Missouri Code of State Regulations › Title 13 - DEPARTMENT OF SOCIAL SERVICES › Division 40 - Family Support Division › Chapter 2 - Income Maintenance › Section 13 CSR 40-2.015 - Authorized Representatives

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: This amendment adds the Adult Expansion
				  Group (AEG) to the list of groups that constitute "MO HealthNet programs" for
				  purposes of this rule. The AEG was created by Amendment 2, which was passed by
				  referendum on August 4, 2020, and which created Article IV, Section 36(c) of
				  the Missouri Constitution, which requires the department to extend MO HealthNet
				  coverage to Missourians ages 19-64 whose income is below 133% of the federal
				  poverty level. This amendment also incorporates three (3) federal regulations
				  and one (1) subpart of the Code of Federal Regulations (CFR). First, the rule
				  governing authorized representatives (
				  42 CFR
				  435.923 ). Second, the rule governing the
				  privacy and security of personally identifiable information (
				  45 CFR
				  155.260 ), which authorized representatives
				  must honor. Third, the rule governing the entities who may receive a reassigned
				  claim from a Medicaid provider (
				  42 CFR
				  447.10 ). Finally, the amendment incorporates
				  the subpart in federal rules- 42 CFR 431 Subpart F-on safeguarding information
				  on Medicaid participants. Authorized representatives must agree to adhere to
				  these rules as a condition of their representation.
PUBLISHER'S NOTE: The secretary of state has
				  determined that the publication of the entire text of the material which is
				  incorporated by reference as a portion of this rule would be unduly cumbersome
				  or expensive. This material as incorporated by reference in this rule shall be
				  maintained by the agency at its headquarters and shall be made available to the
				  public for inspection and copying at no more than the actual cost of
				  reproduction. This note applies only to the reference material. The entire text
				  of the rule is printed here.
(1) Scope. This regulation defines the
				procedures for the appointment of an authorized representative for participants
				in MO Health-Net programs and specifies the parameters of the authorized
				representative's powers and authority. This regulation shall only apply to MO
				HealthNet programs.
(2) For
				purposes of this rule, the following terms shall mean:
(A) "Attorney-in-fact" shall mean an
				individual or corporation appointed to act as agent of a principal in a written
				power of attorney that may be durable or not durable. The written power of
				attorney shall comply with Chapter 404, RSMo;
(B) "Authorized representative" shall mean an
				individual person at least eighteen (18) years of age or an organization
				designated by the participant to act on behalf of the participant, the
				participant's children, or any members of the MO HealthNet household at any
				time for any MO HealthNet program;
(C) "Conservator" or "Guardian" shall mean
				one appointed by a Missouri court under the authority of Chapter 475, RSMo or
				if a foreign guardian or conservator is in compliance with the authority of
				Chapter 475, RSMo to have the care and custody of the estate of a minor or a
				disabled person;
(D) "MO HealthNet
				programs" shall mean the MO HealthNet benefits provided to participants under
				the MO HealthNet programs including, but not limited to, MO HealthNet for the
				Aged, Blind, and Disabled (MHABD) program, MO HealthNet for Families (MHF)
				program, the Adult Expansion Group (AEG) pursuant to Article IV Section 39(c)
				of the Missouri Constitution, MO HealthNet for Kids (MHK) program, MO HealthNet
				for Pregnant Women (MPW) program, and Uninsured Women's Health Services (UWHS)
				program. MO HealthNet programs also include presumptive eligibility for any of
				the above programs; and
(E)
				"Participant" shall mean any adult, or emancipated minor individual who has
				applied for, or is receiving, or has been denied benefits from the MO HealthNet
				programs administered by the division.