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Published Date: 2025-04-22

MA 112 Form Requirement for Newborns

After a baby is born to a mother with Medical Assistance coverage, providers must let the County Assistance Office (CAO) in the mother’s residing county know by filling out the MA 112 Form. The MA 112 Form should be completed and submitted within 3 working days of the child’s birth to ensure they have appropriate access to medical care.

For additional information on the various CAO offices, visit the DHS website.