Dhs 4469 eng-2025

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The document DHS-4469-ENG outlines the enrollment process for individual Personal Care Assistants (PCAs) in Minnesota Health Care Programs (MHCP). It details the requirements for submitting an application and provider agreement, including the need for a Unique Minnesota Provider Identifier (UMPI), completion of a Background Study, and understanding of privacy notices. The document emphasizes the importance of providing accurate information and the consequences of non-compliance, as well as instructions for faxing completed forms.

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