№ files_lp_3_process_7_054879
This document is a repayment agreement form for participants in the IRIS program regarding overdue cost share amounts and outlines the terms for repayment to maintain Medicaid and IRIS eligibility.
Year: 2017
Region / City: Wisconsin
Subject: Medicaid Services, IRIS Program
Document Type: Agreement
Organization: Department of Health Services
Author: Division of Medicaid Services
Target Audience: Medicaid participants in the IRIS Program
Effective Period: Ongoing
Approval Date: N/A
Amendment Date: N/A
Price: 8 / 10 USD
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