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DEPARTMENT OF HEALTH & HOSPITALS Medicaid Program Decision Letterer RecipientFullName :The following decision has been made on your existing coverage:1 Advance Close any program NOT Take Charge and
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Form following decision has is a form used to document decisions made by an individual or a group.
Anyone who has made a decision that needs to be documented.
The form can be filled out online or in paper form, following the instructions provided.
The purpose of the form is to keep a record of important decisions for future reference.
The form should include the date of the decision, the individuals involved, the reasons for the decision, and any outcomes.
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