PDF
Word
Report of Medical Assistance Surcharge Payments for Non-electing Providers - New York
Report of Medical Assistance Surcharge Payments for Non-electing Providers is a legal document that was released by the New York State Department of Health - a government authority operating within New York.
FAQ
Q: What is the Medical Assistance Surcharge?A: The Medical Assistance Surcharge is a fee imposed on certain health care providers in New York.
Q: Who is required to pay the Medical Assistance Surcharge?A: Non-electing providers, including hospitals and nursing homes, are required to pay the Medical Assistance Surcharge.
Q: What does it mean to be a non-electing provider?A: Non-electing providers are those who choose not to participate in the Medical Assistance Program in New York.
Q: How are Medical Assistance Surcharge payments reported?A: Medical Assistance Surcharge payments for non-electing providers are reported on the Report of Medical Assistance Surcharge Payments.
Form Details:
- Released on February 1, 2012;
- The latest edition currently provided by the New York State Department of Health;
- Ready to use and print;
- Easy to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of the form by clicking the link below or browse more documents and templates provided by the New York State Department of Health.
Download Report of Medical Assistance Surcharge Payments for Non-electing Providers - New York
1
2
3
