#75 (New): ARP 1135 State Plan Amendment

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

OMB: 0938-1148

IC ID: 251150

Documents and Forms

Document Name Document Type
Form cms-10398 #75 #75 (New): ARP 1135 State Plan Amendment Form
Form cms-10398 #75 #75 (New): ARP 1135 State Plan Amendment Form
cms-10398 #75 Preprint Attachment 7.7A: Vaccine and Vaccine Administration Preprint Attachment 7.7A (2022 version 3).docx Form
cms-10398 #75 Preprint Attachment 7.7B: COVID-19 Testing Preprint Attachment 7.7B (2022 version 3).docx Form
cms-10398 #75 Preprint Attachment 7.7C: COVID-19 Treatment Preprint Attachment 7.7C (2022 version 3).docx Form
CMS-10398 #75 Template for Medicaid Section 1135 Waiver of SPA Submission Requirements Template 1135 Waiver (2022 version 2).docx Form
GenIC 75 - Generic Supporting Statement (2022 version 5).docx Generic Supporting Statement IC Document