§ 54.632   Letters of agency (LOA).

   (a) Authorizations. Under the Healthcare Connect Fund, the Consortium Leader
   must obtain the following authorizations.

   (1) Prior to the submission of the request for services, the Consortium
   Leader must obtain authorization, the necessary certifications, and any
   supporting  documentation  from  each  consortium member to permit the
   Consortium Leader to submit the request for services and prepare and post
   the request for proposal on behalf of the member.

   (2) Prior to the submission of the funding request, the Consortium Leader
   must secure authorization, the necessary certifications, and any supporting
   documentation from each consortium member to permit the Consortium Leader to
   submit the funding request and manage invoicing and payments on behalf of
   the member.

   (b)  Optional  two-step process. The Consortium Leader may secure both
   required authorizations from each consortium member in either a single LOA
   or in two separate LOAs.

   (c) Required Information in LOA. (1) An LOA must include, at a minimum, the
   name  of  the  entity  filing the application (i.e., lead applicant or
   Consortium  Leader);  name of the entity authorizing the filing of the
   application  (i.e.,  the participating health care provider/consortium
   member); the physical location of the health care provider/consortium member
   site(s); the relationship of each site seeking support to the lead entity
   filing  the  application;  the  specific timeframe the LOA covers; the
   signature, title and contact information (including phone number, mailing
   address, and email address) of an official who is authorized to act on
   behalf of the health care provider/consortium member; signature date; and
   the type of services covered by the LOA.

   (2) For HCPs located on Tribal lands, if the health care facility is a
   contract facility that is run solely by the tribe, the appropriate tribal
   leader, such as the tribal chairperson, president, or governor, shall also
   sign  the  LOA, unless the health care responsibilities have been duly
   delegated to another tribal government representative.

   [ 78 FR 13985 , Mar. 1, 2013]

   return arrow Back to Top