№ files_lp_3_process_7_051911
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Administrative reporting and attestation form establishing eligibility, reinvestment obligations, compliance conditions, and certification requirements for MassHealth DME mobility providers seeking corrective mobility system repair add-on payments in Massachusetts.
Program:
MassHealth Corrective Mobility System Repair Add-on Payments
Document Type:
Reporting and Attestation Form
Issuing Authority:
MassHealth
Governing Regulation:
101 CMR 322.00 Rates for Durable Medical Equipment, Oxygen and Respiratory Therapy Equipment
Jurisdiction:
Commonwealth of Massachusetts
Eligible Participants:
MassHealth-enrolled DME mobility providers or providers contracted with MassHealth Managed Care Entities
Funding Requirement:
Minimum 80% of add-on payment funds must be reinvested in corrective mobility repair services
Claims Code:
K0739U3
Reporting Components:
Baseline Report and Attestation; Performance Metric Report; Investment Impact Report; Additional Compliance Reporting upon EOHHS request
Performance Metric Report Deadline:
Within 30 days after the close of the first full quarter following baseline submission
Investment Impact Report Deadline:
Within 60 days of December 31, 2025
Submission Method:
Email to [email protected]
Note:
with specified subject line
Signature Methods Accepted:
Handwritten signature (scanned), DocuSign, Adobe Sign, or uploaded image of wet signature
Compliance Enforcement:
Subject to financial sanctions or penalties for noncompliance
Price: 8 / 10 USD
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The product description is provided for reference. Actual content and formatting may differ slightly.
Year:
2027
Region / City:
United States
Topic:
Healthcare Technology, Medical Devices
Document Type:
Tracking Form
Agency / Organization:
Centers for Medicare & Medicaid Services
Author:
Unknown
Target Audience:
Healthcare Providers, Medical Device Manufacturers
Effective Period:
Fiscal Year 2027
Approval Date:
Unknown
Date of Changes:
Unknown
Year:
2021
Region / City:
California
Topic:
Vehicle Emissions and Conversion Procedures
Document Type:
Regulatory Procedure
Organization / Institution:
California Air Resources Board (CARB)
Author:
California Air Resources Board
Target Audience:
Vehicle manufacturers, engineers, environmental regulators
Effective Period:
Ongoing
Approval Date:
June 29, 2021
Amendment Date:
[Insert Date of Amendment]
Year:
2022
Effective Date:
1/1/2022
Region:
Region 11
Subject:
Maximum Child Care Allowance (MCCA) rate increase and non-traditional add-on rates
Document Type:
Administrative rate notice
Issuing Body:
OCDEL
Related Institution:
ELRC
Service Type:
Subsidized child care services
Geographic Scope:
Region 11
Provider Types:
Center; Group; FDCH; R/N
Care Categories:
Infant; Young Toddler; Old Toddler; Pre-School; School-Age
Care Modalities:
Full-Time Care; Part-Time Care; Non-Traditional Care
Add-On Rate:
25% for qualifying non-traditional hours
Non-Traditional Hours Definition:
6:00 pm–6:00 am weekdays; any time Saturday or Sunday
Required Documentation:
Published Private Pay Rates; Appendix C-1 ELRC Subsidized Child Care Rates
Administrative Requirements:
Submission of signed and dated updated rates to ELRC; verification required for rate increase to take effect
Year:
2026
Region / City:
Madison, WI
Subject:
Nurse Externship Program Application
Document Type:
Application Form
Organization:
Meriter Hospital
Author:
Meriter Hospital
Target Audience:
Prospective Nurse Externs
Effective Period:
Until January 12th, 2026
Approval Date:
N/A
Date of Last Revision:
N/A
Institution:
Georgia State University
Program:
Educational Leadership Tier 1 Master’s Degree and Add-on Programs
Academic Unit:
College of Education
Department:
Department of Educational Policy Studies
Associated Unit:
Educational Leadership Unit
Related Center:
Georgia State University Principals Center
Document Type:
Program Handbook
Level of Study:
Graduate
Degrees and Certifications Covered:
M.Ed., Add-on Certification, Ed.S., PL-6, Ed.D.
Standards Referenced:
Georgia Leadership Standards; Georgia LKES Standards
Includes:
Policies, program requirements, faculty information, clinical practice log, mentor form
Intended Audience:
Students enrolled in the Educational Leadership Tier 1 Master’s Degree and Add-on Programs
Region:
Georgia, United States
Academic Field:
Educational Leadership
Year:
Not specified
Region / City:
Not specified
Subject:
Nonconformance reporting and corrective action tracking
Document Type:
Internal corrective action form
Organization / Institution:
Not specified
Author:
Not specified
Target Audience:
Not specified
Effective Period:
Not specified
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2022
Region / City:
Kansas
Subject:
Financial Exploitation, Corrective Action Plans
Document Type:
Guidelines
Organization:
Department for Children and Families
Author:
Department for Children and Families
Target Audience:
APS Specialists, APS Supervisors, Regional Staff
Period of Validity:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Date:
3/28/2025
Note:
Region / city
Topic:
Corrective and preventive action planning
Document type:
Template
Author:
Lauren Wallace, MS, RAC-Drugs, Sarah Lines, Liz Kissell
Target audience:
Clinical research professionals, IRB, study sponsors
Context description:
Template for creating a corrective and preventive action plan (CAPA) for studies, processes, or systems, detailing actions to address identified issues.
