MEDICAID PROVIDER AGREEMENTMedicaid Provider Agreement • March 4th, 2024
Contract Type FiledMarch 4th, 2024This agreement is made on Click here to enter a date. between the County of Washtenaw on behalf of the Washtenaw County Community Mental Health Agency (CMHSP) and INSERT Medicaid Provider NAME (“Employee/Agency as Medicaid Provider”).The purpose of this agreement is to define the roles and responsibilities of the above named parties. This agreement shall remain in effect until such time it must be terminated or modified. Any party can initiate a termination or modification by providing written notice within 10 days to the other of the desire to terminate or modify this agreement.