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Table of ContentsState/Territory Name: Oklahoma State Plan Amendment (SPA) #: 180038 This file contains the following documents in the order listed: 1) Approval Letter 2) CMS 179 Form 3) Approved
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To fill out the Guttmacher Inst - Medicaidgov form, follow these steps:
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Step 2: Indicate your current Medicaid status and provide any relevant Medicaid identification numbers.
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Step 3: Specify the type of services you require from Guttmacher Institute.
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Step 4: Provide accurate information about your income, including any Medicaid eligibility factors.
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Step 5: Attach any supporting documents, such as proof of income or Medicaid enrollment.
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It is a form used to report abortion statistics to Medicaid.
Healthcare providers who perform abortions and receive Medicaid payments are required to file this form.
The form must be completed electronically through the designated online portal.
The purpose is to gather data on abortion services provided to Medicaid beneficiaries.
Information such as patient demographics, procedure details, and Medicaid payment information.
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