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Table of Contents State/Territory Name: AZ State Plan Amendment (SPA)#: 220027This file contains the following documents in the order listed: 1) Approval Letter 2) CMS 179 Form/Summary Form (with

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How to fill out arizona state plan amendment

01

Obtain a copy of the Arizona State Plan Amendment (SPA) form.

02

Fill out the applicant information section, which includes name, address, contact information, and program ID.

03

Complete the section detailing the proposed changes to the state plan, ensuring all necessary information is provided.

04

Review the completed SPA form for accuracy and completeness.

05

Submit the SPA form to the appropriate state agency for review and approval.

Who needs arizona state plan amendment?

01

State agencies or organizations in Arizona that participate in federally-funded programs requiring a state plan amendment.

02

Anyone seeking to make changes or updates to an existing Arizona state plan.

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What is arizona state plan amendment?

An Arizona state plan amendment is a formal proposal submitted to the Centers for Medicare and Medicaid Services (CMS) to amend the state's Medicaid program.

Who is required to file arizona state plan amendment?

State Medicaid agencies are required to file Arizona state plan amendments.

How to fill out arizona state plan amendment?

Arizona state plan amendments can be filled out by following the guidelines and instructions provided by CMS.

What is the purpose of arizona state plan amendment?

The purpose of Arizona state plan amendments is to update and modify the state's Medicaid program to comply with federal regulations and guidelines.

What information must be reported on arizona state plan amendment?

Arizona state plan amendments must include detailed information about the proposed changes to the state's Medicaid program.

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