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3 130 CMR: DIVISION OF MEDICAL ASSISTANCE

Trans. by E.L. 255 Rev. 02/13/26

130 CMR 515.000: MASSHEALTH: GENERAL POLICIES

Assets. Property including, but not limited to, real estate, personal property, and funds. This term has the same meaning as resources as defined in 42 U.S.C. 1396p(e)(5).

Authorized Representative (1) A person or organization designated as the authorized representative of an applicant or member in a completed, signed Authorized Representative Designation Form, or similar designation document submitted to the MassHealth agency, in which the authorized representative agrees to comply with rules regarding confidentiality in the course of representing the applicant or member, provided that such person or organization must satisfy one of the following criteria: (a) an authorized representative may be a person or organization appointed by the applicant or member to act responsibly on their behalf in connection with the eligibility process and other ongoing communications with the MassHealth agency. Such person or organization shall have the authority to complete and sign an application on the applicant’s behalf; select a health plan; complete and sign a renewal form; receive copies of the applicant or member’s notices and other communications from the MassHealth agency that may include protected healthcare information, personal data, and financial information, and, unless otherwise specified, act on behalf of the applicant or member in all other matters with the MassHealth agency or the Health Connector; (b) an authorized representative may be a person acting responsibly on behalf of the applicant or member who is sufficiently aware of such applicant’s or member’s circumstances to assume responsibility for the accuracy of the statements made on their behalf during the eligibility process and in other communications with the MassHealth agency. Such person shall have the authority to complete and sign an application on the applicant’s behalf; select a health plan; complete and sign a renewal form; and receive copies of the applicant or member’s notices and other communications from the MassHealth agency that may include protected healthcare information, personal data, and financial information; or (c) an authorized representative may be a person acting responsibly on behalf of the applicant or member who has, under applicable law, authority to act on behalf of such applicant or member in making decisions related to healthcare or payment for healthcare, including, but not limited to, a guardian, conservator, executor, administrator, holder of power of attorney, or healthcare proxy. The extent of such person’s authority to act on behalf of the applicant or member is determined by the applicable law or underlying legal document; and (2) As a condition of any organization serving as an authorized representative under 130 CMR 515.001: Authorized Representative (1)(a), a provider, staff member, or volunteer of such organization must not have a conflict of interest and must affirm that they will adhere to 42 CFR part 431, subpart F.

Blindness. A visual impairment as defined in Title XVI of the Social Security Act. Generally, “blindness” means visual acuity with correction of 20/200 or less in the better eye, or a peripheral field of vision contracted to a 10° radius or less regardless of the visual acuity.

Burial Trust. A trust established by an individual solely for funeral expenses, burial expenses, or both.

Business Day. Any day during which the MassHealth agency’s offices are open to serve the public.