♦ AMPM 650, Attachment A, Decline to Participate in the Screening and/or Referral Process for Health Insurance or Medicare, Including Part D Plan Enrollment

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:

 AMPM 650_Attachment_A-Decline to Participate

Comment Deadline: January 22nd, 2018

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