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Agency Name Effective 11/15 SAMPLE RESOLUTION # AUTHORIZATION FOR THE EXECUTION OF THE CERTIFICATIONS AND ASSURANCES AND AUTHORIZED AGENT FORMS FOR THE LOW CARBON TRANSIT OPERATIONS PROGRAM (LC TOP)
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Organizations or individuals seeking to apply for a Section 1115 demonstration waiver from the Centers for Medicare and Medicaid Services (CMS) need to fill out the effective 1115-dot form.
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What is effective 1115 - dot?
Effective 1115 - dot is a waiver that allows states to implement experimental, pilot, or demonstration projects to improve Medicaid services for beneficiaries.
Who is required to file effective 1115 - dot?
State Medicaid agencies are required to file effective 1115 - dot in order to implement the waiver.
How to fill out effective 1115 - dot?
Effective 1115 - dot must be filled out with detailed information on the proposed projects, goals, anticipated outcomes, and budget for the Medicaid waiver.
What is the purpose of effective 1115 - dot?
The purpose of effective 1115 - dot is to allow states to test innovative approaches to delivering and financing Medicaid services, with the goal of improving health outcomes and reducing costs.
What information must be reported on effective 1115 - dot?
Effective 1115 - dot must include information on the target population, proposed projects, goals, metrics for evaluation, budget, and expected outcomes.
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