GenIC #57 (Revision): Medicaid Section 1115 Substance Use Disorder (SUD) Demonstration: Monitoring Reports Documents and Templates

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

OMB: 0938-1148

IC ID: 252106

Documents and Forms

Document Name Document Type
SUD_MonProtocolInstr.v4.0_PRA.pdf Instruction
CMS-10398 #57 Monitoring Protocol Template SUD_MonProtocolTemp.v4.0_PRA.docx Form
CMS-10398 #57 Monitoring Protocol Workbook SUD_MonProtocolWB.v6.0_PRA.xlsx Form and Instruction
SUD_MonReportInstr.v4.0_PRA.pdf Instruction
CMS-10398 #57 Monitoring Report Template SUD_MonReportTemp.v4.0_PRA.docx Form
CMS-10398 #57 Monitoring Report Workbook SUD_MonReportWB.v6.0_PRA.xlsx Form and Instruction
Video - Downloading 1115 Demonstration Monitoring Report Templates.docx cvpcorp-1115pmda.adobeconnect.com/p4l83cvhhqda/ Instruction
57 - Generic Supporting Statement (2022 version 6).docx Generic Supporting Statement IC Document
SUD Crosswalk 2022_Monitoring Protocol Instructions.xlsx Crosswalk: Monitoring Protocol Instructions IC Document
SUD Crosswalk 2022_Monitoring Protocol Template.xlsx Crosswalk: Monitoring Protocol Template IC Document
SUD Crosswalk 2022_Monitoring Protocol Workbook.xlsx Crosswalk: Monitoring Protocol Workbook IC Document
SUD Crosswalk 2022_Monitoring Report Instructions.xlsx Crosswalk: Monitoring Report Instructions IC Document
SUD Crosswalk 2022_Monitoring Report Template.xlsx Crosswalk: Monitoring Report Template IC Document
SUD Crosswalk 2022_Monitoring Report Workbook.xlsx Crosswalk: Monitoring Report Workbook IC Document
SMDL 17-003.pdf SMDL #17-003 IC Document