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Title XIX WaiverPlease print legibly and fill out completely Client Name×LastFirstMIDOB Age Gender Prime Number County Client / Guardian By federal regulations, if you need services that may be available
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Title XIX waiver is a federal program that allows states to waive certain Medicaid requirements in order to provide innovative and cost-effective healthcare services.
States are required to file Title XIX waivers in order to implement changes to their Medicaid programs.
Title XIX waivers can be filled out by state Medicaid agencies with guidance from the Centers for Medicare & Medicaid Services.
The purpose of Title XIX waivers is to allow states flexibility in designing and implementing their Medicaid programs to better serve their populations.
Title XIX waivers must include details on the proposed program changes, their impact on Medicaid beneficiaries, and how the state plans to evaluate the effectiveness of the changes.
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