Use of Forms. For each DY, separate Forms CMS-64.9 Waiver and/or 64.9P Waiver shall be submitted reporting expenditures for individuals enrolled in the demonstration, subject to the budget neutrality cap. The state must complete separate forms for the following categories: i. AFDC/SOBRA ii. SSI iii. Expansion State Adults iv. MED v. ALTCS-DD vi. ALTCS-EPD
Appears in 6 contracts
Samples: Medicaid Demonstration Agreement, Medicaid Demonstration Agreement, Medicaid Demonstration Agreement
Use of Forms. For each DY, separate Forms CMS-64.9 Waiver and/or 64.9P Waiver shall be submitted reporting expenditures for individuals enrolled in the demonstrationDemonstration, subject to the budget neutrality cap. The state State must complete separate forms for the following categories:
i. AFDC/SOBRA ii. SSI iii. Expansion State Adults ivXX xx. MED v. ALTCS-DD vi. ALTCS-EPDEPD vii. Family Planning Extension viii. Uncompensated Care Payments to IHS and 638 Facilities
Appears in 4 contracts
Samples: Special Terms and Conditions, Special Terms and Conditions, Special Terms and Conditions
Use of Forms. For each DY, separate Forms CMS-64.9 Waiver and/or 64.9P Waiver shall be submitted reporting expenditures for individuals enrolled in the demonstrationDemonstration, subject to the budget neutrality cap. The state State must complete separate forms for the following categories:
i. AFDC/SOBRA ii. SSI iii. Expansion State Adults ivXX xx. MED v. ALTCS-DD vi. ALTCS-EPD
Appears in 4 contracts
Samples: Special Terms and Conditions, Special Terms and Conditions, Special Terms and Conditions