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This document is a decision regarding the determination of a petition for review of the Community Spouse Resource Allowance (CSRA) under the spousal impoverishment rules of the Medical Assistance
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DHA-15 (R10/97) is a form used by the Department of Health Affairs to collect information related to certain healthcare services.
Healthcare providers, organizations, or entities that fall under specific regulatory requirements are required to file DHA-15 (R10/97).
To fill out DHA-15 (R10/97), individuals should follow the instructions provided with the form, ensuring all fields are completed accurately and provide necessary supporting documentation.
The purpose of DHA-15 (R10/97) is to gather essential data for monitoring and evaluating healthcare services and compliance within the health sector.
Information that must be reported on DHA-15 (R10/97) includes provider details, service descriptions, patient demographics, and any relevant financial or operational data.
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