CMS MA Signature Authority Grid (2012 Draft)
CMS MA Signature Authority Grid (2012 Draft).xls
Medicare Advantage Application - Part C and 1876 Cost Plan Expansion Application regulations under 42 CFR 422 subpart K & 417.400
CMS MA Signature Authority Grid (2012 Draft)
OMB: 0938-0935
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-0935 can be found here:
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| CMS MA SIGNATURE AUTHORITY GRID |
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| PRACTICE NAME |
SIGNATURE AUTHORITY |
PHYSICIANS |
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| File Type | application/vnd.ms-excel |
| File Title | HSD Table Templates |
| Author | CGI Federal |
| Last Modified By | CMS |
| File Modified | 2010-05-19 |
| File Created | 2009-08-04 |