Document
PFFS License
ICR 200608-0938-002 · OMB 0938-0935 · Object 217501.
license.doc - State License
State |
Applicant Licensed? Yes or No |
Type of License |
Does State Regulate Medicare? Yes or No |
Which Medicare Activities are Regulated by the State?i |
Restricted Reserve Requirements If yes, give amount |
State Regulator=s Name, Address Phone # |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
i. Include activities such as Medicare marketing, financial performance, benefits, grievances, etc.
pffslice.doc 6/2002
| File Type | application/msword |
| File Title | hcpplice |
| Author | Sylvia Hendel |
| Last Modified By | CMS |
| File Modified | 2006-03-24 |
| File Created | 2006-03-24 |