Official Federal Forms
Centers For Medicare And Medicaid Services
Last updated: 8/28/2024
ESRD Death Notification {CMS-2746}
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Description
CMS-2746 - ESRD DEATH NOTIFICATION. Complete this form within 2 weeks of the date of death. If the patient was a dialysis patient, the dialysis facility last responsible for the patient’s maintenance dialysis (or home dialysis) must complete this form. If the patient was a transplant patient, the transplant center is responsible for completing this form. www.FormsWorkflow.com
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