№ lp_2_1_26837
File format: docx
Character count: 12505
File size: 98 KB
This is a medical form used for submitting a request for hepatitis C treatment coverage, including preferred and non-preferred drug regimens and necessary clinical criteria.
Note:
Year
Subject:
Health Care / Hepatitis C Treatment
Document Type:
Medical Form
Target Audience:
Health Care Providers
Price: 8 / 10 USD
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The product description is provided for reference. Actual content and formatting may differ slightly.
Year:
2025
Region / City:
Not specified
Subject:
Health plan enrollee experience survey
Document Type:
Survey script
Organization / Institution:
Not specified
Author:
Not specified
Target Audience:
Health plan enrollees
Period of validity:
July – December 2024
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2023
Region / City:
Not specified
Theme:
Healthcare, Health Plans
Document Type:
Survey Script
Issuing Organization:
Centers for Medicare & Medicaid Services (CMS)
Author:
Not specified
Target Audience:
Enrollees in Qualified Health Plans
Period of Validity:
2023
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2021
Region / City:
United States
Theme:
Health plan enrollee experience survey
Document Type:
Survey script
Organization / Institution:
QHP Issuer
Author:
Not specified
Target Audience:
QHP enrollees
Period of Action:
July through December 2020
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2024
Survey period:
July–December 2023
Topic:
Health insurance enrollee experience
Program:
Qualified Health Plan (QHP)
Document type:
Survey questionnaire
Target population:
Qualified Health Plan enrollees
Geographic context:
United States
Content sections:
Health plan information, customer service, forms and accessibility, confidence in insurance knowledge, overall rating, discrimination experiences, recommendations, demographic information
Response format:
Multiple-choice scales and rating scales
Year:
2026
Region / City:
Not specified
Subject:
Exception requests for variations from QHP Enrollee Survey requirements
Document Type:
Instructional Form
Organization / Institution:
Not specified
Author:
Not specified
Target Audience:
Vendors conducting the QHP Enrollee Survey
Period of Action:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2026
Document type:
Internet survey script
Survey name:
Qualified Health Plan (QHP) Enrollee Experience Survey
Language:
English
Data collection mode:
Internet survey
Reference period:
July–December 2025
Reference period length:
6 months
Target population:
Qualified Health Plan enrollees
Subject area:
Health insurance enrollee experience
Regulatory authority:
Centers for Medicare & Medicaid Services
OMB control number:
0938-1221
OMB approval expiration:
September 30, 2026
Estimated completion time:
10 minutes
Survey sponsor:
Health plan issuers under QHP program
Data use purpose:
Enrollee experience measurement
Geographic scope:
United States
Document section:
Programming specifications and survey instructions
Source type:
Federal survey instrument documentation
Year:
2025
Region / City:
N/A
Theme:
Healthcare, Health Plans
Document Type:
Survey
Agency / Organization:
Centers for Medicare & Medicaid Services (CMS)
Author:
N/A
Target Audience:
Enrollees of Qualified Health Plans
Period of Validity:
From July to December 2024
Approval Date:
N/A
Date of Changes:
N/A
Year:
2022
Region / City:
Not specified
Theme:
Healthcare, Health Insurance Surveys
Document Type:
Telephone Interview Script
Organization:
Not specified
Author:
Not specified
Target Audience:
Enrollees of Qualified Health Plans
Period of validity:
From July to December 2021
Approval Date:
Not specified
Date of changes:
Not specified
Year:
2022
Region / City:
United States
Theme:
Health care survey
Document Type:
Survey script
Organization / Institution:
Centers for Medicare & Medicaid Services (CMS)
Author:
Not specified
Target Audience:
Enrollees of Qualified Health Plans (QHP)
Effective Period:
2021-2022
Approval Date:
11/30/2023
Revision Date:
Not specified
Survey Format:
Online
Data Collection Method:
Internet survey
OMB Approval Number:
0938-1221
Year:
2022
Region / City:
United States
Topic:
Health Plan Enrollee Experience Survey
Document Type:
Vendor Participation Form
Organization:
Centers for Medicare & Medicaid Services (CMS)
Author:
CMS Project Team
Target Audience:
Vendors applying for participation in the QHP Enrollee Survey
Period of Action:
2022
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2022
Region / City:
United States
Topic:
Qualified Health Plan Enrollee Experience Survey
Document Type:
Vendor Participation Notice
Organization / Institution:
CMS (Centers for Medicare & Medicaid Services)
Author:
CMS
Target Audience:
Prospective vendors for the 2022 QHP Enrollee Survey
Effective Period:
July 15, 2021 - July 30, 2021
Approval Date:
July 30, 2021
Date of Changes:
None
Year:
2021
Region / City:
Not specified
Theme:
Quality Healthcare Programs, Enrollee Surveys
Document Type:
Instruction and Form
Organ / Institution:
Centers for Medicare & Medicaid Services (CMS)
Author:
Not specified
Target Audience:
Vendors involved in QHP Enrollee Survey
Period of Validity:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2020
Region / city:
Not specified
Topic:
Health plan enrollee experience
Document type:
Survey
Organization / institution:
Not specified
Author:
Not specified
Target audience:
Health plan enrollees
Period of validity:
July – December 2019
Approval date:
Not specified
Date of changes:
Not specified
Note:
Year
Topic:
Medicaid, Prescription Drugs, Clinical Criteria
Document Type:
Form
Organization / Institution:
New York Medicaid
Target Audience:
Healthcare providers, prescribers
Year:
2016
Region / City:
United States
Topic:
Pharmacy Information Management
Document Type:
Technical Requirement
Organization / Institution:
Veterans Health Administration (VHA)
Author:
Veterans Health Administration
Target Audience:
Vendors, Pharmaceutical Suppliers, IT Developers
Period of Validity:
From January 18, 2017
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2019
Region / City:
United States
Topic:
Information Technology, Veterans Affairs, Healthcare
Document Type:
Performance Work Statement
Agency / Institution:
Department of Veterans Affairs, Office of Information & Technology
Author:
Not specified
Target Audience:
Contractors, VA staff, IT professionals
Period of Effectiveness:
June 27, 2019, onwards
Approval Date:
June 27, 2019
Amendments Date:
Not specified
Year:
2025
Region / City:
Louisiana
Topic:
Alcohol and Drug Survey
Document Type:
Guidelines
Organization / Institution:
Louisiana Board of Regents
Author:
Dr. Allison Smith
Target Audience:
IRB administrators, researchers, university staff
Period of Validity:
2025
Approval Date:
October 4, 2024
Amendment Date:
November 15, 2024
Note:
Year
Subject:
Emergency Use Treatment
Document Type:
Informed Consent Form
Year:
2025
Jurisdiction:
Washington State
Topic:
Drug supply chain security and pharmacy regulatory compliance
Document type:
Self-inspection worksheet
Issuing body:
Washington State Pharmacy Quality Assurance Commission
Governing law:
Drug Supply Chain Security Act (DSCSA); RCW 18.64.026; WAC 246-945
Applicable entities:
Drug manufacturers; wholesale distributors; dispensers
Regulatory scope:
State and federal pharmacy law
Compliance status:
Optional addendum with mandatory DSCSA compliance
Intended role:
Responsible pharmacy manager or equivalent manager
Retention requirement:
Kept on file; not submitted to the commission
Source type:
Government regulatory document