Form CMS-10398 #15 CMS-10398 #15 Tab A1-A3 - Medicaid Administration: State Plan Administ

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

A1-A3 (1)

GenIC #15 (Extension w/o change): Medicaid State Plan Eligibility

OMB: 0938-1148

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-1148 can be found here:

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File Type	application/pdf
File Modified	2013-05-24
File Created	2013-05-06