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Crosswalk: Attachment 5a - Monitoring Report Template.xlsx
Crosswalk - Attachment 5a Monitoring Report Template.xlsx
[Medicaid] Generic Clearance for Medicaid and CHIP State Plan, Waiver, and Program Submissions (CMS-10398)
Crosswalk: Attachment 5a - Monitoring Report Template.xlsx
OMB: 0938-1148
OMB.report
HHS/CMS
OMB 0938-1148
ICR 202401-0938-016
IC 260271
Crosswalk: Attachment 5a - Monitoring Report Template.xlsx
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0938-1148 can be found here:
2024-09-27 - Reinstatement with change of a previously approved collection
2024-07-11 - Reinstatement without change of a previously approved collection
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