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COMMUNITY PATHWAYS WAIVER Main and Appendix A Amendment #2-Page 1 of 48Request Home and Request for an Amendment to a 1915© Home CommunityBased Services Waiver I. Request Information A. The State
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Submit the filled-out application form along with any required supporting documents to the designated authority or organization.
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Who needs application for a 1915?

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The application for a 1915 may be required by individuals or organizations who are seeking to avail benefits or services related to the specific program associated with the 1915 application. The specific eligibility criteria and purpose of the application may vary depending on the program or service being applied for. It is advisable to refer to the program guidelines or consult with the relevant authority to determine if the application for a 1915 is needed.
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Application for a 1915 is a form used to apply for a specific waiver under the Medicaid program.
Certain individuals or organizations may be required to file the application for a 1915, such as Medicaid beneficiaries or their authorized representatives.
The application for a 1915 can typically be filled out electronically on the Medicaid portal or submitted in paper form by mail.
The purpose of the application for a 1915 is to request a waiver for specific Medicaid program requirements in order to receive certain services.
The application for a 1915 must include information such as the Medicaid beneficiary's personal details, requested services, medical history, and reasons for requesting the waiver.
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