Instructions for Form CDA255M Mippa Expenditure Report - California

Instructions for Form CDA255M Mippa Expenditure Report - California

This document contains official instructions for Form CDA255M , Mippa Expenditure Report - a form released and collected by the California Department of Aging. An up-to-date fillable Form CDA255M is available for download through this link.

FAQ

Q: What is Form CDA255M?
A: Form CDA255M is the Mippa Expenditure Report form used in California.

Q: Who needs to fill out Form CDA255M?
A: Healthcare facilities and providers in California that received payments under the Medicare Improvements for Patients and Providers Act (MIPPA) need to fill out this form.

Q: What is the purpose of Form CDA255M?
A: The purpose of Form CDA255M is to report expenditures made under the MIPPA program.

Q: What kind of information is required on Form CDA255M?
A: The form requires information on the total expenditures made under the MIPPA program during the reporting period.

Q: Are there any penalties for not submitting Form CDA255M?
A: Yes, there may be penalties for not submitting the form or for submitting it late. It is important to comply with the reporting requirements to avoid penalties.

Q: Is there any assistance available for filling out Form CDA255M?
A: Yes, the California Department of Health Care Services may provide assistance or guidance for filling out the form. You can contact them for further information.

Q: Does Form CDA255M require any supporting documents?
A: The form may require supporting documentation to verify the reported expenditures. You should review the instructions provided with the form to determine what documents need to be submitted.

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Instruction Details:

  • This 1-page document is available for download in PDF;
  • Actual and applicable for the current year;
  • Complete, printable, and free.

Download your copy of the instructions by clicking the link below or browse hundreds of other forms in our library of forms released by the California Department of Aging.

Download Instructions for Form CDA255M Mippa Expenditure Report - California

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