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Evangelical Good Samaritan Soc'y v. North Dakota Dep't of Human Servs.

Supreme Court of North Dakota

April 28, 2015

The Evangelical Good Samaritan Society d/b/a Good Samaritan Society - Mott, Appellee
v.
North Dakota Department of Human Services, Appellant

Appeal from the District Court of Burleigh County, South Central Judicial District, the Honorable Cynthia Feland, Judge.

Charles (Casey) L. Chapman (argued), Bismarck, N.D., and Christina Lollar (on brief), Harrisburg, __ Pa. __, for appellee.

John H. Tyler (argued), Office of Attorney General, Bismarck, N.D., and Jeanne M. Steiner (on brief), Special Assistant Attorney General, Office of Administrative Hearings, Bismarck, N.D., for appellant.

Carol Ronning Kapsner, Lisa Fair McEvers, Daniel J. Crothers, Dale V. Sandstrom, Gerald W. VandeWalle, C.J.

OPINION

Page 795

Carol Ronning Kapsner, Justice.

[¶1] The Department of Human Services appeals from a judgment reversing the Department's dismissal of Emma Rieger's appeal challenging its denial of her Medicaid application and remanding for a fair hearing on the application. Because the law allows The Evangelical Good Samaritan Society, doing business as the Good Samaritan Society - Mott (" Society" ), to act as Rieger's authorized representative for purposes of appealing the Department's denial of her Medicaid application, we affirm the judgment.

I

[¶2] On March 21, 2013, Rieger entered the Society's basic care facility in Mott. On May 28, 2013, Rieger executed a

Page 796

general durable power of attorney appointing two women " to be my attorneys-in-fact and co-agents in my name and for my benefit."

[¶3] State Medicaid regulations provided that " [a]ll individuals wishing to make application for medicaid must have the opportunity to do so, without delay," N.D. Admin. Code § 75-02-02.1-02(1)(a), and defined an " application" as " a written request made by an individual desiring assistance under the medicaid program, or by an individual seeking such assistance on behalf of another individual . . . ." N.D. Admin. Code § 75-02-02.1-02(1)(b). Furthermore, a " prescribed application form must be signed by the applicant or by someone acting responsibly for an incapacitated applicant." N.D. Admin. Code § 75-02-02.1-02(1)(c). The definition section of the regulations governing the chapter on appeals and hearings provided:

" Authorized representative" means an individual, including an attorney at law, who has been authorized by the claimant to act for and represent the claimant in any and all aspects of a hearing. The claimant need not designate an authorized representative.

N.D. Admin. Code § 75-01-03-01(4).

[¶4] On July 15, 2013, the United States Department of Health and Human Services gave notice that a new rule governing " authorized representatives" would become effective January 1, 2014. See 78 Fed. Reg. 42160, 42303 (July 15, 2013). The new regulation, 42 C.F.R. § 435.923, provides in part:

( a)(1) The agency must permit applicants and beneficiaries to designate an individual or organization to act responsibly on their behalf in assisting with the individual's application and renewal of eligibility and other ongoing communications with the agency. Such a designation must be in accordance with paragraph (f) of this section, including the ...

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