♦ AMPM 1240-I, Attachment A, ALTCS FFS Home Modification Request Justification Form

Do not include Personal Health Information (PHI) in your comments.

  • Please ensure to include the Policy Page Number relating to each comment.
  • You will receive acknowledgement that your comments have been received. AHCCCS cannot provide responses to individual comments.

Proposed Policy:

 1240-I, Attachment A, ALTCS FFS Home Modification Request Justification Form

Comment Deadline: September 07, 2017

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