This version of the form is not currently in use and is provided for reference only. Download this version of the document for the current year.
Dda Operated Medicaid Licensed Practitioner Application and Agreement is a legal document that was released by the Maryland Department of Health - a government authority operating within Maryland.
Q: What is the DDA Operated Medicaid Waiver Programs Licensed Practitioner Application and Agreement in Maryland?
A: It is a document that practitioners need to fill out and sign to participate in DDA operated Medicaid waiver programs.
Q: Who needs to fill out and sign this application and agreement?
A: Practitioners who want to participate in DDA operated Medicaid waiver programs in Maryland.
Q: What is the purpose of this document?
A: The document outlines the terms and conditions for practitioners to provide services through DDA operated Medicaid waiver programs.
Q: Are all practitioners required to fill out this application and agreement?
A: Yes, practitioners who wish to participate in DDA operated Medicaid waiver programs must fill out and sign this document.
Form Details:
Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Maryland Department of Health.