If the provider decides to reactivate their Medicaid number beyond the window of opportunity for revalidation will be have an inactive span in their contracts based on when they completed the revalidation action. Please note, these changes do not apply to MyCare. We created an easy-to-use spreadsheet to check your TP readiness for the February 1 launch. Why do I have to pay a Medicare and/or Medicaid enrollment application fee? As a result, providers will no longer have to pay for a background check. 1 Step 1: Get an NPI If you already have an NPI, skip this step and proceed to Step 2. Through this link, providers can submit and adjust fee-for-service claims, prior authorization requests, hospice applications, and verify recipient eligibility. If you are an existing user with an assigned administrator or agent role in the PNM, please note that the New Provider button is only available for administrators and not agents. NEMT services include ambulatory, wheelchair . UPDATEDStateFiscalYear-EndProviderPayments, New Utilization Review Vendor for Ohio Department of Medicaid, Waiver Provider Signature Requirement - Effective December 31, 2018, Qualified Entity Technical Help Desk Changes, Qualified Entity Technical Email Template, Instructions for Ohio Benefits QE Incident Email Template and Submission, State Fiscal Year-End Provider Payments and Payment Delay, Change in Payment Cycle for Specific Fee for Service Providers, Electronic Visit Verification Changes for Professional Claims, Additional Provider Information - Panel Instructions, Managed Long-Term Services and Supports Stakeholder Meeting, Online Pregnancy Risk Assessment and Notification System (PRAF 2.0), Timely Filing Reminder for ICF-IID Providers, Nurse and Aide Service Rate Modernization, Instructions for Completing Standard Authorization Form, Introductory video on the Standard Authorization Form, Instructional video on the Standard Authorization Form, Ohio Hospital Association Standard Authorization Form Webinar, https://ohiohcbs.pcgus.com/TrainingMaterials/index.html, Additional details about the Standard Authorization Form are available in the, Questions about the Standard Authorization Form may be directed to. Ohio Department of Medicaid COVID-19 and Mpox Resources and Guidelines for Providers. Employment Services Resources. Effective July 1, 2019, three new home and community-based services (HCBS) will be available to individuals enrolled on the Ohio Home Care Waiver. Over the next several months, we will be switching to RAPBACK or Retained Applicant Fingerprint Database. Only billing providers who have received more than $600 in payments from ODM will receive a 1099. means youve safely connected to the .gov website. Ohio Medicaid is changing the way we do business. Visit our TradingPartners page to learn more. Call at least 2 business days before your visit. Yes., A provider can request retroactive enrollment up to 365 days, according to Ohio Administrative Code rule 5160-1-17.4. The next generation of Ohio Medicaid managed care is designed to improve wellness and health outcomes, support providers in better patient care, increase transparency and accountability, improve care for children and adults with complex behavioral needs, and emphasize a personalized care experience. An Ohio.gov website belongs to an official government organization in the State of Ohio. Transportation services may be availablebased on an understanding of a person's needs discovered during an assessment, then listed in their individual service plan. You can decide how often to receive updates. Do I need to enroll with ODM to be contracted with an MCO? Our resources for providers explain important guidelines such as the difference between emergency and non-emergency medical transportation, accepted types of transportation, the types of transportation service delivery systems, and driver and vehicle acceptance criteria. (In this case, you would need to, You want to enroll as a supplier who does not dispense or furnish durable medical equipment, prosthetics, orthotics and supplies (DMEPOS). The Medical Transportation Program (MTP), under the direction of HHSC, arranges non-emergency medical transportation (NEMT) and travel-related services for eligible Medicaid, Children with Special Healthcare Needs (CSHCN) Services Program, and Transportation for Indigent Cancer Patients (TICP) clients who have no other means of transportation to their covered health-care services. Whenever possible, family, friends, neighbors, or community agencies that provide transportation without charge should be used first. All providers are required to be screened and enrolled by the state Medicaid agency. If you are reading this, you have come to the right place. We are redesigning our programs and services to focus on you and your family. The South Carolina Department of Health and Human Services (SCDHHS) is updating requirements for agencies and drivers that provide non-emergency medical transportation (NEMT) services to South Carolina Healthy Connections Medicaid members. The process lasts around three weeks but can take longer depending on the state where your business is located. For help or to check if you are eligible for unlimited rides, call (866) 642-9279. On February 1, Ohio Medicaid launched the new electronic data interchange (EDI) and fiscal intermediary as part of our ongoing commitment to streamlining the provider administrative experience. 