DSHS Form 05-255 LA Medicaid Transformation Demonstration Notice of Action Exception to Rule - Washington (Lao)

DSHS Form 05-255 LA Medicaid Transformation Demonstration Notice of Action Exception to Rule - Washington (Lao)

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.

FAQ

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.

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Form Details:

  • Released on May 1, 2017;
  • The latest edition provided by the Washington State Department of Social and Health Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

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.

Download DSHS Form 05-255 LA Medicaid Transformation Demonstration Notice of Action Exception to Rule - Washington (Lao)

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