Oregon Oregon Health Authority, Health Systems Division: Medical Assistance Programs

Rule Rule 410-200-0111
Authorized Representatives


(1) With the exception of individuals who are included in the EDG solely because they are part of a tax-filers tax group (see OAR 410-200-0305 (Eligibility Determination Group — MAGI Medicaid/CHIP)) and except as limited in sections (3), (4), and (5) of this rule, the following individuals may appoint an authorized representative on a form designated by the Agency:
(a) The primary contact;
(b) An individual age 18 or older who is included in the EDG with the primary contact, head of household (see OAR 461-001-0015 (Definitions; SNAP)), or primary person (see OAR 461-001-0000 (Definitions for Chapter 461)), for all programs with which the primary contact, head of household, or primary person participates;
(c) An individual given legal guardianship or power of attorney for an individual age 18 and older.
(2) The Agency shall accept an applicant or beneficiary’s designation of an authorized representative via any of the following methods that must include either a handwritten or electronic signature of both the applicant or beneficiary and designated authorized representative:
(a) The Internet;
(b) E-mail;
(c) Mail;
(d) Telephonic recording;
(e) In person; or
(f) Other electronic means.
(3) An authorized representative designated for one program is the authorized representative for all programs and benefits of the primary contact, head of household (see OAR 461-001-0015 (Definitions; SNAP)), or primary person (see OAR 461-001-0000 (Definitions for Chapter 461)), excluding Temporary Assistance for Domestic Violence Survivors (see OAR 461-135-1200 (Specific Requirements; TA-DVS)) and long-term care services (see OAR 461-001-0000 (Definitions for Chapter 461)).
(4) Unless limited elsewhere in this rule, the authorized representative:
(a) May, with the exception of the Authorized Representative designation form and subject to the exception in subsection (b) of this section, complete, sign, and submit an application, renewal, or documents on the applicant’s or beneficiary’s behalf;
(b) May act on behalf of the applicant or recipient by reporting information and submitting requests to the Agency, except an individual’s long-term care (see OAR 461-001-0000 (Definitions for Chapter 461)) services provider cannot serve as the individual’s designated representative (see OAR 411-004-0010 (Definitions)) or representative (see OAR 411-028-0010 (Definitions) and 411-030-0020 (Definitions)) for long-term care services; and
(c) May receive copies of the applicant or beneficiary’s notices and other communications from the Agency.
(5) The following may not serve as an authorized representative:
(a) An individual serving an Intentional Program Violation (see OAR 461-195-0601 (Intentional Program Violations; Defined)), unless the Agency determines no one else is available to serve as the authorized representative;
(b) Homeless meal providers for homeless SNAP recipients;
(c) An individual who presents a risk of harm to case individuals;
(d) An individual who presents a conflict of interest;
(e) An agency employee or an employee of a contractor who is involved in the certification or issuance processes for Agency program benefits may not act as an authorized representative without the specific written approval of a designated Agency official, and only if that official determines that no one else is available to serve as an authorized representative;
(f) Retailers who are authorized to accept Department Electronic Benefit Transfer (EBT) cards may not act as an authorized representative without the specific written approval of a designated Agency official, and only if that official determines that no one else is available to serve as an authorized representative.
(6) The authorized representative must maintain the confidentiality of any information provided by the Agency regarding the represented individuals.
(7) An individual ceases to be an authorized representative when:
(a) The represented individual notifies the Agency that the designation is terminated;
(b) The represented individual appoints a different authorized representative;
(c) The authorized representative informs the Agency that the designation is terminated;
(d) The Agency determines the authorized representative is no longer permitted to be the authorized representative; or
(e) There is a change in the legal authority upon which the individual or organization’s authority was based.
(8) An authorized representative may be subject to overpayments (see OAR 461-195-0501 (Definitions and Categories of Overpayments) and 461-195-0541 (Liability for Overpayments)) in addition to other penalties:
(a) In group living (see OAR 461-001-0015 (Definitions; SNAP)) arrangements or substance use disorder (SUD) treatment centers, the facility may be prosecuted under applicable federal or state law;
(b) For other authorized representatives not covered by subsection (a) of this part, the Agency may prohibit the person from serving as a representative for one year.
(9) Conditions and requirements related to the designation and administration of authorized representatives described in OAR 461-115-0090 (Authorized Representatives; General) also apply to HSD Medical Programs.
Source

Last accessed
Jun. 8, 2021