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.
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.
Instruction Details:
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.