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GenIC #68 (New) - Section 1006(b) of the SUPPORT Act: Medicaid Assisted Treatment (MAT)

IC 244016 under ICR 201712-0938-019 · OMB 0938-1148.

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GenIC #68 (New) - Section 1006(b) of the SUPPORT Act: Medicaid Assisted Treatment (MAT) CMCS
 
New
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-10398 #68 SPA Coverage Template for Limitations (Supplement to Attachment 3.1-A) 09-29-2020-1006(b)-SPA Template-Supp to Att.3.1-A (2020 version 3).docx Yes Yes Fillable Fileable
Form CMS-10398 #68 SPA Coverage Template for Limitations (Supplement to Attachment 3.1-B) 09-29-2020-1006(b)-SPA Template-Supp to Att. 3.1-B (2020 version 3).docx Yes Yes Fillable Fileable

Health Health Care Services

 

56 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 66 0 66 0 0 0
Annual IC Time Burden (Hours) 4,485 0 4,485 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Generic Supporting Statement GenIC 68 - Generic Supporting Statement (2020 version 6).docx 10/27/2020
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