Get Attachment A-1. Annual Certification Of Compliance With Home Care Worker Wage Parity - Hca-nys

Completing the Attachment A-1 form requires careful attention to detail to ensure compliance with home care worker wage parity regulations. This guide provides clear, step-by-step instructions for filling out the form accurately and efficiently online.

Follow the steps to complete the form correctly.

1. Press the ‘Get Form’ button to obtain the document and open it in your preferred online editor.
2. In the first section, enter the name of your managed care organization (MCO) in the space provided to ensure it is properly identified.
3. Next, input your National Provider Identifier number in the designated area. This number is crucial for compliance verification within the healthcare system.
4. Proceed to the certification statement. Review the declaration carefully to confirm that all Medicaid services track compliance with the wage parity regulations.
5. You will need to sign the form. Make sure the signature is from one of the approved individuals listed in the notes section (e.g., Chief Executive Officer, President).
6. Under the signature, print your name clearly, followed by your title, as required. This affirms your authority in signing the document.
7. Finally, review all entered information for accuracy. Once confirmed, you can save your changes, download the completed form, or print it for your records.

Complete your documents online to ensure compliance and facilitate your review process.