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OMB Control Number: 0938XXXX Expires: XX/XX/XXXXMedicare Advantage Qualifying Payment Arrangement Incentive (MALI) Demonstration Submission Form for Medicare Advantage Qualifying Payment Arrangement

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What is qualifying payment arrangement submission?

Qualifying payment arrangement submission is a formal submission of payment arrangement details to ensure compliance with relevant regulations and guidelines.

Who is required to file qualifying payment arrangement submission?

Entities and individuals who have entered into qualifying payment arrangements are required to file a submission.

How to fill out qualifying payment arrangement submission?

To fill out qualifying payment arrangement submission, provide all requested information accurately and completely as per the guidelines provided.

What is the purpose of qualifying payment arrangement submission?

The purpose of qualifying payment arrangement submission is to document and disclose details of payment arrangements in order to demonstrate compliance.

What information must be reported on qualifying payment arrangement submission?

Qualifying payment arrangement submission must include details of the parties involved, payment terms, amounts, and any relevant supporting documentation.

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