The FY 2009 Reconciliation Application
Application will be available approximately on April 1, 2009 and
must be post marked by May 1, 2009.
There are only two forms that will need to be mailed in and those
are the HRSA 99 and 99-3 because of the legal requirement for original
signatures. The affiliation agreements, supporting documentation
and Medicare Cost Report (MCR) worksheets may be sent as a PDF to
SLinney@hrsa.gov or a hard
copy can be mailed to CHGME Payment Program along with your signed
HRSA 99 and 99-3. As in past years, the HRSA
99 (
44 KB) and HRSA
99-3 (
64 KB), all required attachments and documentation, and
the web application must to be “postmarked” no later than May 1,
2009.
As always, if additional information or assistance is needed, please
contact your CHGME Payment Program designated regional manager:
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