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Table of Contents State/Territory Name: California State Plan Amendment (SPA) #: 200025 This file contains the following documents in the order listed: 1) Approval Letter 2) CMS 179 Form/Summary Form

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How to fill out california state plan amendment

01

Obtain the California State Plan Amendment form from the relevant state department.

02

Fill out all required information on the form, including your agency or organization's details.

03

Provide a detailed description of the proposed changes or amendments to the state plan.

04

Attach any supporting documentation or evidence required to demonstrate the need for the amendment.

05

Review the completed form for accuracy and completeness before submitting it.

06

Submit the filled-out California State Plan Amendment form to the appropriate state agency for review and approval.

Who needs california state plan amendment?

01

Government agencies or organizations in California that provide services or programs funded through state plans may need to fill out a California State Plan Amendment.

02

Any entity seeking to make changes or updates to an existing state plan in order to better meet the needs of the population they serve may also need to fill out a California State Plan Amendment.

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What is california state plan amendment?

California state plan amendment is a proposal to change or update the state's Medicaid program.

Who is required to file california state plan amendment?

State Medicaid agencies are required to file california state plan amendment.

How to fill out california state plan amendment?

California state plan amendment can be filled out online through the state's Medicaid portal.

What is the purpose of california state plan amendment?

The purpose of california state plan amendment is to improve or expand Medicaid services in the state.

What information must be reported on california state plan amendment?

California state plan amendment must include details of proposed changes to the Medicaid program, along with supporting data.

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