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Get the free 2010 Draft Form 1115 -- Request for Consent for a Water s-Edge Re-Election. 2010 Dra...

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Caution: DRAFT FORM This is an advance draft copy of a California tax form. It is subject to change and FT approval before it is officially released. If you have any comments on this draft form, you
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Draft form 1115 is a document used for reporting information related to Medicaid and the Children's Health Insurance Program (CHIP) waiver programs.
State Medicaid agencies are required to file draft form 1115 with the Centers for Medicare and Medicaid Services (CMS).
Draft form 1115 should be completed with accurate and detailed information about the proposed waiver program, including the goals, objectives, and expected outcomes.
The purpose of draft form 1115 is to seek approval from CMS for waivers to the standard Medicaid and CHIP rules, in order to implement innovative health care programs.
Draft form 1115 must include details about the target population, services to be provided, evaluation methods, and budget projections for the waiver program.
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