Northwestern Facilities with Active Medicaid AgreementMedicaid Agreement • August 1st, 2022
Name of Facility Type of Facility State Genders Served Ages Served Contact Information Teton Peaks PRTF Idaho Female Ages 13-17 Phone: (208) 227-2100tetonpeaks.com Yellowstone Boys and GirlsRanch PRTF Montana Male and Female Male: Ages 11-18Female: Ages 12-18 Phone: (800) 726-6755ybgr.org Jasper Mountain PRTF Oregon Male and Female Ages 3-13 Phone: (541) 741-7402Jaspermountain.org Wyoming Behavioral Health Institute PRTF Wyoming Male and Female Ages 5-17 Phone: (307) 237-7444WBIHelp.com Stewards of Children RTC Idaho Male and Female Ages 12-17 Phone: (208) 932-2208Sor4life.com
criminal violation to an appropriate prosecuting authority.Medicaid Agreement • January 9th, 2020
MEDICAID AGREEMENT LETTERMedicaid Agreement • October 28th, 2009
MEDICAID AGREEMENT LETTERMedicaid Agreement • September 4th, 2015
Basis for Agreement: LOI # 7599917Medicaid Agreement • September 26th, 2022 • Rhode Island
This agreement, hereinafter “Agreement”, including attached ADDENDA, is hereby entered into this 1st day of July 2020 by and through the Executive Office of Health and Human Services (hereinafter referred to as the “EOHHS” or the “Executive Office”) and UnitedHealthcare Insurance Company (UHIC) (hereinafter referred to as “the Contractor”).
ContractMedicaid Agreement • February 25th, 2021
Participating facility Name: Federal Medicare Provider #: Corporation/Organization Name (If applicable): Address: Phone: Administrators Name: Administrators Email Address: Survey Champion Name (if different than administrator): Survey Champion Email Address: Licensed Skilled Nursing Bed Count: Total number of Long-Stay Residents with a of BIMS 8+: OPTIONAL EMPLOYEE SURVEY: (check yes or no) ☐ Yes / ☐ No Total Number of Employees if surveying (Full / Part time):
Social Security Administration § 416.2161Medicaid Agreement • December 12th, 2023
these agreements, we make the Med- icaid determinations when determina- tions or redeterminations are nec- essary for SSI purposes. Our deter- minations may include non-SSI re- quirements that are mandated by Fed- eral law. When we determine that a person is eligible for Medicaid in ac- cordance with § 416.2111 or that we are not making the determination, we no- tify the State of that fact.
Medicaid AgreementMedicaid Agreement • January 18th, 2018
We would like to welcome you to Young Smiles Children’s Dentistry, and hope to establish a good working relationship with you and your family. You may be aware that there are very few dentists in Fairbanks accepting Medicaid. As a courtesy, we accept Medicaid to help our community and those in need of assistance. In accepting Medicaid patients, we are required to follow certain guidelines set by the State of Alaska.
