#74 (New): Coverage of Routine Patient Cost for Items & Services in Qualifying Clinical Trials

[Medicaid] Generic Clearance for Medicaid and CHIP State Plan, Waiver, and Program Submissions (CMS-10398)

OMB: 0938-1148

IC ID: 251149

Documents and Forms

Document Name Document Type
Form CMS-10398 #74 #74 (New): Coverage of Routine Patient Cost for Items & Services in Qualifying Clinical Trials Form
Form CMS-10398 #74 #74 (New): Coverage of Routine Patient Cost for Items & Services in Qualifying Clinical Trials Form
CMS-10398 #74 Att. 3.1-A (Qualifying Clinical Trial Draft Preprint) Preprint Att. 3.1-A (2022 version 3).docx Form
CMS-10398 #74 Att. 3.1.-B (Qualifying Clinical Trial Draft Preprint) Preprint Att. 3.1-B (2022 version 3).docx Form
Qualifying Clinical Trial Attestation Form 74 - QUALIFYING CLINICAL TRIAL ATTESTATION FORM CLEAN 8.17.21 I.pdf Form and Instruction
74 - Generic Supporting Statement (2022 version 5).docx Generic Supporting Statement IC Document
84f2c322 - GenIC #74 Comment.pdf Public Comment IC Document
Public Comments Received on GenIC #74.docx Response to Public Comment IC Document