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GenIC #53 (New): Section 1115 Substance Use Disorder (SUD) Demonstration: Guide for Developing Implementation Plan Protocols

IC 230306 under ICR 201712-0938-019 · OMB 0938-1148.

Documents and Forms
Document Name
Document Type
Form and Instruction
Other-SMD Letter 17-003 (Strategies
Form and Instruction
IC Document
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GenIC #53 (New): Section 1115 Substance Use Disorder (SUD) Demonstration: Guide for Developing Implementation Plan Protocols
 
New
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10398 #53 Section 1115 Substance Use Disorder (SUD) Demonstration: Guide for Developing Implementation Plan Protocols 53 - SUD Implementation Plan Template 11 17 2017 [rev OSORA PRA].docx Yes Yes Fillable Fileable
Other-SMD Letter 17-003 (Strategies to Address the Opioid Epidemic) 53 - Opioid and other SUD 1115s smd #17-003.pdf No   Printable Only

Health Health Care Services

 

49 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 49 0 49 0 0 0
Annual IC Time Burden (Hours) 784 0 784 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement GenIC 53 - Supporting Statement [rev#3 12-14-2017 by OSORA PRA].docx 03/01/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.