Document type:
Guidance document
Subject area:
Clinical research compliance
Topic:
Corrective and Preventive Action (CAPA)
Applicable field:
Clinical trials
Responsible parties:
Sponsor, monitor, site personnel, principal investigator
Regulatory body referenced:
Institutional Review Board (IRB)
Key components:
Root cause analysis, corrective action, preventive action, follow-up evaluation
Authorship requirements:
Responsible individual or organization
Approval requirements:
Author signature, IRB review
Record retention:
Site regulatory file
Intended use:
Documentation of discrepancies and corrective measures in clinical research
Year:
2023
Region / City:
New Jersey, USA
Subject:
Education, Professional Development
Document Type:
Guideline, Template
Organization / Institution:
New Jersey Department of Education
Author:
New Jersey Department of Education
Target Audience:
Teachers, School Administrators
Period of Validity:
Not specified
Approval Date:
Not specified
Date of Last Revision:
Not specified
Year:
2022
Region / City:
Wisconsin
Topic:
Health Services, HIV Care, Disease Control
Document Type:
Corrective Action Plan
Organization / Institution:
Department of Health Services
Author:
Unknown
Target Audience:
Subrecipients, Healthcare Providers
Period of Implementation:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2022
Region / City:
Not specified
Topic:
Environmental Compliance / Stormwater Management
Document Type:
Template
Organization:
EPA
Author:
Not specified
Target Audience:
Operators of construction sites under EPA CGP
Period of Validity:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2015
Region / City:
CRC
Topic:
Clinical Trials, Corrective and Preventive Action
Document Type:
Standard Operating Procedure
Organization:
Clinical Research Center (CRC)
Author:
Not specified
Target Audience:
Clinical Research Personnel
Period of Validity:
Ongoing
Approval Date:
01/01/2015
Effective Date:
01/01/2015
Review/Revision Date:
06/01/2016
Year:
2022
Region / State:
Georgia, USA
Document Type:
Template / Report Form
Intended Users:
UST Owners/Operators, Professional Engineers, Professional Geologists
Regulatory Reference:
Georgia Rules for Underground Storage Tank Management, Rule 391-3-15-.09
Attachments Included:
Figures, Tables, Appendices
Facility Information:
Required (ID, Name, Address, County, City, Zip Code)
Author:
UST Owner/Operator and Preparer (matching GA Secretary of State records)
Certification:
Required by UST Owner/Operator and Professional Engineer/Geologist
Content Sections:
Plan Certification, Initial Response Report, Tank History, Initial Site Characterization
Data Format:
Microsoft Word with protected fields for data entry
Instructions:
Follow Georgia EPD CAP-Part A Guidance Document strictly
Note:
Year
Topic:
Environmental Management, Corrective Action Reports
Document Type:
Instruction Manual
Organization / Institution:
Georgia Environmental Protection Division
Target Audience:
Facility operators, project officers, environmental consultants
Jurisdiction:
State of Georgia
Regulatory authority:
Georgia Department of Natural Resources, Environmental Protection Division
Program area:
Hazardous Waste
Document type:
Financial assurance letter
Subject matter:
Financial test for closure, post-closure care, and corrective action
Related regulations:
Georgia Rules 391-3-11-.05; 40 CFR Parts 264, 265, and 144
Issuing party:
Chief Financial Officer of the firm
Recipient:
Georgia EPD Director, Land Protection Branch
Facilities covered:
Hazardous waste management facilities and UIC facilities
Geographic scope:
Georgia and other U.S. states
Financial mechanisms referenced:
Financial test and corporate guarantee
Intended use:
Demonstration of financial responsibility
Year:
2022
Region / City:
Switzerland
Topic:
Corrective and Preventive Actions in Clinical Trials
Document Type:
Instruction Template
Organization:
Swissmedic
Author:
Not specified
Target Audience:
Clinical trial administrators, quality assurance personnel
Effective Period:
Not specified
Approval Date:
Not specified
Amendment Date:
Not specified
Year:
2022
Region / City:
Georgia, USA
Topic:
Environmental Protection / Underground Storage Tanks
Document Type:
Template / Form
Agency / Organization:
Georgia Environmental Protection Division (EPD)
Author:
Georgia EPD
Target Audience:
UST Owners/Operators, Environmental Engineers, Professional Geologists
Effective Period:
N/A
Approval Date:
N/A
Revision Date:
N/A