Current through all regulations passed and filed through September 16, 2024
(A)
Designation of an
authorized representative.
(1)
An individual may designate any person or organization
to serve as that individual's authorized representative. Any person serving as
an authorized representative must be at least eighteen years or
older.
(2)
Authority for a person or organization to act on behalf
of the individual accorded under state law, including but not limited to, a
court order establishing legal guardianship, must be treated as a written
designation by the individual of authorized representation.
(3)
The designation
of an authorized representative must be in writing, and must identify what
duties the individual is authorizing the representative to
perform.
(4)
If the designated authorized representative is
unwilling or unable to accept the responsibility of being an authorized
representative, the authorized representative must inform the administrative
agency and the individual of the refusal or withdrawal.
(B)
The
authorized representative:
(1)
Must present proper identification, if requested by the
administrative agency, prior to the disclosure of medicaid information to the
authorized representative.
(2)
Must agree to
maintain or be legally bound to maintain the confidentiality of any information
regarding the individual provided by the administrative agency.
(3)
Will receive
copies of notices and correspondence sent to the individual by the
administrative agency.
(4)
Stands in the place of the individual. Any
responsibility of the individual is a responsibility of the authorized
representative. Any action taken by the authorized representative or failure to
act will be accepted as the action or lack of action of the
individual.
(5)
Shares all responsibilities set out in rule
5160:1-2-08 of the
Administrative Code.
(C)
The
administrative agency may contact the individual to clarify or verify
information provided by an authorized representative if the authorized
representative provides information that seems contradictory, unclear, or
unrealistic.
(D)
The administrative agency may choose not to contact the
authorized representative if the administrative agency believes that the
authorized representative might endanger the individual in a situation of
domestic violence, abuse, or neglect in accordance with
45
C.F.R. 164.502(g)(5) (as in
effect October 1, 2015).
(E)
If the authorized representative is a provider or staff
member or volunteer of an organization, the authorized representative must
affirm that he or she will adhere to the regulations in 42 C.F.R. Part 431
Subpart F (as in effect October 1, 2015),
42 C.F.R.
447.10 (as in effect October 1, 2015),
45
C.F.R. 155.260(f) (as in
effect October 1, 2015), as well as other relevant state and federal laws
concerning conflicts of interest and confidentiality of
information.
(F)
The power to act as authorized representative is valid
until the individual notifies the administrative agency that the authorized
representative is no longer authorized to act on his or her behalf, or the
authorized representative informs the administrative agency the he or she no
longer is acting in such capacity, or there is a change in the legal authority
upon which the authorized representative's authority was based. Such notice
should include the applicant or authorized representative's signature as
appropriate.
(G)
Assistance from persons or organizations who are not
authorized representatives.
(1)
A person or organization may accompany and assist an
individual with portions of the application, verification, or redetermination
process without being an individual's authorized
representative.
(2)
The administrative agency must not reveal confidential
information or send notices or correspondence to a person or organization who
is assisting an individual, unless the person or organization is designated as
an authorized representative.
(3)
A person or
organization who is assisting an individual must provide accurate information
to the administrative agency, to the best of his or her knowledge, regardless
of whether the person or organization is an authorized
representative.
