Exhibit AE

Exhibit AE.doc

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

Exhibit AE

OMB: 0938-0193

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64


Revision: HCFA‑AT‑80‑60 (BPP)

August 12, 1980


State:


Citation 4.19(h) The Medicaid agency meets the requirements

42 CFR 447.201 of 42 CFR 447.203 for documentation and

42 CFR 447.203 availability of payment rates.

AT‑78‑90




























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TN No.

Supersedes Approval Date Effective Date

TN No.


File Typeapplication/msword
AuthorCMS
Last Modified ByCMS
File Modified2008-05-07
File Created2008-05-07

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