Minnesota Health Care Programs

1.2.6 Signature

Application Signature

The application filer or their authorized representative must sign the application. See 1.2.2 MHCP Application Submission, for a description of an application filer, and EPM 1.3.1.2 Authorized Representative, for a description of an authorized representative. A signature may be handwritten or it may be electronic if it meets certain criteria.

A person under 18 who does not live with a parent, relative caretaker, foster parent, or legal guardian may sign an application on their own behalf. This includes both minors with and without children.

Renewal Signature

The enrollee, a person who qualifies as an application filer, or their authorized representative must sign a renewal form when a renewal signature is required.

A signature is required on paper renewal forms including the pre-populated renewal form.
No signature is required when eligibility is automatically renewed using information in an enrollee's case file and data provided by trusted electronic sources.

Other Minnesota Health Care Programs (MHCP) Eligibility Forms

Refer to the Eligibility Forms that Require a Signature document for a quick reference guide to MHCP eligibility forms that require a signature.

Electronic Signature

A valid electronic signature may be used to sign MHCP applications, renewals, and other eligibility forms that require a signature.

To be considered a valid electronic signature, the signature must be:

gathered via software that complies with the Electronic Signatures in Global and National Commerce Act (ESIGN) and submitted with a certificate of completion, audit record, or similar audit trail; or
gathered or transmitted electronically and meet all of the following criteria:
- The signature must show the signor's intent to sign and be logically associated with or attached to a specific form.
  
  A signature on a form meets this criterion.
  
  A signature that is not on a form must be dated and include a short statement indicating intent and association. Acceptable statements include but are not limited to:
  - "I understand that I am signing the DHS-[form number] and I agree to all the terms and conditions of the form."
  - "I understand that I am signing [title of specific MHCP application or form] and I agree to all the terms and conditions of the form."
- The signature must identify the person who is signing.
  
  A legible handwritten signature or typed or legibly printed name accompanied by a handwritten signature (legible or not) meets this criterion.
- The signature must be received in a form that is tamper-proof and cannot be modified

Examples of valid electronic signatures:

A signature on Minnesota Eligibility Technology System (METS) online application available on the MNsure website.
An image of legible handwritten signature transmitted electronically such as by fax, e-mail, or text message that is dated and includes an acceptable statement of intent.
A signature captured by a software product that complies with ESIGN, submitted with a completion certificate.

Examples of signatures that are not valid electronic signature:

A signature gathered electronically that is submitted along with a form but does not include an acceptable statement of intent.
An image of handwritten signature that is placed on a form by digitally copying and pasting it onto the document.
A typed name created by selecting a script of calligraphy font that has not been gathered via software that complies with ESIGN.
A signature gathered via software that complies with ESIGN that is not accompanied by a certificate of completion, audit record or audit trail.

Special Circumstances

A person who is mentally competent but unable to sign the application due to physical limitations may:

Sign electronically, or
Sign a paper application by making a distinct mark, such as an X. Two witnesses must sign and date the application to verify that the person making the mark is indeed the person who is applying.

If a person has a court or tribal court-appointed guardian, one of the following people must sign the application:

The guardian, or
An authorized representative designated by the guardian

If a person does not have a court-appointed guardian but does have a court-appointed conservator, any of the following people may sign the application:

The person
An authorized representative designated by the person or conservator
The conservator, if the court has not limited the conservator's powers in such a way that the conservator does not have the power to apply for health care assistance, services, or benefits available to the person

If a person is incapacitated and does not have a court-appointed guardian, court-appointed conservator, or an authorized representative appointed by either the guardian or conservator, any of the following people may sign the application:

An application filer acting responsibly for the incapacitated person
An authorized representative designated by the county, tribal or state servicing agency. See EPM section 1.3.1.2 MHCP Authorized Representative for more information.

Legal Citations

Code of Federal Regulations, title 42, section 435.907

Code of Federal Regulations, title 42, section 435.916

Code of Federal Regulations, title 42, section 435.923

Code of Federal Regulations, title 45, section 155.230

Code of Federal Regulations, title 45, section 155.335

Minnesota Statutes, section 256L.05

Minnesota Statutes, section 524.5-313

Minnesota Statutes, section 524.5-417

Minnesota Statues, chapter 325L