Common Contracts
3 similar Health and Human Services contracts
SETTLEMENT CONFERENCE FACILITATION AGREEMENT OF PARTICIPATIONHealth and Human Services • May 30th, 2019
Please submit this agreement, along with your completed SCF Request Spreadsheet, to OMHA_SCFAppeals@cms.hhs.gov . Handwritten signatures are required for this form. If you are an individual with a disability that would prevent you from entering a handwritten signature, please use the accessible version of the Settlement Conference Facilitation Agreement of Participation available on the OMHA website at www.hhs.gov/omha .
SETTLEMENT CONFERENCE FACILITATION AGREEMENT OF PARTICIPATIONHealth and Human Services • June 13th, 2018
Please submit this agreement, along with your completed SCF Request Spreadsheet, to OMHA_SCFAppeals@cms.hhs.gov . Handwritten signatures are required for this form. If you are an individual with a disability that would prevent you from entering a handwritten signature, please use the accessible version of the Settlement Conference Facilitation Agreement of Participation available on the OMHA website at www.hhs.gov/omha .
SETTLEMENT CONFERENCE FACILITATION AGREEMENT OF PARTICIPATIONHealth and Human Services • June 11th, 2018
Note: This is an accessible version of this form, to be completed only by individuals with a disability that would prevent the individual from entering a handwritten signature. All other individuals should use the version of the Settlement Conference Facilitation Agreement of Participation that requires a handwritten signature, available on the OMHA website at www.hhs.gov/omha .
