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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 | 3x | export const WaiverBAttachments = () => ( <> <p> The regulations at 42 C.F.R. §430.25, 431.55 and 42 C.F.R. §441.301 describe the requirements for submitting section 1915(b) and 1915(c) waivers. </p> <table className="faq-table border-collapse border border-gray-300 w-full"> <thead> <tr> <th className="border border-gray-300 px-4 py-2">Attachment Name</th> <th className="border border-gray-300 px-4 py-2">Description</th> </tr> </thead> <tbody> <tr> <td className="border border-gray-300 px-4 py-2"> 1915(b)(4) FFS Selective Contracting (Streamlined) waiver application pre-print (Initial, Renewal, Amendment) </td> <td className="border border-gray-300 px-4 py-2"> State submission of the 1915(b)(4) Waiver Fee-for-Service Selective Contracting Program preprint narrative (Sections A, B, and C) </td> </tr> <tr> <td className="border border-gray-300 px-4 py-2"> 1915(b) Comprehensive (Capitated) Waiver Application Pre-print (Initial, Renewal, Amendment) </td> <td className="border border-gray-300 px-4 py-2"> State submission of the 1915(b) preprint narrative (Sections A, B, C and D) (non-FFS Selective Contracting Waiver programs) </td> </tr> <tr> <td className="border border-gray-300 px-4 py-2"> 1915(b) Comprehensive (Capitated) Waiver Cost effectiveness spreadsheets (Initial, Renewal, Amendment) </td> <td className="border border-gray-300 px-4 py-2"> Appendix D Cost Effectiveness Demonstration for 1915(b) Waivers only (not applicable to 1915(b)(4) Fee-for-Service Selective Contracting programs) </td> </tr> <tr> <td className="border border-gray-300 px-4 py-2"> 1915(b)(4) FFS Selective Contracting (Streamlined) and 1915(b) Comprehensive (Capitated) Waiver Independent Assessment (first two renewals only) </td> <td className="border border-gray-300 px-4 py-2"> State submission of the findings from the Independent Assessment of their 1915(b) waiver program </td> </tr> <tr> <td className="border border-gray-300 px-4 py-2"> Tribal Consultation (Initial, Renewal, Amendment) </td> <td className="border border-gray-300 px-4 py-2"> Document that outlines the changes the waiver action is making and the impact that tribes can expect from the waiver action </td> </tr> <tr> <td className="border border-gray-300 px-4 py-2">Other</td> <td className="border border-gray-300 px-4 py-2"> {`Any other documents or spreadsheets that are supplemental to the state's waiver application`} </td> </tr> </tbody> </table> </> ); |