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Exhibit 3Case 5:11cv00273BO Document 2083 Filed 12/02/15-Page 1 of 3NOTICE TO PERSONS WHO HAVE BEEN DENIED OR TERMINATED FROM RECEIVING MEDICAID COVERED INCOME PERSONAL CARE SERVICES IN NORTH CAROLINA:PROPOSED

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Individuals who are seeking health information or services in the state of New York.

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Healthcare providers who need to report certain information or comply with state regulations.

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What is nys department of heatlh?

The New York State Department of Health (NYSDOH) is the department of the New York state government responsible for public health.

Who is required to file nys department of heatlh?

Healthcare providers, facilities, and certain other entities are required to file with the NYSDOH.

How to fill out nys department of heatlh?

The NYSDOH provides guidelines and forms for reporting health information that must be followed when filling out the department's forms.

What is the purpose of nys department of heatlh?

The purpose of the NYSDOH is to protect and improve the health of New York residents through various public health initiatives.

What information must be reported on nys department of heatlh?

Information such as patient demographics, diagnoses, treatments, and outcomes may need to be reported to the NYSDOH.

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