Adult Care Home Hearing Request Form NC Medicaid 9053 Revised …

Adult Care Home Hearing Request Form NC Medicaid-9053 Revised 2026_1.pdf

PDF • 181.01 KB - June 18, 2026

Note: Latest version of this form published on June 18, 2026.

Division/Office

Division of Health Benefits

First Published

June 18, 2026

Last Updated

June 18, 2026