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A completed Physician Certification for Serious Illness or Need for Life-Support Equipment form is required for each CMNP application and must be signed by one of the following: 1. Licensed Physician 2. Certified Nurse Practitioner 3. Physician’s Assistant

Exception: For applicants aged 60 and older, a navigator may submit a CMNP application without the PC form initially. The navigator then has 90 days to obtain and submit the PC form. The LAA must process the application upon receipt and notify the navigator of the 90-day timeframe. 55-Day and 30-Day Medical Utility Holds ● A 55-Day Hold may be placed with a utility provider by an LAA or navigator if a CMNP applicant has a termination notice, even before an application is submitted.

● If no application is submitted within 55 days, a second hold (30-Day Medical Hold) may be requested. This requires a Physician Certification form to be submitted to the utility along with the hold request.

● After these two holds, a CMNP application must be submitted for further assistance.

Expedited Screenings CMNP cases are automatically prioritized for expedited processing. Vulnerable Population Waiver (VPW) All CMNP cases are screened for a Vulnerable Population Waiver (VPW) within 48 hours of receiving the application or VPW request. ● The VPW screening is conducted during the application processing if the PC Form is included. ● If the PC form is submitted after initial processing, a VPW can still be completed later, provided a signed VPW form accompanies the PC form.

Updated May 2025