This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington.
The document is provided in Lao. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is DSHS Form 05-255 LA Medicaid Transformation Demonstration Notice of Action Exception to Rule?
A: DSHS Form 05-255 LA Medicaid Transformation Demonstration Notice of Action Exception to Rule is a form used in Washington to notify individuals of an exception to a rule under the Medicaid Transformation Demonstration program.
Q: Who uses DSHS Form 05-255 LA Medicaid Transformation Demonstration Notice of Action Exception to Rule?
A: This form is used by the Washington State Department of Social and Health Services (DSHS) to communicate with individuals who are enrolled in the Medicaid Transformation Demonstration program.
Q: What is the purpose of DSHS Form 05-255 LA Medicaid Transformation Demonstration Notice of Action Exception to Rule?
A: The purpose of this form is to inform individuals of an exception to a rule under the Medicaid Transformation Demonstration program and how it may impact their benefits or coverage.
Q: Is DSHS Form 05-255 LA Medicaid Transformation Demonstration Notice of Action Exception to Rule specific to the Lao language?
A: Yes, this particular form is available in Lao language.
Form Details:
Download a printable version of DSHS Form 05-255 LA by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.