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Table of Contents State/Territory Name: Alaska State Plan Amendment (SPA) #: 200004 This file contains the following documents in the order listed: 1) Approval Letter 2) CMS 179 Form/Summary Form
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Obtain a copy of the state plan amendment form from the appropriate department or website.
02
Review the instructions provided with the form to understand the requirements for filling it out.
03
Fill in all required information accurately and completely, including your organization's details and the specific amendment being requested.
04
Attach any supporting documentation or evidence as necessary to support your amendment request.
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Submit the completed form and documentation according to the instructions provided, making sure to meet any deadlines or requirements.

Who needs state plan amendment this?

01
Organizations or entities that participate in state-funded programs or services may need to fill out a state plan amendment.
02
These could include healthcare providers, educational institutions, social service agencies, and other organizations that receive funding or support from the state government.
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State plan amendment is a proposed change to a state's Medicaid plan that must be approved by the Centers for Medicare & Medicaid Services (CMS).
State Medicaid agencies are required to file state plan amendments.
State plan amendments must be filled out according to the guidelines provided by CMS.
The purpose of a state plan amendment is to update or modify the Medicaid program to comply with federal requirements.
State plan amendments must include information about the proposed changes to the Medicaid program and how they will impact beneficiaries.
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