Nursing home residents are allowed to designate organizations as authorized representatives for Medicaid enrollment, final rule affirms

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Organizations may serve as authorized representatives for nursing home residents in the Medicaid application and enrollment process, according to a final rule issued by the Centers for Medicare & Medicaid Services.

The rule implements several provisions of the Affordable Care Act. With regard to “authorized representatives,” the new regulation was designed to be “consistent with current state policy and practice,” according to the text of the final rule.

After posting a proposed version of the regulation, CMS received “a number of comments” addressing who may serve as an authorized representative. Some commenters called for organizations to be disallowed altogether or for states to decide whether organizations can serve as representatives, in the interest of better accountability and transparency.

In the final rule, CMS confirmed that organizations may serve as representatives, specifically citing the needs of nursing home residents who do not have family available for assistance. The rule also defines what authorized representatives may do, such as signing an application on a resident's behalf, and specifies that representatives must follow state and federal laws regarding conflict of interest and confidentiality of information.

The final rule was published Monday in the Federal Register. Click here to access.