State Operations Manual (Pub. 100-07), Ch. 3 § 3049
Completing Certification and Transmittal (Form CMS-1539)
3049 - Completing Certification and Transmittal (Form CMS-1539)
(Rev. 1, 05-21-04)
3049A - Voluntary Terminations and Close of Business
(Rev. 202, Issued: 06-19-20, Effective: 06-19-20, Implementation: 07-27-20)
In the upper left-hand corner The SA enters “VOLUNTARY TERMINATION--CODE
2.”
The SA completes items 1, 3, 7, 26, 28, 29, 30 (signature of SA official delegated to sign),
and 32.
Reconsideration, Hearings, and Appeals