Get the free 11/15/2023 form approved - NJ.gov
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PRINTED: 06/16/2023 DEPARTMENT OF HEALTH AND HUMAN SERVICESFORM APPROVEDCENTERS FOR MEDICARE & MEDICAID SERVICESOMB NO. 09380391STATEMENT OF DEFICIENCIES AND(X1) PROVIDER/SUPPLIER/CLIAPLAN OF CORRECTIONSIDENTIFICATION
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What is 1115 form approved?
The 1115 form is a specific form that relates to amendments or modifications to a previously approved Medicaid demonstration project as per the Centers for Medicare & Medicaid Services (CMS).
Who is required to file 1115 form approved?
State Medicaid agencies are required to file the 1115 form when seeking approval for modifications to their existing Medicaid demonstration programs.
How to fill out 1115 form approved?
To fill out the 1115 form, states need to provide comprehensive information about their requested changes, including program objectives, target population, and financial implications. Detailed instructions are provided on the CMS website.
What is the purpose of 1115 form approved?
The purpose of the 1115 form is to allow states to test new approaches in Medicaid that differ from federal program standards while still providing coverage for eligible populations.
What information must be reported on 1115 form approved?
The 1115 form requires states to report details like the scope of the project, expected outcomes, budget impact, and evaluation plans for the proposed Medicaid modification.
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