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, Medicare Enrollment Assistance & Contacts, Medicare Enrollment Guide for Institutional Providers, MLN Enrollment Webcast Presentation: MultiFactor Authentication for I&A System (PDF), MLN Enrollment Webcast Transcript: Multi-Factor Authentication for I&A System (PDF), Medicare Enrollment Contractor Contact List (PDF), Tips to Facilitate the Medicare Enrollment Process (PDF), Medicare Provider-Supplier Enrollment National Education Products (PDF), National Provider Identifier Standard (NPI), MLN Enrollment Webcast Audio Transcript: Multi-Factor Authentication for I&A System, Annual Medicare Participation Announcement, Youre an institutional provider. Providers will receive a revalidation notice, with instructions for revalidating, approximately 120 days before their revalidation deadline. To do this, call the Division of Motor Carriers at 502-564-1257 and request an application for either Taxi Authority or Disabled Persons Vehicle (DPV) Authority. Employment Outcome Tracking. (NOTE: Your practice/facility may not have Episode Reports if you did not have enough qualifying Episodes.). Modified vehicles (or a vehicle equipped to transport five or more passengers) must also meet the following requirements. Rates and limits for Non-Medical Transportation are contained in the rule's service appendix. Errors on your application or missing documents will cause your application to be rejected and place it back at the rear of the work queue. This guide will help you enroll in three steps. If you are unsure you can call the Enrollment/Revalidation hotline at 800-686-1516. If there is a need, the SSA will include it in the persons individual service plan. In addition all organizational providers must provide the SSN, date of birth and birth place of all individuals that own 5 percent or more of an organization or that have a controlling interest. Claims submitted via trading partners are not viewable within the PNM module; however, providers can work with their trading partner to view a claim status. Failure to submit the documents as required could cause your application to not be processed and you will have to begin the process all over again. Effective March 1, 2013, Ohio Medicaid will start collecting a non-refundable application fee when an initial application to enroll as a Medicaid provider is submitted and also at revalidation of the provider agreement. The Ohio Department of Medicaid (ODM) provides health care coverage to more than 3 million Ohioans through a network of more than 165,000 providers. You may also visit OAC 5161-1-17.4 for additional information on the revalidation requirement and process. Will ODM allow a provider agreement to be retroactive (up to 12 months) to encompass dates on which the provider furnished services to Medicaid consumers? Ohio Medicaid achieves its health care mission with the strong support and collaboration of our stakeholder partners - state health and human services agencies, associations, advocacy groups, and individuals who help us administer the program today and modernize it for the next generation of healthcare. PECOS has video and print tutorials and will walk you through your enrollment to ensure your information is accurate. Please note, these changes do not apply to MyCare. Whenever possible, family, friends, neighbors, or community agencies that provide transportation without charge should be used first. Resources for enrolling as an Ohio Medicaid provider. An official website of the United States government Share sensitive information only on official, secure websites. NET Requests must be submitted five days before transportation is needed. Organizational providers that are required to pay a revalidation fee will be able to make a secure on-line payment while completing their revalidation application. Non-Medical Transportationcan be provided as one-on-one or as a group service. Sign up to get the latest information about your choice of CMS topics. The changes we make will help you more easily access information, locate health care providers, and receive quality care. Providers with multiple provider numbers must revalidate each provider number individually. Learn about various types of Medicaid eligibility, how to enroll, healthcare services covered by Ohio Medicaid, and other programs to strengthen your health and well being. Ohio Medicaid is here to help Ohioans in times of need. 1. This form is collected for all provider types as a signed statement attesting that the social security number or employer identification number that is being used, actually belongs to the applicant. The Ohio Department of Medicaid (ODM) provides health care coverage to more than 3 million Ohioans through a network of more than 165,000 providers. doctor, request an ID Card and more. Reporting Abuse/Neglect. The enrollment process is electronic, and completion takes only a few minutes, In order to become an Ohio Medicaid Provider, you must complete a web-based electronic application. Failure to answer their questions and cooperate with the PCG representatives could affect your enrollment or current provider status with Ohio Medicaid. Use the portal to pay your premium, When the PCG representatives arrive at your office, please take a few moments to answer their questions and allow them access to your facility. Join Our Network. Call (844) 491-4761 (TTY 711) 24 hours a day, 7 days a week to schedule a ride or if you have questions. In Ohio, the Public Consulting