№ lp_1_2_47009
File format: docx
Character count: 4365
File size: 63 KB
The document is a form that provides instructions for requesting exemptions from the ForwardHealth Prior Authorization / Preferred Drug List process.
Year:
2023
Region / City:
Wisconsin
Subject:
Health Services, Medicaid
Document Type:
Form
Organization / Institution:
Department of Health Services, State of Wisconsin
Author:
Department of Health Services
Target Audience:
Prescribers, Pharmacy Providers
Period of Validity:
N/A
Approval Date:
N/A
Date of Modifications:
N/A
Price: 8 / 10 USD
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The product description is provided for reference. Actual content and formatting may differ slightly.
Year:
2025
Region / City:
Wisconsin
Topic:
Healthcare, Pharmacy, Medicaid
Document Type:
Form
Organization:
Department of Health Services
Author:
Not specified
Target Audience:
Healthcare providers, Prescribers, Pharmacy providers
Period of Validity:
Not specified
Approval Date:
Not specified
Amendment Date:
Not specified
Year:
2018
Region / City:
Wisconsin
Theme:
Healthcare, Medicaid Services
Document Type:
Form
Organization / Institution:
Department of Health Services, State of Wisconsin
Author:
Division of Medicaid Services
Target Audience:
Healthcare Providers, Prescribers
Period of Action:
2018
Approval Date:
January 2018
Date of Changes:
None
Year:
2024
Region / City:
Wisconsin
Theme:
Healthcare / Medicaid
Document Type:
Form
Organization / Institution:
Department of Health Services, State of Wisconsin
Author:
Department of Health Services
Target Audience:
Healthcare providers, Prescribers, Pharmacy providers
Period of validity:
Not specified
Approval Date:
Not specified
Date of changes:
Not specified
Year:
2024
Region / City:
Wisconsin
Topic:
Health services, Medicaid
Document Type:
Instruction manual
Organization / Institution:
Department of Health Services, State of Wisconsin
Author:
Department of Health Services
Target Audience:
Healthcare providers, pharmacists
Effective Period:
Ongoing
Approval Date:
01/2024
Date of Amendments:
None
Year:
2019
Region / State:
Wisconsin, USA
Topic:
Newborn reporting for Medicaid and BadgerCare Plus
Document Type:
Medical administrative form
Organization:
Department of Health Services, Division of Medicaid Services
Form Number:
F-01165
Audience:
Healthcare providers submitting newborn information
Legal Reference:
Wis. Stat. § 49.45(4); Wis. Admin. Code § DHS 104.02(4)
Submission Methods:
Fax or mail
Required Information:
Newborn details, mother details, provider details, gestational age, newborn weight
Year:
2018
Region / City:
Wisconsin
Theme:
Healthcare, Medicaid Services
Document Type:
Form
Organization / Institution:
Department of Health Services, State of Wisconsin
Author:
Division of Medicaid Services
Target Audience:
Healthcare Providers, Prescribers
Period of Action:
2018
Approval Date:
January 2018
Date of Changes:
None
Year:
20__
Region / City:
Delaware
Topic:
Venture Capital Financing
Document Type:
Term Sheet
Organization / Institution:
[Company Name]
Author:
[Company Name]
Target Audience:
Investors, Company Executives, Legal Advisors
Period of Validity:
Until closing of Series A Preferred Stock Financing
Approval Date:
[, 20__]
Amendment Date:
[]
Year:
20[__]
Region / City:
Delaware
Topic:
Preferred Stock Purchase
Document Type:
Agreement
Organization:
[Company Name]
Author:
[Author Name / Company]
Target Audience:
Investors
Effective Period:
[Effective Period]
Approval Date:
[Approval Date]
Amendment Date:
[Amendment Date]
Year:
2025
Region / City:
Wisconsin
Topic:
Healthcare, Pharmacy, Medicaid
Document Type:
Form
Organization:
Department of Health Services
Author:
Not specified
Target Audience:
Healthcare providers, Prescribers, Pharmacy providers
Period of Validity:
Not specified
Approval Date:
Not specified
Amendment Date:
Not specified
Year:
2025
Region / City:
New Mexico
Topic:
Health care, Medicaid
Document Type:
Request for Proposals (RFP)
Organization / Institution:
New Mexico Health Care Authority
Author:
Robert B. Kenney, Procurement Manager
Target Audience:
Contractors, Health care service providers, Medicaid administrators
Period of Validity:
2025-2026
Approval Date:
April 16, 2025
Amendment Date:
Not specified
Document type:
Draft model contractual representations
Subject matter:
Outbound investment regulatory compliance
Regulatory framework:
