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In addition to who can be interviewed for an applicant/recipient, this section may also be applied towards who DFR can discuss missing and needed verifications to determine Medicaid eligibility for an applicant/recipient. An applicant or authorized representative may be the interviewee and can conduct all business related to the application process. The initial contact person (ICP) who makes the initial request for assistance cannot be interviewed or request an interview be rescheduled unless they are the designated Authorized Representative, or the applicant or member is also present and gives one- time permission.

For Authorized Representatives, the Authorized Representative for Health Coverage, State Form 55366 must be used to authorize someone to apply on behalf of an AG and must be filed in the case record.

Alternatively, the prospective authorized representative and the applicant/member may call DFR and jointly agree to the authorized representative relationship over the phone.3 Any individual other than the parent of an applicant/recipient under age 18 must be authorized verbally or in writing by the applicant unless medical documentation (such as a doctor’s statement) is presented showing that the applicant is medically unable to provide such authorization (Refer to IHCPPM Section 2005.10.00).

For a spouse of an applicant/recipient to be interviewed, the spouse must either be an authorized representative for the applicant/recipient or be given verbal permission by the applicant/recipient to be interviewed on behalf of the applicant/recipient. Verbal permission can occur in person or over the phone. If it is done over the phone, DFR must ensure that the applicant/recipient giving the verbal permission is in fact the applicant/recipient by asking that person to verify a few things about themselves including but not limited to last four digits of SSN, date-of-birth, address, case number, and RID number. An applicant/recipient may also give verbal authorization to someone other than a spouse. Someone who is merely given verbal permission is not an authorized representative and is not authorized to speak with the DFR about the applicant/recipient’s case beyond that occurrence. Despite the availability of an authorized representative, the DFR may require personal contact with the applicant if such contact is necessary to determine eligibility under any program.

Note: If an applicant/recipient fails to cooperate with the Authorized Representative or third party, then the worker must reach out to the applicant/recipient.

The authorized representative must be familiar with the AG situation to represent them properly. The worker will determine if the authorized representative is representing the AG