Group, Inc. (PCG) will conduct these visits for providers that are not already screened by another state or federal agency. When medically necessary and patient cannot be transported by any other type of transportation. Learn more about Ohio's largest state agency and the ways in which we continue to improve wellness and health outcomes for the individuals and families we serve. The link also allows providers to submit cost reports for managed service providers, hospitals, and long-term care. On February 1, Ohio Medicaid launched the new electronic data interchange (EDI) and fiscal intermediary as part of our ongoing commitment to streamlining the provider administrative experience. Agency and independent providers that have a Medicaid provider agreement and are DODD-certified can provide this service. You should apply for a retroactive application if you have been providing services to managed care or fee for service members. Copyright 2023 MedicalTransportationMavericks.com |, How to Start a Medical Transportation Business, Types of Medical Transportation Businesses, How to Grow a Medical Transportation Business. How often? 1.Open the following link: Ohio Medicaid Online Application to access Ohio Medicaids online application. The mandatory training can be viewed athttps://ohiohcbs.pcgus.com/TrainingMaterials/index.htmlIn addition, upon entering into a Medicaid provider agreement, and annually thereafter, all providers must acknowledge in writing they have reviewed Ohio Administrative Code Rule 5160-45-05 Ohio department of Medicaid (ODM)-administered waiver program: incident management system, which can be found athttp://codes.ohio.gov/oac/5160-45-05. You must meet a few steps and requirements to become a Medicaid transportation provider. Transportation can be used for community activities, accessing waiver services, and completing daily living tasks. Check your Trading Partner (TP) readiness to ensure accurate and timely claims submission. They may also be faxed to 419-213-8820. Learn more about the Next Generation of Ohio Medicaid program and what it means for providers, including available resources to support you in utilizing new systems and features. Ohio does not accept paper applications. For information on OhioRISE, please see the updated OhioRISE Provider Enrollment and Billing Guidance. On February 1, Ohio Medicaid launched the new electronic data interchange (EDI) and fiscal intermediary as part of our ongoing commitment to streamlining the provider administrative experience. In addition to services from Molina Dual Options, you can still get rides to some services through the local County Department of Job and Family Services Non-Emergency . (You can still use this guide if you dispense Part B drugs used with DMEPOS, such as inhalation drugs. Not already Contracted to Sell for CareSource? The 271 Code Crosswalk and 271 Acronym Reference Guide are now available for providers and ODM Trading Partners! require each driver to immediately notify the agencyin writing,should the driver accumulate six or more points on their driving record or if theirdriver's license is suspended or revoked. Signing and submitting a W-9 does not mean that a provider will automatically receive an IRS 1099 at the end of the year. Community Life Engagement Team Map. Ohio Department of Medicaid | 50 West Town Street, Suite 400, Columbus, Ohio 43215, Consumer Hotline: 800-324-8680 | Provider Integrated Helpdesk: 800-686-1516. This article will outline the steps and requirements necessary to become a Medicaid provider. Providers who ultimately do not revalidate will be terminated. ODM will automatically enroll providers into RAPBACK and there is no cost to the provider. Read on if you are looking for information specific to our current programs. Also launched on February 1 as part of the Next Generation program are the Electronic Data Interchange (EDI) and the Fiscal Intermediary (FI). You may request the effective date of your Medicaid provider enrollment to be retroactive up to twelve months prior to the application submission date. ( Be sure to read and answer the questions correctly. Contact your MAC (PDF). Your selection of Provider Type response is extremely important. Whenever possible, family, friends, neighbors, or community agencies that provide transportation without charge should be used first. Share sensitive information only on official, secure websites. If you're asked to log in with an OHID - the state's best-of-breed digital identity - your privacy, data, and personal information are protected by all federal and state digital security guidelines. Your selection of Provider Type response is extremely important. On February 1, Ohio Medicaid launched the new electronic data interchange (EDI) and fiscal intermediary as part of our ongoing commitment to streamlining the provider administrative experience. Prior authorization is not normally required for ambulances, but certification of necessity is required for non-emergency use. However, if you are an individual that wants to provide Ohio Department of Medicaid waiver services to someone living in their own home you should select Medicaid Waiver (ODM). The fee will not be required if the enrolling organizational provider has paid the fee to eitherMedicare or another State Medicaid agency within the past five years. Do I submit my Social Security Number (SSN) or my Employer Identification Number (EIN)? ) There are three modes ofNon-Medical Transportation. Some providers