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Minnesota Health Care Programs

1.3.1.2 Authorized Representative (Archive)

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

  • Provide documentation

  • Appeal agency decisions

  • Receive forms and notices

  • Pay premiums

  • 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

Any applicant or enrollee may designate an authorized representative, unless the person has a court-appointed guardian. If a person has a court-appointed guardian, only the guardian may designate an authorized representative.

If an applicant or enrollee has a court-appointed conservator and the court has not limited the conservator's power 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, then either the applicant or enrollee, or the conservator, may designate an authorized representative.

Designations by an applicant or enrollee must be in writing and must include the applicant or enrollee's signature unless the applicant or enrollee is unable to sign, in which case legal documentation of authority may serve in place of the applicant or enrollee's designation.

A designation may be made by submitting one of the following documents to the county, tribal, or state servicing agency:

  • A completed Authorized Representative Designation attached to any MHCP application

  • A completed Giving Permission for Someone to Act on My Behalf (DHS-3437) or Minnesota Family Planning Program (MFPP) - Giving Permission for Someone to Act on My Behalf (DHS-3437A)

  • A written statement that clearly indicates the applicant or enrollee is giving permission to a specified person to act on their behalf in the health care application or eligibility process, including the name, address, and phone number of the person designated to act on their behalf. The statement must be signed by the applicant or enrollee as well as the person being designated to act on the applicant or enrollee's behalf.

  • A court order establishing legal guardianship

  • A court order establishing a conservatorship

  • A valid Power of Attorney

    • 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.

    • A Power of Attorney is durable if it contains language such as, “This power of attorney shall not be affected by the incapacity of 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 applicant or enrollee may change the authorized representative designation at any time. The 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

  • The applicant or enrollee dies

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.

If a servicing agency disqualifies an authorized representative, it must determine whether a vulnerable adult referral to social services is needed.

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.

Legal Citations

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

Published: November 1, 2018

Archived: June 1, 2020