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PRINTED: 08/12/2022 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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Any organization or entity operating in California that receives funding or assistance from the state government may need to fill out a California State Plan Amendment. This includes healthcare providers, social service agencies, educational institutions, and other entities that have contracts or agreements with the state.

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What is california state plan amendment?

A California state plan amendment is a proposed change to the state's Medicaid program that must be submitted to the federal government for approval.

Who is required to file california state plan amendment?

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

How to fill out california state plan amendment?

California state plan amendments must be filled out following specific guidelines provided by the federal government.

What is the purpose of california state plan amendment?

The purpose of California state plan amendments is to ensure compliance with federal regulations and to make changes to the state's Medicaid program.

What information must be reported on california state plan amendment?

California state plan amendments must include details about proposed changes to the Medicaid program, including the impact on beneficiaries and providers.

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