Common Contracts
2 similar null contracts
DEPARTMENT OF HEALTH SERVICES STATE OF WISCONSIN Division of Care and Treatment Services 42 CFR 431.107 F-00312A (08/2016)May 5th, 2020
WISCONSIN MEDICAID crs benefit PROVIDER AGREEMENT AND ACKNOWLEDGEMENT OF TERMS OF PARTICIPATION FOR INDIVIDUAL OR NON-SPECIFIED COMMUNITY RECOVERY SERVICES PROVIDERS1 Completion of this form is required under Federal Law by the Centers for Medicare & Medicaid Services, Department of Health and Human Services, under the Code of Federal Regulations 42 CFR 431.107.
DEPARTMENT OF HEALTH SERVICES STATE OF WISCONSIN Division of Care and Treatment Services 42 CFR 431.107 F-00312A (08/2016)July 31st, 2019
WISCONSIN MEDICAID crs benefit PROVIDER AGREEMENT AND ACKNOWLEDGEMENT OF TERMS OF PARTICIPATION FOR INDIVIDUAL OR NON-SPECIFIED COMMUNITY RECOVERY SERVICES PROVIDERS1 Completion of this form is required under Federal Law by the Centers for Medicare & Medicaid Services, Department of Health and Human Services, under the Code of Federal Regulations 42 CFR 431.107.
