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Get 1135 Waiver At A Glance
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How to fill out the 1135 Waiver At A Glance online
The 1135 Waiver At A Glance form is essential for healthcare providers seeking temporary modifications to certain Medicare, Medicaid, and CHIP requirements during declared emergencies. This guide will provide clear, step-by-step instructions for filling out this form online, ensuring that you can navigate the process with confidence.
Follow the steps to successfully complete the form online.
- Press the ‘Get Form’ button to retrieve the 1135 Waiver At A Glance form and open it in the editor.
- Carefully read all introductory materials provided on the form to understand the criteria and purpose of the waiver.
- Fill in the required fields with accurate details about your healthcare facility, including name, address, and contact information.
- Provide specific information regarding the nature of the emergency that has prompted the waiver request, including dates and any relevant documentation.
- Indicate which specific Medicare, Medicaid, or CHIP requirements you are requesting to waive or modify during the emergency period.
- Review your entries to ensure all information is complete and correct before submission.
- Once all sections are filled out, you can save your changes, download a copy of the completed form, and print it for your records or share it as needed.
Complete your 1135 Waiver At A Glance form online today for a smoother emergency response.
The waiver is either limited to a seventy-two-hour period beginning with the implementation of the Hospital's disaster protocol or, in the case of a pandemic infectious disease, until the termination of the declaration of the public health emergency. period during which the waiver is in effect.”
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