Non-Subtantive change Crosswalk

CMS 10752 1135 Waiver_Flexibility Request and 1135 Inquiry Form Revision Table.docx

Submissions of 1135 Waiver Request Automated Process (CMS-10752)

Non-Subtantive change Crosswalk

OMB: 0938-1384

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Revisions to Form CMS-10752 Submissions of 1135 Waiver Request Webform


Issue #

Page #

Section

Changes to the Application

Reason for the Change

2

WAIVER (ORGANIZATION WORKFLOW) -

Organization Categories

Added ‘State Medicaid Agency’ in Organization Categories, under the General tab

Added missing option to Waiver Workflow

2

WAIVER (ORGANIZATION WORKFLOW) -

Organization Categories

Added ‘Qualified Health Plan’ in Organization Categories, under the General tab

Added missing option to Waiver Workflow

2

WAIVER (ORGANIZATION WORKFLOW) -

Organization Categories

Added ‘Medicare Advantage / Part Plan D’ in Organization Categories, under the General tab

Added missing option to Waiver Workflow

2

WAIVER (ORGANIZATION WORKFLOW) -

Organization Categories

Added ‘Program of All-Inclusive Care for Elderly’ PACE in Organization Categories, under the Emergency Provider/Supplier tab

Added missing option to Waiver Workflow

2

WAIVER (ORGANIZATION WORKFLOW) -

Organization Categories

Removed extra instance of ‘Community Mental Health Care’ CMHC from Organization Categories, under the Emergency Provider/Supplier tab

Removed duplicate option from Waiver Workflow

2

WAIVER (ORGANIZATION WORKFLOW) -

Header text

Changed date to: 05/31/2024

Expiration date changed

4

INQUIRY (ORGANIZATION WORKFLOW) -
Header text

Changed date to: 05/31/2024

Expiration date changed

6

INQUIRY (BENEFICIARY WORKFLOW) -
Header text

Changed date to: 05/31/2024

Expiration date changed

4

INQUIRY (ORGANIZATION WORKFLOW) -
Organization Categories

Removed extra instance of ‘Community Mental Health Care’ CMHC from Organization Categories, under the Emergency Provider/Supplier tab

Removed duplicate option from Inquiry Workflow

6

INQUIRY (BENEFICIARY WORKFLOW) -
Organization Categories

Removed extra instance of ‘Community Mental Health Care’ CMHC from Organization Categories, under the Emergency Provider/Supplier tab

Removed duplicate option from Inquiry Workflow

2

WAIVER (ORGANIZATION WORKFLOW) -Waiver/Flexibility Request Type

Capitalized ‘related’ - Ensuring Correct Processing of Home Health Disaster Related Claims: Allow MACs to extend auto-cancellation date of Requests for Anticipated Payment (RAPs) during emergencies

Typo

2

WAIVER (ORGANIZATION WORKFLOW) -Waiver/Flexibility Request Type

Capitalized ‘medicare’ - Extension for Medicare Geographic Classification Review Board (MGCRB) Applications: Allows an extension to the deadline of application re-classification requirements [


Typo

2

WAIVER (ORGANIZATION WORKFLOW) -Waiver/Flexibility Request Type

Revised: ‘pre-exisiting’ - Extension of pre-existing fee-for-service prior authorizations


Typo

2

WAIVER (ORGANIZATION WORKFLOW) -Waiver/Flexibility Request Type

Revised: ‘Teatment’ - Psychiatric Residential Treatment Facility (PRTF): Payment


Typo

2

WAIVER (ORGANIZATION WORKFLOW) -Waiver/Flexibility Request Type

Revised: ‘Teatment’ - Psychiatric Residential Treatment Facility (PRTF): Survey, Certification, Quality and Enforcement


Typo


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorAlexander Rooke
File Modified0000-00-00
File Created2021-08-06

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