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          Comments to the MFCU

          Fighting Medicaid  and Nursing Home Patient Abuse and Neglect
          Office of New York State Attorney General

          Please complete this form with as much information and in as detailed a manner as possible.

          Type of Insurance Fraud / Complaint
          Section I

          What Type of Provider or Professional is Involved: (check all applicable)

          (if different than provider’s address)
          Section II

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