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DocuSign Envelope ID: 76B5A5905F3146E2BE76A63634BCAF0FHEALTH AND HUMAN SERVICES COMMISSION CONTRACT NO. HHS000177300001 AMENDMENT NO. 2 The HEALTH AND HUMAN SERVICES COMMISSION (HHSC or System Agency)
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hhs000177300001-amendment-2pdf is a form used for filing amendments related to a specific healthcare program.
All healthcare providers participating in the program are required to file hhs000177300001-amendment-2pdf.
hhs000177300001-amendment-2pdf must be filled out electronically using the designated software provided by the program authority.
The purpose of hhs000177300001-amendment-2pdf is to report any changes or updates to the information previously submitted.
hhs000177300001-amendment-2pdf requires reporting of any changes in enrollment status, provider information, or program participation details.
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