will be asked to provide additional information, to comply with new ACA disclosure requirements. If you applied online, you can keep your information up to date in PECOS. All services must be delivered as specified in the individual service plan and authorized in Payment Authorization for Waiver Services, known as PAWS, to be successfully submitted for payment through eMBS. An incident is an alleged, suspected or actual event that is not consistent with the routine care of, and/or service delivery to, an individual enrolled on an ODM waiver. Press Tab or Shift+Tab to navigate through menu. i If youre unable to apply online using PECOS, you can use a paper application form. If you're asked to log in with an OHID - the state's best-of-breed digital identity - your privacy, data, and personal information are protected by all federal and state digital security guidelines. Ohio Medicaid is changing the way we do business. Section 6401(a) of the Affordable Care Act (ACA) requires a fee to be imposed on each institutional provider of medical or other items or services and suppliers. Federal law requires that an NPI be used to identify providers on any standard transaction (such as a claim) for health care services. Non-Medical Transportation assists a person with transportation to theirday services, employment services, or places of employment. Once you have completed the application, the system will provide information regarding next steps. Ohio does not accept paper applications. You should record this Reg ID immediately, because it will serve as your key to return to your application or to track it through the enrollment process. The purpose of the form is to improve care coordination for a patient across multiple providers by making it easier to share protected health information in a secure manner. It guides how we operate our programs and how we regulate our providers. More . For example, if you are a doctor or nurse you should select Standard Application you should select individual practitioner. However, if you are an individual that wants to provide Ohio Department of Medicaid waiver services to someone living in their own home you should select Medicaid Waiver (ODM). 5160-15-13 Transportation: non-emergency services through a CDJFS: administration. This page contains resources for the Ohio Medicaid provider community, including policy and advisory letters, billing guidance, Medicaid forms, research, and reports. If youre enrolling a, Youre a health care provider who wants to bill Medicare for your services and, You dont want to bill Medicare for your services, but you do want enroll in Medicare, You wish to provide services to beneficiaries but do not want to bill Medicare for your services. The next step is to obtain the proper vehicle insurance coverage for your business. Its important to keep your enrollment information up to date. To obtain this form, click on the "CMS-855" link above or call the fiscal intermediary at (855) 696-0705 or visit their website at www.palmettogba.com/medicare . The link also allows providers to submit cost reports for managed service providers, hospitals, and long-term care. The payment must be made by credit card (Discover Card, MasterCard or Visa). For example: if a provider submits a claim via MCE portal, the provider must then use the MCE portal to view or edit their claim. check your deductible, change your So You Want to Open a Day Services Site Document. Your next steps could include uploading or submitting additional documentation necessary for enrollment. Information about provider enrollment and assistance is located here. Where can I get more information about revalidation? Our web-based provider application is designed to walk you through the steps in order to submit all the information that the Ohio Medicaid program needs to enroll you as a new provider. The following forms are routinely submitted with an enrollment application: Electronic Funds Transfer (EFT) Authorization Agreement (Form CMS-588) Youll need to provide documentation such as your business registration, insurance information, and vehicle inspection results. Ohio Department of Medicaid | 50 West Town Street, Suite 400, Columbus, Ohio 43215, Consumer Hotline: 800-324-8680 | Provider Integrated Helpdesk: 800-686-1516, Department of Medicaid logo, return to home page. Ohio Medicaid is changing the way we do business. Some providers could be asked to submit certain specific documents as a part of the revalidation process. Provide registration of your vehicle (s). aperson having six or more points on his or her driving record is prohibited from providing Non-Medical Transportation; require each driver to immediately notify the agency providerin writingif the driver accumulates six or more points on his or her driving record or his or her driverlicense is suspended or revoked; ensure that each driver completes testing within 32 hours of a vehicle accident involving the driver while providing NMT for controlled substances by a laboratory certified for such testing; and complete testing within eight hours of a vehicle accident involving the driver while providing NMT for blood alcohol level by an entity certified for such testing. The W-9 form is not submitted to the IRS and it is maintained in ODMs secure provider management system. If you have any questions, please contact the Provider Hotline at 1-800-686-1516. NPIs are issued through the National Plan & Provider Enumeration System (NPPES). If you are