Form CMS-10434 #22 CMS-10434 #22 Health Homes Intro Screenshots

Medicaid and CHIP Program (MACPro) (CMS-10434)

QSSI-MACPro-PRA-HH1

GenIC #22 - Health Home State Plan Amendment (SPA)

OMB: 0938-1188

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Centers for Medicare & Medicaid Services
CMS eXpedited Life Cycle (XLC)

Medicaid and CHIP Program (MACPro)
HH1 - Health Homes Intro RU PRA document
Version 1.0
08/10/2017

Document Number: 167-QSSI-MACPro-PRA-HH1-D
Contract Number: HHSM-500-2007-00024I: HHSM-500-T0014

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Table of Contents

Table of Contents
1. HH1 – Health Homes Intro Screenshots ................................................................ 1
1.1

“Executive Summary” and “General Assurances” Sections............................. 1

List of Figures
Figure 1: Executive Summary and General Assurances ................................................. 1

HH1 - Health Homes Intro RU PRA document Version 1.0

i

08/10/2017

CMS XLC

1.

HH1 – Health Homes Intro Screenshots

HH1 – Health Homes Intro Screenshots
1.1

“Executive Summary” and “General Assurances” Sections

Figure 1: Executive Summary and General Assurances

HH1 - Health Homes Intro RU PRA document Version 1.0

1

08/10/2017


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