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UNOFFICIAL 1711.1-7 (b) The designation of an authorized representative must be in writing and signed by the individual. Legal documentation of authority to act on behalf of an individual under State law, to include a court order establishing legal guardianship, or power of attorney, shall serve in the place of a written authorization.

(c) The authority of an authorized representative is valid until: (1) The applicant or beneficiary withdraws the authorization by notifying the department that the representative is no longer authorized to act on the applicant’s or beneficiary’s behalf; (2) There is a change in the legal document of authority to act on the applicant’s or beneficiary’s behalf; or (3) The authorized representative informs the department that he is no longer acting as the individual’s authorized representative. (d) An authorized representative may be authorized to: (1) Sign an application on behalf of an applicant; (2) Receive copies of an individual’s notices and other communications from the department; (3) Act on behalf of the individual in all other matters with the department; and (4) Complete and submit redetermination forms. (e) An authorized representative must agree to maintain, or be legally bound to maintain, the confidentiality of any information regarding the applicant or beneficiary provided by the department. (f) An authorized representative who is a provider, staff member or volunteer of an organization must agree to sign an agreement to comply with regulations relating to: (1) Confidentiality of information (42 C.F.R. part 431, subpart F); (2) Prohibition against reassignment of provider claims as appropriate for a health facility