C19 -TOC Table of Contents 19.1 Definitions 19.2 Emergency Assistance 19.3 Reserved for Future Use 19.4 Reserved for Future Use 19.5 Indigent Burial Program 19.6 Reserved for Future Use 19.7 Special Reduced Residential Service Rate (20% Utility Discount Program) 19.8 Tel-Assistance/Lifeline Appendix A Emergency Assistance Income Limits Appendix B Reserved for Future Use Appendix C Hospitals with Border Status for Medicaid Appendix D Public Forms DFA-67-A - Burial Billing DFA-BU-1 - Application for Burial Benefits DFA-BU-2 - Affidavit of Responsible Relative DFA-EA-1- Application for Emergency Assistance DFA-TA-2 - Tel-Assistance/Lifeline Application DFA-TA-3 - Tel-Assistance/Lifeline Fact Sheet Appendix E Reserved for Future Use Home I Manual Changes and DW-17's I Manual Search Manual Archive I Manual Change Archive This page was last updated on September 8, 2014 .
Hospitals with Border Status for Medicaid
Public Forms DFA-67-A - Burial Billing DFA-BU-1 - Application for Burial Benefits DFA-BU-2 - Affidavit of Responsible Relative DFA-EA-1- Application for Emergency Assistance DFA-TA-2 - Tel-Assistance/Lifeline Application DFA-TA-3 - Tel-Assistance/Lifeline Fact Sheet
Appendix E
Reserved for Future Use
Home I Manual Changes and DW-17's I Manual Search Manual Archive I Manual Change Archive
This page was last updated on September 8, 2014 .