Florida Department of State and Division of Library and Information Services

Reference: Ref-07915

Reference Name: Unborn Activation Form, AHCA Form 5240-006, February 2017
Agency: 59 Agency for Health Care Administration
59G Medicaid

Original Document(s):
2/2/2017 For use by providers to activate a newborn’s Medicaid Identification (ID) Number when they have been determined ...
Modified Document(s): No Modified document(s).
Description: For use by providers to activate a newborn’s Medicaid Identification (ID) Number when they have been determined eligible by the Florida Department of Children and Families.

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
59G-1.045 		Medicaid Forms 19983084 Effective:
02/08/2018
View Text Final
59G-1.045 		Medicaid Forms 18753415 Effective:
04/05/2017



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