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PRINTED: 01/23/2023 FORM APPROVEDDEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION(X1) PROVIDER/SUPPLIER/CIA IDENTIFICATION
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ffs ampamp ma im stands for Form For Submission and Maintenance of Medical Insurance.
Employers and self-employed individuals are required to file ffs ampamp ma im for their employees or themselves.
ffs ampamp ma im can be filled out online on the designated website by providing information about the medical insurance coverage.
The purpose of ffs ampamp ma im is to ensure that individuals have medical insurance coverage and to track changes in coverage over time.
Information such as the name of the insured individual, policy number, coverage start and end dates, and insurance provider must be reported on ffs ampamp ma im.
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