IM-50 04/26/02 MC-4 AND MC-4A
FORMS MANUAL REVISION #14
|FORMS MANUAL REVISION #14:
MC-4 IMPORTANT INFORMAITON AND MC-4A
MC+ INCOME GUIDELINES
|The MC-4 and MC-4A has been revised to
reflect the elimination of the Custodial Parent Program. Additional
information has been added to the MC-4 with regard to drug dispensing fees
and cost sharing. The MC-4A was revised to reflect the April 2002
federal poverty level guidelines.
There has been no change in policy for use of these forms.
An initial supply will be sent when printed. Additional forms may be ordered through the warehouse.
Distribution # 2
Attachment not available online.