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CHANGE NOTICE FOR MANUAL NO.12-03, Notices

DATE: AUGUST 26, 2002

Change No: 12-03

Effective: October 1, 2002

I. BACKGROUND

II. CONTENT OF CHANGE

III. Implementation

IV. MAINTENANCE OF MANUAL

Insert: Nothing to insert.

If you have any questions regarding this information, please contact your Medicaid Program Representative.

[This policy material was researched and written by Vanessa Broadhurst, Policy Consultant, Medicaid Eligibility Unit.]

MA-3430

MA-3430, Fig. 1A, DSS-8108

MA-3430, Fig. 1B, DSS-8108 (Spanish)

MA-3430, Fig. 2A, DSS-8109

MA-3430, Fig. 2B, DSS-8109 (Spanish)

MA-3430, Fig. 2 Instructions

MA-3430, Fig. 3A, DSS8-8110

MA-3430, Fig. 3B, DSS-8110 (Spanish)

MA-3430, Fig 3 Instructions

MA-3430, Fig 4, DSS-1473

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