C19 -TOC Table of Contents 19.1 Definitions 19.2 Emergency Assistance 19.3 Non-Emergency Medical Transportation 19.4 Reserved for Future Use 19.5 Indigent Burial Program 19.6 Reserved for Future Use 19.7 Public Utility Program 19.8 Tel-Assistance, Lifeline, and Link Up Appendix A Emergency Assistance Income Limits Appendix B Counties Served - Utility Program 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 OFA-NEMT-1 - NEMT Application OFA-NEMT-1A - Supplement to NEMT Application Appendix E Tel-Assistance/Lifeline and Link Up Participating Telephone Companies Home I Manual Changes and DW-17's I Manual Search Manual Archive I Manual Change Archive This page was last updated on February 13, 2009 .
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 OFA-NEMT-1 - NEMT Application OFA-NEMT-1A - Supplement to NEMT Application
Home I Manual Changes and DW-17's I Manual Search Manual Archive I Manual Change Archive
This page was last updated on February 13, 2009 .