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Get DHS 1144E Instructions

L authorization of case management, hourly skilled nursing and personal care services for Medicaid recipients under age 21 years who are medically fragile. EPSDT stands for Early and Periodic Screening, Diagnosis and Treatment. EPSDT is the Medicaid program for Medicaid recipients under age 21 years. II. General Instructions: Type or print legibly. An incomplete form will be returned to the provider. A. Recipient Information: This section is to be completed by the provider. 1. Enter Medicaid .

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