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Get UnitedHealthcare Provider Entity Disclosure Form 2016-2024

Ling interest and management information from providers that participate in the Medicaid and/or the Children’s Health Insurance Program (CHIP) managed care network pursuant to a Medicaid and/or CHIP State Contract with the State Agency and the federal regulations set forth in 42 CFR Part §455. Required information includes: 1) the identity of all owners and others with a controlling interest; 2) certain business transactions as described in 42 CFR §455.105; 3) the identity of managing employ.

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