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NEW YORK STATE DEPARTMENT OF HEALTH Office of Medicaid Management ATTACHMENT IIT NOTICE OF DECISION TO DISCONTINUE PARTICIPATION IN THE CARE AT HOME I AND II WAIVER PROGRAM (ONLY) NOTICE DATE: EFFECTIVE
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How to fill out notice of decision discontinue:

01
Begin by addressing the notice to the appropriate party or organization. Include the name, title, and contact information of the recipient.
02
Clearly state the decision that is being discontinued. Explain the reasons for discontinuing the decision in a concise and professional manner.
03
Provide any relevant background information or context regarding the decision that is being discontinued. This can help the recipient understand the reasoning behind the decision.
04
Outline any alternative solutions or actions that will be taken in place of the discontinued decision. Offer suggestions or recommendations to minimize any potential negative impact.
05
Include any supporting documentation or evidence to support your decision to discontinue. This can help validate your reasoning and make the notice more comprehensive.
06
Clearly communicate any deadlines or timelines associated with the discontinuation of the decision. Specify any actions or steps that need to be taken by the recipient following the receipt of the notice.
07
End the notice with a polite and professional closing. Provide your contact information and encourage the recipient to reach out with any questions or concerns.

Who needs notice of decision discontinue:

01
Organizations or individuals who have made a decision that needs to be discontinued.
02
Parties who were affected by the initial decision and need to be informed about the discontinuation.
03
Stakeholders or relevant authorities who need to be updated on the current status of the decision and any changes being made.
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The notice of decision discontinue is a formal document that informs relevant parties of the decision to stop a particular action or process.
Anyone who is responsible for making decisions regarding a particular matter may be required to file a notice of decision discontinue.
To fill out a notice of decision discontinue, one must include relevant information such as the decision to discontinue, the reasons for the decision, and any potential implications.
The purpose of a notice of decision discontinue is to formally communicate the decision to discontinue a particular action or process to all relevant parties.
The notice of decision discontinue must include details about the decision, the reasons for discontinuation, and any relevant dates or deadlines.
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