- Refuse to provide required information
Only a court can disqualify a guardian or conservator.
When a county, tribal or state servicing agency disqualifies an authorized representative, the applicant or enrollee can designate a new one.
Authorized Representative Receipt of Forms and Notices
Unless the client indicates otherwise, the authorized representative will receive all forms and copies of eligibility and premium notices.
Authorization to Release Information
The General Consent/Authorization for Release of Information (DHS-3549) allows the county, tribal or state servicing agency to share information about the applicant or enrollee with the person or organization specified on the form. These forms do not appoint the person to be an authorized representative.
Code of Federal Regulations, title 42, section 435.923
Code of Federal Regulations, title 45, section 155.227
Minnesota Rules, part 9505.0085, subpart 2
CREDIT: The content of this post has been copied or adopted from the Minnesota Healthcare Programs Eligibility Policy Manual, originally published by the Minnesota Department of Human Services.
This is also part of a series of posts on Minnesota Healthcare Eligibility Policies.