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MAP 649F Undercare
MAP 649F UnderCare Transmittal.pdf
Undercare Renewal/Follow-up Transmittal
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13 Apr, 2015
79 kb
Downloads: 2820
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HSCP-3046 Home Care Services Program Cover Sheet
HCSP-3046 1-26-2015.pdf
This is the cover sheet to be used for Home Care Services Program
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13 Apr, 2015
38 kb
Downloads: 3056
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HCSP 3047 MLTC Cover Sheet
HCSP 3047 1-26-2015.pdf
This is the cover sheet to be used for MLTC cases
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13 Apr, 2015
44 kb
Downloads: 3114
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HSCP-3047b MLTC Nursing Home Eligibility Determination Cover Sheet
HCSP-3047b 1-26-2015.pdf
This is the cover sheet to used for MLTC NHED
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13 Apr, 2015
55 kb
Downloads: 4692
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HCSP-3047a MLTC/PRU
HCSP-3047a MLTC-PRU 1-26-15.pdf
This is the MLTC Provider Relations Unit cover sheet to be used
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13 Apr, 2015
47 kb
Downloads: 2944
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HCSP 3026 ALP Medicaid Cover Sheet
HCSP-3026 HCSP Cover Sheet for ALP-MLTC 1-26-2015.pdf
This is the cover sheet for HRA-ALP Medicaid Cover Sheet
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13 Apr, 2015
44 kb
Downloads: 3010
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Notice of Admission/Discharge for the Assisted Living Program
HCSP 3027 1-26-2015.pdf
This form is to be mailed to Home Care Services Program once a client is admitted or discharged from Assisted Living Programs
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13 Apr, 2015
44 kb
Downloads: 3195
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MAP-58u List of Medicaid Offices
MAP-58u Where To Apply.pdf
This is a list of Medicaid Offices throughout NYC's 5 boroughs, along with a list of MICSA/MAP sites with certified application counselotrs
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13 Apr, 2015
377 kb
Downloads: 3466
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Spousal Refusal Form - Suffolk County
Spousal Refusal Form - suffolk county.doc
This is the spousal refusal form for Suffolk County residents
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13 Apr, 2015
25 kb
Downloads: 11115
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15-INF-03 Informational Letter Personal Needs Allowance in Non-Medical & Medical Facilities
15-INF-03 Informational Letter Personal Needs Allowance in Non-Medical and Medical Facilities.pdf
This informational letter provides social services districts with updated charts that represent the monthly Personal Needs Allowance, PNAs, for residents of non-medical facilities the PNAs in medical facilities.
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13 Apr, 2015
302 kb
Downloads: 2628
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