AI- 59536
Health & Human Services Dept. 13.A.
CC - REGULAR
- Meeting Date:
- 05/02/2017
- Submitted For:
- Eddie Olivarez
- Submitted By:
- Mike Escaname, HEALTH & HUMAN SERVICES DEPT.
- Department:
- HEALTH & HUMAN SERVICES DEPT.
Information
CAPTION
Health Division:
Requesting authorization to submit the revalidation application to continue enrollment in Medicare, and approval for County Judge and County Treasurer to sign related forms and documents.
Requesting authorization to submit the revalidation application to continue enrollment in Medicare, and approval for County Judge and County Treasurer to sign related forms and documents.
BACKGROUND
11/29/2011 - AI-29795 - Approval to submit Medicare enrollment application
10/30/2012 - AI-34819 - Approval of EFT form.
10/30/2012 - AI-34819 - Approval of EFT form.
Fiscal Impact
- CALENDAR YEAR:
- 2017
- ACCT. #:
- 7-1100-441-00-340-001-0-340
- FUNDS AVAILABLE Y/N?:
- Y
- MATCHING FUNDS Y/N?:
BUDGETARY IMPACT:
Previous fee in 2012 was $523.00, funds available as of 04/25/2017.(Processing fee, if any, yet to be determined.)
Attachments
Form Review
| Inbox | Reviewed By | Date |
|---|---|---|
| Budget and Management | Veronica Ortiz | 04/25/2017 08:45 AM |
| Final Approval | Veronica Ortiz | 04/25/2017 10:51 AM |
- Form Started By:
- Mike Escaname
- Started On:
- 04/25/2017 08:09 AM
- Final Approval Date:
- 04/25/2017