Hs 328 cdph 2026

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The document outlines the regulations governing the effective date of provider agreements for services under Medicare and Medicaid in California. It specifies that the effective date is determined by the completion of an onsite survey, contingent upon meeting federal health and safety standards. If a provider fails to meet these requirements, the agreement becomes effective when compliance is achieved or when an acceptable correction plan is submitted. The notice also includes instructions for returning a signed acknowledgment to the California Department of Public Health.

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Click ‘Get Form’ to open the hs 328 cdph in the editor.
Begin by reviewing the notice regarding the effective date of provider agreements. Familiarize yourself with the federal regulations outlined in sections I and II, as they are crucial for understanding your obligations.
In the signature field, provide your signature to confirm that you have received, read, and understood the notice. This is a mandatory step for compliance.
Next, print your name clearly in the designated area below your signature. Ensure that it matches any official documentation you may have.
Finally, enter today’s date in the specified field to complete the form. This date is essential for record-keeping purposes.

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What is the difference between CDFA and CDPH?

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Hs 328 cdph 2026

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