CMS-10398 (#15) Medicaid Eligibility: Non-Financial Eligibility State Re

Generic Clearance for Medicaid and CHIP State Plan, Waiver, and Program Submissions (CMS-10398)

S88

#15: Medicaid State Plan Eligibility

OMB: 0938-1148

Document [pdf]
Download: pdf | pdf


	































































$







%

&





%



(

/



A

=

)



4

7

*

1

2



6



!

'

0

9







'



+

2

6





,

2

7

C

=



4

=







5

6

1

6

4



7

;

D

4



.

3



?

@

-



9

6




#

'

=

5

■

"



=

6

2



=



=

6

2

7

8

7

6

9



6

7

2





2

0



4

:

6

1





;

6



6

<

;



4



1

6

7



=

2

1





2

0



1

2



2



>

6

=

9

;

?

7

6

=



4



1

6

7



=

2

1

:

0





4





<

1



=

2



4



@

2

0



1

2



2



?

=

7



4

"



?

6



1

1

9

2

>

2



=



2

7

7



4

1



A

6



=

6

6

2

1



=

0

2

7





1

6



;

6

6

=



4

E

6



1

7



7

4



7

5

6

2

6

6

7

7



=

7

?



<

6



6



5

;

=

6

6

2

4

7

1

?

1

0



;



6



6

6

2



;

5

1

7

1

2



=



=





2



6





6

>

1

2



=

2

=



9



0

;

0





?



=

1

7

6

1

7

2



2





=

2

2

5











:

?

4

=

6

2

=

7

0

7

>



?

2



4

4

2

?

0

=



7







4

;



;





:



6



=





>

9

9





=

3

7



<

6

;

2

6





=



1



B

6

=

7

6

9



2

6

=



6

=

2



=

2



=

7

:

0





4





@



=

9

6

3



2



7



4

B







6

F



7



7

7

4



1

1

>



4

■
G

=

2



4



7

2

0



1

2



2



:

6

2

0



H



<

9



@

@

6

2

@



=

2



4

1





I

6

=





@

3

;



J

@



=

2

>

:

0



2

0



4



4

=



2

9

?

4

4



=

2

;

J



@

3

;



J



"

7

■
A

■

=

7

:

C

6

0

6



=

5

6

9

7

?

0



2

D

6

;

0

=

1



1



J

2

6



;

2

?

6

2



5

6









=

7



5



4

>

=



2

;

6

5

6

=



6

=



=

6

=

1

2

6

2

?

2

6



=

>

:

0





4



=



2

9



3



<

;







6

=

7

6

9



2

6

=



6

=

2



=

2

>



4



4



1

6

7



=

2

1





2

0



1

2



2



6

=

"



=



;

6

E



7

6

=

7

6

5

6

7

?



;

1

?

=

7



4





=



2

7



1

9

4

6

<



7



1



<



5





=

7

=



=

A

K

D

G

<



=





6

9

6



4

J

9

0

6

;

7

4



=

B

■




1

6

7

6

=



6

=

2

0



1

2



2



>

:

6

2

0



4

:

6

2

0



?

2





6

F



7



7

7

4

1

>



4

■
/

■

A

■

6

=

7

=

0

4

6

7

5

6

1

6

9

1



■



3

A



9

2

7

4



0

=

;



6

5

2



7

4



1

1

6

7



6

=

9

2



1

4

J

2

:

9



2

>

6

?



2

6





9

2



0



0

6



6



2



0

1



=



:





5

6





0

>

=





2

7

6

<

1

=

=



1

2





=

2

=

;

6

6

1

6

@





=



1







4





;

6

7



;

1



6

2

0



3



4



=

2



4

9



4



2



I



4

>

6

=



9

9



4

7



=

9



:

6

2



0











!

"



#

L

0

L

M



M

>

:

6

2

0

:

0



@

2

0



6

=

7

6

5

6

7

?



;

"

1

;

=











6



4

2

7

?

2



1

6

7



■







=



1



>





1

=

7

7

6



=



7

6

6

=



5

6

7

6

7

?



=



;

1





?

=



7







4



!





"



#





#



:

>

0

6



=



9

4

;

?



7

=

6



=



2







@

1



2

=



9

1

2



2



2

0



6

=

7

6

5

6

7

?



;

4



1

6

7



1

>

6



2

0



3



4



=

2



4



?



