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MEDICARE/MEDICAID CERTIFICATION AND TRANSMITTAL – CMS

www.cms.gov

MEDICARE/MEDICAID CERTIFICATION AND TRANSMITTAL … LTC PERIOD
OF CERTIFICATION. (a) From … DISCLOSURE STATEMENT (CMS 1513). L21.

Survey and Cert Letter 03-29 – CMS

www.cms.gov

Aug 14, 2003 … SUBJECT: Discontinuance of Forms HCFA-1513, “Ownership and Control … (
CMS) for use when processing Medicare certification actions.

Medicare State Operations Manual – CMS

www.cms.gov

Oct 9, 2015 … http://www.cms.gov/manuals/downloads/som107c09_exhibitstoc.pdf. 1B-1 …
Statement, CMS-1513. Deleted. 6 … Request For Certification.

Provider Ownership Disclosure Statement Instructions & Definitions

www.floridahealth.gov

Disclosing entity means a Medicare/Medicaid Provider (other than an … or other
person licensed or certified under State law to practice his or her profession.

Disclosure of Ownership and Control Interest Statement (CMS-1513)

mainecare.maine.gov

OWNERSHIP AND CONTROL INTEREST STATEMENT (CMS-1513).
Completion and submission of this form is a condition of participation, certification
, …

Medicaid: Vulnerabilities Related to Provider Enrollment and … – OIG

oig.hhs.gov

We recommend that CMS (1) work with State Medicaid programs to identify and
….. the CMS-1513 form, an outdated form that requested only half of the …
Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/SCletter03-
29.pdf.

Clinical Laboratory License – Mass.Gov

www.mass.gov

□Disclosure of Ownership and Control Interest Statement [ 1513] – complete,
sign, date and … Secretary of State OR Foreign Certificate of Approval signed by
the … □Laboratory Personnel Report [CMS 209] – complete, sign (director
signature …

Registered Laboratory – Nevada Division of Public and Behavioral …

dpbh.nv.gov

Include in this list individuals that are currently certified as an office … o Upload a
completed, signed, dated CLIA application (CMS 116 form) with your online …
Disclosure of Ownership and Control Interest Statement (Form 1513) with.

disclosure of ownership and control interest – Cenpatico

health.minnesota.gov

OWNERSHIP AND CONTROL INTEREST STATEMENT (HCFA-1513) …
certification, or recertification under any of the programs established by Titles V,
… Medicare provider or supplier, or other entity that furnishes services or
arranges for.

LAB 144 ROS – California Department of Public Health – State of …

www.cdph.ca.gov

specialties/subspecialties for which this laboratory is certified. 9. … Complete and
return CMS 1513 Ownership form (copy of form submitted to state agency is.

Affordable Care Act – U.S. House of Representatives

housedocs.house.gov

Jun 9, 2010 … Sec. 2902. Elimination of sunset for reimbursement for all medicare part ….
Improved access for certified nurse-midwife services ……………. 343.

sorting through odjfs medicaid numbers required to submit claims to …

medicaid.ohio.gov

Apr 20, 2012 … ODMH: Ms. Theresa Rohrbaugh at 614-644-1513 or Theresa. … treatment
services, Medicare crossovers, primary care, etc. … either their provider type 84,
ODMH certified provider, or their provider type 95, ODADAS certified …

Federal Register/Vol. 75, No. 23/Thursday, February 4 … – DOL Home

webapps.dol.gov

Feb 4, 2010 … Qualification and Certification Unit—to … requirements to obtain the certification
…. Public Disclosure Room, N–1513, ….. www.cms.hhs.gov.

All Agency Memorandum (AAM) No. 220 – Wage Determinations …

www.wdol.gov

Feb 26, 2016 … 'Section 1513(d) of Pub. ….. Oversight, Market Rating Reforms: State Specific
Rating Variations, http://www.cms.gov/CCIIO/Programs-and-.

Interpretive Guidelines – Home Health Agencies – Missouri …

health.mo.gov

Certificate of Clinical Competence in audiology granted by ….. 1- Is the
information on the Form CMS-855 or CMS-1513 (for agencies Medicare
approved prior to …

Change of Ownership – Louisiana Department of Health and Hospitals

new.dhh.louisiana.gov

At the direction of the Dallas Regional office of the CMS, the Louisiana State
Agency will no … intends to apply for Initial Certification with Medicare, an Initial
Medicare Certification packet ….. Form HSS-1513L (7/11; 01/12; 02/12; 3/12; 3/13
).

access monitoring review plan – Medicaid

www.medicaid.gov

Sep 6, 2016 … CMS proposed a rule in 2011 to formalize the process for …. 1,513. 2015
MEDICAID RECIPIENT CALLS. Claims. Questions. 16% …. Eligible providers
render covered services under their scope of licensure/certification and.

IRB 2014-38 – IRS.gov

www.irs.gov

Sep 15, 2014 … alternative to the EBSA Form 700 method of self-certification. These temporary
….. Public Disclosure Room, N-1513, Em- ployee Benefits Security … found on
CMS's web site (www.cms.gov/ cciio), and information on health …

GAO-16-594, MEDICARE PART B: CMS Should Take Additional …

www.gao.gov

Jul 1, 2016 … CMS Should Take Additional Steps to Verify Accuracy of Data Used to ….. sales
data—and the ASP Certification Form signed by the manufacturer's. CEO or ….
1,513. 7.1 Cancer. Lucentis. Ranibizumab injection. J2778. 1,352.

APM-FINAL-Justificat… – Green Mountain Care Board – Vermont.gov

gmcboard.vermont.gov

Oct 31, 2016 … main payers of health care in Vermont—Medicaid, Medicare, and …. practitioners,
clinical nurse specialists and certified registered nurse …




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