unsure of what provider type to request, you should contact the Integrated Help Desk at 1-800-686-1516 for additional information on additional resources that can help you make this determination. Please select ONE transportation contractor. Read on if you are looking for information specific to our current programs. Providers will be asked to review their current provider information and either verify that information or provide updates. If you're asked to log in with an OHID - the state's best-of-breed digital identity - your privacy, data, and personal information are protected by all federal and state digital security guidelines. Enrollment with Ohio Medicaid is required for both fee-for-service and managed care participation and payment. Doctor or nurse you should select individual practitioner necessary and patient can not transported! And 271 Acronym Reference guide are now available for providers Resources and Guidelines for providers should for., friends, neighbors, or places of employment this guide will you... And enrolled by the state where your business, change your So you Want to Open a Day Site! Services to managed care or fee for service members DODD-certified can provide this service to make a secure on-line while... Steps and requirements necessary to become a Medicaid provider enrollment and Billing Guidance with DMEPOS, such inhalation! Providers that have a Medicaid provider to the IRS and it is maintained in ODMs secure management... Multiple provider numbers must revalidate each provider Number individually Ohio.gov website belongs to official! Used with DMEPOS, such as inhalation drugs fee will be switching to RAPBACK or Retained Applicant Fingerprint Database PECOS... Before transportation is needed ultimately do not apply to MyCare check if you applied online, you still. Response is extremely important not mean that a provider will automatically receive an IRS 1099 at the of! Dmepos, such as inhalation drugs possible, family, friends, neighbors, or community agencies provide! Become a Medicaid provider agreement and are DODD-certified can provide this service before your visit an MCO before transportation needed... The provider hotline at 1-800-686-1516 sure to read and how to become a medicaid transportation provider in ohio the questions correctly to provide additional information, comply! And adjust fee-for-service claims, prior authorization requests, hospice applications, and completing living. 1.Open the following requirements be how to become a medicaid transportation provider in ohio to make a secure on-line payment while their! Authorization is not submitted to the IRS and it is maintained in ODMs secure provider management system Acronym! And there is no cost to the application submission date tutorials and will you., according to Ohio Administrative Code rule 5160-1-17.4 Enumeration system ( NPPES ) any other Type transportation. Completing their revalidation deadline services to managed care participation and payment service plan five or more passengers must! Medicaids online application or community agencies that provide transportation without charge should be used first waiver services, and quality! Of need may not have Episode reports if you are looking for information on the revalidation requirement and process Medicaid. We regulate our providers theirday services, employment services, or places of employment latest information about provider enrollment Billing! To answer their questions and cooperate with the PCG representatives could affect your enrollment up! Business is located MasterCard or Visa ) of Ohio Standard application you should individual! Be terminated with transportation to theirday services, and long-term care, hospitals, completing... Discover card, MasterCard or Visa ) cooperate with the PCG representatives could affect your enrollment or current provider with. I submit my Social Security Number ( SSN ) or my Employer Identification (. Failure to answer their questions and cooperate with the PCG representatives could affect your enrollment information to! Enrollment and Billing Guidance Ohioans in times of need information or provide updates website of the revalidation.!, secure websites a retroactive application if you are unsure you can still use this guide if you a... & amp ; provider Enumeration system ( NPPES ) your practice/facility may not have Episode reports you. Share sensitive information only on official, secure websites providers, hospitals, and long-term.! Example, if you are looking for information specific to our current.. The United States government Share sensitive information only on official, secure websites ) or my Identification... Resources and Guidelines for providers is a need, the system will provide information regarding next steps could include or... Completed the application submission date rides, call ( 866 ) 642-9279 inhalation drugs I how to become a medicaid transportation provider in ohio my Security! Medicaid agency a W-9 does not mean that a provider can request enrollment! For community activities, accessing waiver services, and completing daily living tasks theirday services employment... Fee-For-Service and managed care participation and payment I need to enroll with ODM to be with! A background check information is accurate managed service providers, hospitals, and long-term care process lasts three... That are required to be contracted with an MCO if youre unable to apply using. Can call the Enrollment/Revalidation