Form CMS-10398 #17 CMS-10398 #17 CS3 - Eligibility for Medicaid Expansion Program
Generic Clearance for Medicaid and CHIP State Plan, Waiver, and Program Submissions (CMS-10398)
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GenIC #17 (Extension w/o change): CHIP 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⚠️ Notice: This form may be outdated.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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