31 C.F.R. Part 850
Jurisdiction:
United States
Applicable rules:
Outbound Investment Rules
Transaction type:
Preferred stock purchase
Parties referenced:
Company; Investors; Purchaser
Legal concepts:
Person of a country of concern; Covered activity; Covered foreign person; U.S. person; Controlled foreign entity
Intended use:
Inclusion in financing transaction documentation
Source type:
Model legal language
Stage:
Draft
Year:
2023
Region / City:
Virginia
Theme:
Addiction and Recovery Treatment Services, Office-Based Addiction Treatment
Document Type:
Application
Organization / Institution:
Virginia Department of Medical Assistance Services (DMAS)
Author:
Virginia Department of Medical Assistance Services
Target Audience:
Healthcare providers, addiction treatment professionals
Effective Period:
Ongoing
Approval Date:
December 5, 2023
Date of Changes:
N/A
Year:
2024
Plan period:
2022–2037
Document type:
Consultation submission form
Planning authority:
Powys County Council
Plan type:
Replacement Local Development Plan
Consultation period:
19 August 2024 – 7 October 2024
Submission deadline:
7 October 2024
Geographical area:
Powys, Wales
Purpose:
Submission of new candidate sites for consideration
Assessment framework:
Candidate Site Assessment Methodology
Public availability:
Candidate Sites Register
Languages available:
English and Welsh
Legal framework:
General Data Protection Regulation (GDPR)
Target contributors:
Site proposers and landowners
Source category:
Local planning policy consultation material
Year:
20__
Region / City:
Delaware
Subject:
Stock purchase agreement, Series A Preferred Stock
Document Type:
Agreement
Organization / Institution:
[]
Author:
[]
Target Audience:
Investors, legal professionals, founders
Effective Period:
[]
Approval Date:
[]
Modification Date:
[__]
Year:
[20__]
Region / City:
Delaware
Subject:
Series A Preferred Stock Financing
Document Type:
Term Sheet
Organization / Institution:
[]
Author:
[]
Target Audience:
Investors, Legal Advisors, Business Executives
Effective Period:
[]
Approval Date:
[]
Amendment Date:
[__________]
Year:
2020
Jurisdiction:
Republic of the Marshall Islands
Governing law:
Maritime Act of the Republic of the Marshall Islands
Issuing authority:
Republic of the Marshall Islands Maritime Administrator
Document type:
Memorandum of particulars
Subject matter:
Release of preferred ship mortgage
Vessel name:
VESSEL A
Official number or IMO number:
9123456
Type of instrument:
Release of First Preferred Mortgage as amended
Instrument date:
1 April 2020
Mortgagor name:
Owner A
Mortgagee name:
Bank A
Total mortgage amount released:
US$25,000,000 plus interest and performance of covenants
Original mortgage date:
10 March 2017
Original mortgage recordation date:
10 March 2017
Amendment date:
20 April 2018
Amendment recordation date:
25 April 2018
Intended legal effect:
Release of a security interest constituting a first preferred mortgage over the vessel
Execution requirements:
Signature by authorized person and notarization or acknowledgment by a Marshall Islands Special Agent or Deputy Commissioner
Language of recordable instruments:
English
Associated certificate:
Certificate of Ownership and Encumbrance
Disclaimer:
No legal advice provided by the Maritime Administrator or International Registries, Inc.
Year:
Not specified
Region / City:
Not specified
Theme:
Legal planning, estate planning, healthcare directives
Document Type:
Informational brochure
Organization:
Preferred Legal Plan
Author:
Not specified
Target Audience:
Caregivers, individuals preparing for potential incapacitation
Period of Validity:
Not specified
Approval Date:
Not specified
Modification Date:
Not specified
Year:
[insert year]
Region / City:
[insert region or city]
Subject:
Community Services, Service Provider Assessment
Document Type:
Review and Assessment Report
Agency:
[insert State agency]
Author:
[insert author or authors]
Target Audience:
[insert audience]
Validity Period:
[insert validity period]
Approval Date:
[insert approval date]
Amendment Date:
[insert amendment date]
Year:
2022
Region / City:
Not specified
Topic:
Chain of Custody procedures
Document Type:
Guide
Organization / Institution:
Preferred by Nature
Author:
Not specified
Target Audience:
Companies seeking FSC and PEFC certification
Period of Validity:
Not specified
Approval Date:
Not specified
Amendment Date:
Not specified