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This document certifies the contract between a private, non-profit hospital and a state or local government entity to provide health care services to low income individuals.
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How to fill out Certification of Contract with State/Local Government to Provide Health Care Services
01
Obtain the Certification of Contract form from the appropriate state/local government health department.
02
Review the requirements and guidelines for filling out the form carefully.
03
Enter your business or organization name at the top of the form.
04
Provide your contact information, including address, phone number, and email.
05
Outline the specific health care services you intend to provide.
06
Include details about your qualifications and experience in the field.
07
Attach any necessary supporting documents (licensure, certifications, etc.).
08
Review all entries for accuracy and completeness.
09
Sign and date the form.
10
Submit the completed form according to the provided instructions, along with any required fees.
Who needs Certification of Contract with State/Local Government to Provide Health Care Services?
01
Healthcare providers looking to contract with state or local government.
02
Organizations providing health care services to public health programs.
03
Entities involved in community health initiatives funded by government contracts.
04
Private practitioners seeking government reimbursement for services.
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People Also Ask about
Is DSH the same as 340B?
There are six hospital types eligible to participate in the 340B Program: Disproportionate Share Hospitals (DSH) Sole Community Hospitals (SCH) Rural Referral Centers (RRC)
What is 340B A )( 4 of the Public Health Service Act?
Section 340B(a)(4) of the Public Health Service Act (PHS) Act (42 U.S.C. 256b) lists eligible organizations that can participate in and purchase discounted drugs under the 340B Program. HRSA's Office of Pharmacy Affairs (OPA) requires registration and approval for covered entities to participate in the 340B Program.
What is the simple explanation of 340B?
Section 340B of the Public Health Service Act requires pharmaceutical manufacturers participating in Medicaid to sell outpatient drugs at discounted prices to health care organizations that care for many uninsured and low-income patients.
Who are the participants in the 340B program?
Section 340B requires pharmaceutical manufacturers that participate in the Medicaid and Medicare Part B programs to enter into a contract with the Secretary of Health and Human Services (HHS) requiring them, among other things, to give specified discounts on covered outpatient drugs purchased by certain “covered
What are the restrictions of the 340B program?
The 340B law prohibits the resale or transfer of discounted outpatient drugs to anyone other than a patient of the covered entity, which is commonly referred to as “diversion.” HRSA has defined a covered entity patient through an October 24, 1996 Federal Register notice available on OPA's website.
What is Section 340B A )( 4 of the Public Health Service Act?
Section 340B(a)(4) of the PHS Act defines the types of entities eligible to participate in the 340B Program. Section 340B(a)(4)(L) states that a subset of Medicare disproportionate share hospitals (DSHs), as defined in section 1886(d)(1)(B) of the Social Security Act (SSA), are eligible for the 340B Program.
Is 340B Medicaid or Medicare?
The Issue. Section 340B of the Public Health Service Act requires pharmaceutical manufacturers participating in Medicaid to sell outpatient drugs at discounted prices to health care organizations that care for many uninsured and low-income patients.
What is the difference between Medicaid and 340B?
Medicaid was created to provide health care coverage for the poor and disabled, and 340B was created to stretch scarce federal resources to provide more care to more patients of safety-net hospitals.
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What is Certification of Contract with State/Local Government to Provide Health Care Services?
The Certification of Contract with State/Local Government to Provide Health Care Services is a formal document that verifies a healthcare provider's contractual agreement with state or local government entities to deliver healthcare services.
Who is required to file Certification of Contract with State/Local Government to Provide Health Care Services?
Healthcare providers who enter into contracts with state or local government to deliver health care services are required to file the Certification of Contract.
How to fill out Certification of Contract with State/Local Government to Provide Health Care Services?
To fill out the Certification, a provider must provide detailed information about the contract, including the names of the parties involved, the scope of services, duration of the contract, and sign the certification affirming the truthfulness of the information provided.
What is the purpose of Certification of Contract with State/Local Government to Provide Health Care Services?
The purpose of the Certification is to ensure that healthcare providers comply with applicable laws and regulations when entering into contracts with government entities and to promote transparency in government healthcare procurement.
What information must be reported on Certification of Contract with State/Local Government to Provide Health Care Services?
The information that must be reported includes the provider's name, contact details, nature of the healthcare services provided, details of the contract terms, and any pertinent compliance information required by state or local government regulations.
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