Exhibit AD

Exhibit AD.doc

State Plan Under Title XIX of the Social Security Act (Base plan pages, Attachments, Supplements to Attachments)

Exhibit AD

OMB: 0938-0193

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63


Revision: HCFA‑AT‑80‑38(BPP)

May 22, 1980


State:


Citation 4.19(g) The Medicaid agency assures appropriate

42 CFR 447.201 audit of records when payment is based on

42 CFR 447.202 costs of services or on a fee plus

AT‑78‑90 cost of materials.





























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TN No.

Supersedes Approval Date Effective Date

TN No.


File Typeapplication/msword
AuthorCMS
Last Modified ByCMS
File Modified2008-05-06
File Created2008-05-06

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