№ lp_1_2_48644
File format: docx
Character count: 6166
File size: 39 KB
This is an instructional form used by fiscal employer agents to identify exemptions from certain taxes and Electronic Visit Verification requirements for participant-hired live-in workers in the IRIS program.
Year:
2023
Region / City:
Wisconsin
Theme:
Medicaid, Healthcare Services
Document Type:
Instructional Form
Organization / Institution:
Department of Health Services, Division of Medicaid Services
Author:
Department of Health Services
Target Audience:
Participants and fiscal employer agents (FEAs) in the IRIS program
Period of Validity:
Not specified
Approval Date:
Not specified
Date of Modifications:
Not specified
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The product description is provided for reference. Actual content and formatting may differ slightly.
Year:
2018
Region / City:
Wisconsin
Theme:
Health and Safety Assurance, IRIS Program
Document Type:
Request Form
Agency / Institution:
Department of Health Services, Division of Medicaid Services
Author:
IRIS Consultant
Target Audience:
IRIS Program Participants and Consultants
Effective Period:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2023
Region / City:
Wisconsin
Topic:
Risk Management, Medicaid, Health Services
Document Type:
Form
Organization:
Department of Health Services, Division of Medicaid Services
Author:
Not specified
Target Audience:
IRIS program participants and consultants
Effective Period:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2019
State:
Wisconsin
Program:
IRIS
Subject:
One-time expense requests
Document type:
Participant education and acknowledgement form
Form number:
F-01205C
Issuing authority:
Department of Health Services, Division of Medicaid Services
Eligibility criteria:
IRIS program participation requirements
Reviewing body:
Department of Health Services
Required signatories:
Participant, Guardian (if applicable), IRIS Consultant
Year:
2017
Region / City:
Wisconsin
Theme:
Medicaid, IRIS Program
Document Type:
Instructional Form
Organization / Institution:
Department of Health Services
Author:
N/A
Target Audience:
IRIS Consultant Agencies
Effective Period:
N/A
Approval Date:
N/A
Date of Changes:
N/A
Year:
2017
Region / City:
Wisconsin
Topic:
Medicaid Services
Document Type:
Form
Organization / Institution:
Department of Health Services, Division of Medicaid Services
Author:
Department of Health Services
Target Audience:
Medicaid service consultants and participants
Period of Validity:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2025
Region / City:
Wisconsin
Theme:
Public health, disability services
Document type:
Form, Request
Agency:
Department of Health Services, Division of Public Health
Author:
Not specified
Target audience:
IRIS participants, legal guardians, representatives
Period of validity:
Not specified
Approval date:
Not specified
Date of changes:
Not specified
Year:
2025
Region / City:
Wisconsin
Topic:
Health Services
Document Type:
Form
Organization:
Department of Health Services, Division of Public Health
Author:
Department of Health Services
Target Audience:
Managed Care Organizations, IRIS Consultant Agencies, PACE Organizations, Bureau of Quality & Oversight
Period of Effectiveness:
N/A
Approval Date:
N/A
Amendment Date:
N/A
Contextual Description:
Form used by organizations to request disenrollment from the Family Care, PACE, Partnership, and IRIS programs in Wisconsin.
Year:
2023
Region / City:
Not specified
Topic:
Banking testing and assessment
Document Type:
Report
Organ / Institution:
Banks
Author:
Not specified
Target Audience:
Internal resolvability testing teams (IRT)
Period of validity:
Not specified
Date of approval:
Not specified
Date of amendments:
Not specified
Note:
Year
Region / City:
Wisconsin
Theme:
Health Services, Medicaid, Criminal Background Checks
Document Type:
Appeal Form
Organization / Institution:
Wisconsin Department of Health Services
Target Audience:
IRIS program participants
Contextual description:
A formal appeal request form for IRIS participants to challenge background check results that affect eligibility for Medicaid reimbursement of services by a participant-hired worker with criminal convictions.
Year:
2024
Region / City:
Wisconsin
Subject:
Medicaid Program, IRIS Budget Amendment
Document Type:
Form
Organization / Institution:
Department of Health Services, Division of Medicaid Services
Author:
Department of Health Services
Target Audience:
ICA Staff, Medicaid Participants
Effective Period:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2023
Region / City:
Wisconsin
Topic:
Healthcare Services, Risk Management
Document Type:
Agreement
Organization / Institution:
Department of Health Services
Author:
Unknown
Target Audience:
IRIS Participants, IRIS Consultants
Validity Period:
Ongoing
Approval Date:
Unknown
Modification Date:
Unknown
Year:
2023
Region / City:
National Finance Center
Topic:
Web-based application for payroll/personnel data access
Document Type:
Video
Institution:
National Finance Center
Audience:
Employees, Agencies, Security Officers
Period of validity:
N/A
Approval Date:
N/A
Modification Date:
N/A
Year:
2022
Region / City:
Wisconsin
Topic:
Health Services, Medicaid
Document Type:
Application Form
Agency / Institution:
Department of Health Services, Division of Medicaid Services
Author:
Not specified
Target Audience:
Potential IRIS program service providers
Period of Validity:
Not specified
Approval Date:
Not specified
Date of Amendments:
Not specified
Year:
2017
Region / City:
Wisconsin
Topic:
Health and Safety, Incident Reporting
Document Type:
Instructional Form
Organ / Institution:
Department of Health Services
Author:
Wisconsin Department of Health Services
Target Audience:
IRIS Program Providers
Period of Validity:
N/A
Approval Date:
N/A
Modification Date:
N/A
Year:
2017
Region / City:
Wisconsin
Topic:
Healthcare, Medicaid Services
Document Type:
Instructional Form
Organization / Institution:
Department of Health Services
Author:
Wisconsin Department of Health Services
Target Audience:
IRIS Program Participants
Effective Period:
Ongoing
Approval Date:
February 2017
Change Date:
N/A
Year:
2017
Region / City:
Wisconsin
Theme:
Medicaid, IRIS Program
Document Type:
Form, Instructions
Organization:
Department of Health Services, Division of Medicaid Services
Author:
Unknown
Target Audience:
IRIS participants and IRIS consultant agencies
Period of Validity:
Annual
Approval Date:
Unknown
Date of Amendments:
Unknown
Context:
A form used by IRIS participants and consultants to request the continuation of an approved budget amendment in the IRIS program.
Year:
2026
Organization:
U.S. Department of Labor, Occupational Safety and Health Administration
Type of document:
Agreement template / Memorandum of understanding
Subject:
Alliance Program Ambassador relationship
Legal status:
Non-binding
Effective date:
Upon signing
Expiration:
Duration of cooperative association, subject to 30-day termination notice
Contact:
[email protected]
OMB Control Number:
1218-0274
Year:
2018
Region / city:
Tokai
Topic:
Fisheries management, Operating models
Document type:
Report
Organization:
Unknown
Author:
Unknown
Target audience:
Fisheries scientists, model developers
Period of validity:
Unknown
Approval date:
November 2018
Modification date:
Unknown
Year:
2004
Region / City:
USA
Subject:
Education
Document Type:
Guideline
Organization:
U.S. Department of Education
Author:
Not specified
Target Audience:
Educators, Special Education Teachers
Period of Validity:
Ongoing
Approval Date:
Not specified
Amendment Date:
Not specified