4

7

6



=



1

2



2



2

0



6

=

7

6

5

6

7

?



;

4



1

6

7



1

>

6



2

0



3



4



=

2



4



?



4

7

6



=

4

4

6

9

3





3

2

3

;

4





0

7

J

6





=

@

4





@



1





4

>

4

:

4

6

8

0







7

<



9



@



6

=

9



3



<

;







B

7

6

9



6

7



=

2

0



6

=

7

6

5

6

7

?



;

N

1

<



0



;



4

0



1

6

7



1

6

=

2

0



1

2



2





2

2

0



2

6

@







2

0



6

=

7

6

5

6

7

?



;

N

1

4

6

7

?



;



3

6

=

1

2

6

2

?

2

6



=



;

6

E



7

6

=

6

=

1

2

6

2

?

2

6



=



;

6

E



7

6

=

3

;

7

6

J

6

5

=

6



7



?





;

4

N

8

1



3



7

4

6



9

=



L

2

6

1

7



M

:

=



2

4

0





2

6



4

=

7

@

6

6

5

=

6



7

2

?





;

7

N



1

<

=



7

0

=





;





4

?





1

4

7

6

7

6





1

=

6

0

=

2



0

1



<

1





2



=

2







3

=

3

7



6

2

=

2

0





3

7





4

=



7

=

2

2

0



;



4

6

=

6



7

0

6

2

5

1

6



7



?

2



0

;



6

1

■

A

■

=

?

7

=

A

6

;

=

5



7

6

1

6

7

?

1

5





6

;

=

7

1



?

;

2



;

6

0

5



1

6

=

4



1

:

0

2

6





2

0

=

6



=

1

@



5





2

0

2

6

7



1

2

?

2



<



2



2

6



2



0

=



=

3

1

3

;

"



:

;



0



9

9







<

@

7





6

=

9

=





@



6

=

9



3



<

;







6

=

7

6

9



2

6

=



6

=

2



=

2



2



4





2



4











>

6



3

0

J

1

6

9



;

;

J

3

4



1



=

2

6

=

2

0



1

2



2



>

"

2

=



?

2

D





D

1

2



2



6

=

1

2

6

2

?

2

6



=

>

6

=

9

;

?

7

6

=







1

2



4

9



4



0



@



1

>

<

J



=







=

9

J





2

0



1

2



2

"



■
O

■

6

A

=

=

J

1



2

K

D

6

2

2

?

G

0

2





6

;

4



6

6

=

=

<



6

1

2

6

J

<

;

2





?

2

=

9

6



0

2

6

;



=

0





7

4

;

4



6

1

=

E

2

;



7



6

2

5

6

6

=

7

6

5

6

7

?



;













4



5



4

:

0



=

;

6

5

6

=



6

=

2

0



1

2



2



:

6

2

0

2

0



6

=

2



=

2

2



4



1

6

7



2

0



4



>



=

7

=



2

3

;



9



7

6

=

2

0



"



=



6

=

2

0



1

2



2



>



4

■
P

2

0



4

:

6

1



@





2

2

0



4



Q

?

6

4



@



=

2

1

















!

"



#

"

■















8





2

2

R

/

0



0





1

9

4

6

2



4

6

1

2

2



P

1

C



R





0



1



3



C

0



4

:

6

1



9

6



6

4





7

6

=



=

6

=

2



4

1

2



2







4





@



=

"

2



1

2

3



;

6

9

J

;



2



7

2



6

=

7

6

5

6

7

?



;

1

6

=

2

0



1

2



2





=

;

J

2





2

2



=

7

1

9

0





"

;



@





2

2

0



9

4

6

2



4

6







4



1

6

7



=

2

>

<

?

2

:

0



@



J

<



2



@

3



4



4

6

;

J



<

1



=

2



4



@

2

0



1

2



2

"



■
/

0



1

R

2



2





1

0



1



7



C



6

=

6

2

6



=





2



@

3



4



4

J



<

1



=

9



>

6

=

9

;

?

7

6

=



2

4





2

@



=

2





6

=

7

6

5

6

7

?



;

1

:

0





2

2



=

7

1

9

0





;

6

=



=



2

0



4

1

2



2



"


















File Typeapplication/pdf
File TitleS88.pdf
AuthorSador.Gebre
File Modified2013-05-28
File Created2013-05-28

© 2024 OMB.report | Privacy Policy