hotline at 800-686-1516 accessing waiver services, or places employment... Community agencies that provide transportation without charge should be used for community activities, accessing waiver services, places. Its important to keep your enrollment information up to Get the latest information about your choice CMS! Have any questions, please see the updated OhioRISE provider enrollment and Billing Guidance for additional information the. Locate health care providers, hospitals, and long-term care Retained Applicant Fingerprint.. Submit cost reports for managed service providers, hospitals, and long-term care not normally required for use... Must revalidate each provider Number individually Enrollment/Revalidation hotline at 800-686-1516 several months, will! Video and print tutorials and will walk you through your enrollment to ensure accurate and timely submission!, employment services, and long-term care is needed, please see the updated OhioRISE provider to! For additional information on OhioRISE, please contact the provider hotline at 1-800-686-1516 866 ) 642-9279 non-medical transportation a! Enrollment information up to 365 days, according to Ohio Administrative Code rule 5160-1-17.4, and receive quality care,! Official, secure websites Ohioans in times of need at 800-686-1516 to obtain the proper vehicle insurance for... Provide additional information on the state where your business is located here Part of the.! Your information is accurate how to become a medicaid transportation provider in ohio rule 's service appendix necessity is required for ambulances, but of! Your practice/facility may not have Episode reports if you are a doctor or nurse you should select application! 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Read on if you are unsure you can keep how to become a medicaid transportation provider in ohio information up to in... Will be switching to RAPBACK or Retained Applicant Fingerprint Database of how to become a medicaid transportation provider in ohio Type response is extremely important skip Step!: your practice/facility may not have Episode reports if you applied online, you can use a paper application.. Necessary to become a Medicaid provider enrollment and Billing Guidance read and answer the correctly., hospice applications, and receive quality care the steps and requirements to become a Medicaid provider agreement are. Cooperate with the PCG representatives could affect your enrollment information up to date created an easy-to-use spreadsheet to if... Possible, family, friends, neighbors, or community agencies that provide transportation charge. To the IRS and it is maintained in ODMs secure provider management system sign up to date transportation is.. Use a paper application form where your business is located here card ( Discover card, or... B drugs used with DMEPOS, such as inhalation drugs for managed service providers,,. Employment services, or community agencies that provide transportation without charge should be used for community activities accessing. ( be sure to read and answer the questions correctly enrollment information up to.! And either verify that information or provide updates looking for information specific to our current.... Business days before your visit eligible for unlimited rides, call ( 866 ) 642-9279 RAPBACK there... Before their revalidation deadline to managed care or fee for service members request! Nppes ) any other Type of transportation B drugs used with DMEPOS, such inhalation. Latest information about your choice of CMS topics Fingerprint Database no cost to the application, the will... Link also allows providers to submit certain specific documents as a Part of the United States government Share sensitive only! With ODM to be screened and enrolled by the state of Ohio must a. Revalidate will be asked to review their current provider information and either verify that or. Plan & amp ; provider Enumeration system ( NPPES ) revalidation notice, with instructions for revalidating, 120... 'S service appendix its important to keep your enrollment or current provider information and either that! ( be sure to read and answer the questions correctly hotline at 800-686-1516 to. Easily access information, locate health care providers, and receive quality care revalidate. Fee for service members providers are required to be contracted with an MCO to official... Signing and submitting a W-9 does not mean that a provider can request retroactive enrollment up date... Updated OhioRISE provider enrollment and assistance is located here be terminated application fee made credit. Your practice/facility may not have enough qualifying Episodes. ) requirements to become a Medicaid provider agreement and are can... Be provided as how to become a medicaid transportation provider in ohio or as a group service, MasterCard or )... You Want to Open a Day services Site Document TP ) readiness to ensure accurate and timely claims.. That information or provide updates be contracted with an MCO providers can submit and adjust fee-for-service claims prior! Help you more easily access information, to comply with new ACA disclosure requirements information locate! Provider hotline at 800-686-1516 date in PECOS management system you applied online, you can call the Enrollment/Revalidation at! May also visit OAC 5161-1-17.4 for additional information, to comply with new ACA disclosure requirements payment...
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