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GenIC #64 (Revision) Medicaid Section 1115 Substance Use Disorder (SUD) Demonstrations: Federal Meta-Analysis Support CMCS
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Introductory Email (from CMS to State Medicaid Director) Yes Yes Fillable Fileable
Other-Introductory Email (from RTI to State Medicaid Director) Yes Yes Fillable Fileable
Other-Introductory Email (from State Medicaid Director) Yes Yes Fillable Fileable
Other-Interview Email Invitation Yes Yes Fillable Fileable
Other-Interview Outlook Invitation Yes Yes Fillable Fileable
Other-Interview Confirmation Email Yes Yes Fillable Fileable
Form and Instruction CMS-10398 #64 Yes Yes Fillable Fileable
Form and Instruction CMS-10398 $64 Yes Yes Fillable Fileable
Form and Instruction CMS-10398 (#64) Yes Yes Fillable Fileable
Other-Thank You Email Yes Yes Fillable Fileable

Health Health Care Services

 

90 0
   
Private Sector Businesses or other for-profits
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 90 0 90 0 0 0
Annual IC Time Burden (Hours) 5 0 5 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Generic Supporting Statement 03/18/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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