DHS-3050 – Providing Information
Use the DHS-3050 to communicate:
- MA and MA-LTC eligibility, including approvals, denials and closings, to the LTCF. Do not release information about why the eligibility determination occurred unless a release of information has been filed.
- Spenddown recipient amount.
- Managed care information.
- Other information as needed.
To Do: Take some time to review the DHS-3050 to learn about when you need to use this form.
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Level of Care Requirement - LTC Screenings - LTCF