Reference: Ref-07444

Reference Name: Form DH8001-CMS
Agency: 64 Department of Health
64C Division of Children's Medical Services

Original Document(s):
8/31/2016 CMS Clinical Eligibility Attestation (05/2016)
Modified Document(s): No Modified document(s).
Description: CMS Clinical Eligibility Attestation (05/2016)

Disclaimer: External links within the reference material are subject to change outside of the rulemaking process.

Rules/Notices using this Reference Material
Notice /
Adopted
Section Description ID Publish
Date
View Text Final
64C-2.002
Eligibility for CMS Network Services 17994778 Effective:
09/27/2016