[Medicaid] GenIC #34 (Revised): Model Application Template and Instructions for State Child Health Plan Under Title XXI of the Social Security Act, State Children's Health Insurance Program

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

OMB: 0938-1148

IC ID: 262311

Documents and Forms

Document Name Document Type
Form CMS-10398 #34 [Medicaid] GenIC #34 (Revised): Model Application Template and Instructions for State Child Health Plan Under Title XXI of the Social Security Act, State Children's Health Insurance Program Form and Instruction
Form CMS-10398 #34 [Medicaid] GenIC #34 (Revised): Model Application Template and Instructions for State Child Health Plan Under Title XXI of the Social Security Act, State Children's Health Insurance Program Form and Instruction
CMS-10398 #34 Title XXI State Plan Template 34 - Draft title-xxi-state-plan-template Childrens Vaccine Assurances FINAL (CLEAN)8-10-23.pdf Form and Instruction
Draft title-xxi-state-plan-template Childrens Vaccine Assurances FINAL (REDLINE).docx Other-Track Change: Title XXI State Plan Template
GenIC # 34 - Generic Supporting Statement (2023 version 5).docx Generic Supporting Statement IC Document
Vaccine SHO #23-003.pdf State Health Official (SHO) Letter # 23-003 IC Document