№ lp_1_2_43183
File format: docx
Character count: 3944
File size: 55 KB
This document provides instructions for healthcare providers in Wisconsin on how to complete the Prior Authorization/Drug Attachment (PA/DGA) form for drug requests under the Medicaid program.
Year:
2024
Region / City:
Wisconsin
Topic:
Health services, Medicaid
Document Type:
Instruction manual
Organization / Institution:
Department of Health Services, State of Wisconsin
Author:
Department of Health Services
Target Audience:
Healthcare providers, pharmacists
Effective Period:
Ongoing
Approval Date:
01/2024
Date of Amendments:
None
Price: 8 / 10 USD
The file will be delivered to the email address provided at checkout within 12 hours.
The file will be delivered to the email address provided at checkout within 12 hours.
Don’t have cryptocurrency yet?
You can still complete your purchase in a few minutes:- Buy Crypto in a trusted app (Coinbase, Kraken, Cash App or any similar service).
- In the app, tap Send.
- Select network, paste our wallet address.
- Send the exact amount shown above.
The final amount may vary slightly depending on the payment method.
The file will be sent to the email address provided at checkout within 24 hours.
The product description is provided for reference. Actual content and formatting may differ slightly.
Year:
2024
Region / City:
Wisconsin
Theme:
Healthcare / Medicaid
Document Type:
Form
Organization / Institution:
Department of Health Services, State of Wisconsin
Author:
Department of Health Services
Target Audience:
Healthcare providers, Prescribers, Pharmacy providers
Period of validity:
Not specified
Approval Date:
Not specified
Date of changes:
Not specified
Year:
2023
Region / City:
Wisconsin
Subject:
Health Services, Medicaid
Document Type:
Form
Organization / Institution:
Department of Health Services, State of Wisconsin
Author:
Department of Health Services
Target Audience:
Prescribers, Pharmacy Providers
Period of Validity:
N/A
Approval Date:
N/A
Date of Modifications:
N/A
Year:
2019
Region / State:
Wisconsin, USA
Topic:
Newborn reporting for Medicaid and BadgerCare Plus
Document Type:
Medical administrative form
Organization:
Department of Health Services, Division of Medicaid Services
Form Number:
F-01165
Audience:
Healthcare providers submitting newborn information
Legal Reference:
Wis. Stat. § 49.45(4); Wis. Admin. Code § DHS 104.02(4)
Submission Methods:
Fax or mail
Required Information:
Newborn details, mother details, provider details, gestational age, newborn weight
Year:
2018
Region / City:
Wisconsin
Theme:
Healthcare, Medicaid Services
Document Type:
Form
Organization / Institution:
Department of Health Services, State of Wisconsin
Author:
Division of Medicaid Services
Target Audience:
Healthcare Providers, Prescribers
Period of Action:
2018
Approval Date:
January 2018
Date of Changes:
None
Year:
2012
Region / City:
United States
Theme:
Social science, health, finance, business ownership
Document Type:
Survey instrument
Agency / Organization:
Bureau of Labor Statistics (BLS)
Author:
Not specified
Target Audience:
Researchers, policymakers, survey respondents
Period of validity:
Ongoing
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2026
Region / City:
United States
Subject:
Occupational Safety and Health Training
Document Type:
Work Plan
Organization / Institution:
Program Partners
Author:
N/A
Target Audience:
Bidders, Trainers, Program Partners
Effective Period:
2026
Approval Date:
N/A
Date of Changes:
N/A
Year:
2025–2026
Region:
United Kingdom
Type of document:
Procurement notice
Identifier:
ocds-h6vhtk-0504a3RM1557.15
Authority:
Crown Commercial Service (CCS)
Audience:
Potential suppliers and bidders
Publication date:
23/10/2025
Tender submission deadline:
30/01/2026 15:00
Assessment summaries issued:
04/09/2026
Contract award notice:
07/09/2026
Framework contract start date:
17/09/2026
Platform:
Central Digital Platform (CDP)
Content:
Timelines, submission instructions, clarification procedures, consortium and subcontractor rules, tender evaluation stages, and competition rules
Effective Date:
07/10/2025
Year:
2025
Note:
Region / City
Theme:
Nuclear Safety / Inspection Procedures
Document Type:
Inspection Manual
Organization / Institution:
U.S. Nuclear Regulatory Commission (NRC)
Target Audience:
Nuclear plant operators, NRC inspectors, licensed operators
Date of Changes:
07/10/2025
Note:
CSP Name
Controlled Unclassified Information:
Yes
Prepared by:
Organization Name
Prepared for:
Organization Name
Instruction:
Delete template instructions before finalization
Revision History:
See document for detailed dates and changes
Contact:
[email protected]
Website:
www.fedramp.gov
Type of document:
Security guidance / procedural template
Audience:
Internal and external users of CSP systems
Year:
2025
Region / City:
Not specified
Topic:
Nuclear Regulatory Commission Inspection and Performance Indicators
Document Type:
Inspection Manual
Organization / Institution:
U.S. Nuclear Regulatory Commission
Author:
U.S. Nuclear Regulatory Commission
Target Audience:
NRC Inspectors, Licensees of Nuclear Facilities
Period of validity:
From January 1, 2025
Approval Date:
Not specified
Date of changes:
Not specified
Year:
2017
Region / City:
California
Theme:
Electronic Filing Services
Document Type:
Agreement
Organ / Institution:
Judicial Council of California
Author:
Judicial Council of California
Target Audience:
Judicial Branch Entities, Contractors
Duration:
Until Expiration Date
Approval Date:
[Date]
Amendment Date:
[Date]
Year:
2023
Region / City:
Utah
Topic:
Information Technology Contracts
Document Type:
Contract Terms and Conditions
Organization:
Utah Department of Technology Services (DTS)
Author:
State of Utah
Target Audience:
State of Utah Government Departments, Agencies, and Eligible Users
Contract Period:
From effective date of contract
Date of Approval:
Not specified
Date of Amendments:
Not specified
Year:
2023
Region / City:
Accra, Ghana
Theme:
Graphic Design, USAID, Regional Development
Document Type:
Request for Proposals (RFP)
Organization:
Creative Associates International, USAID Office of Transition Initiatives
Author:
Creative Associates International
Target Audience:
Graphic Design Consultants, Local Partners, USAID Contractors
Period of Effectiveness:
July 15th - December 31st, 2023
Approval Date:
N/A
Amendment Date:
N/A
Year:
2023
Region / City:
Indiana
Theme:
Behavioral Health Workforce Recruitment and Retention
Document Type:
Technical Proposal Template
Organization:
State of Indiana
Author:
Not specified
Target Audience:
Applicants for Behavioral Health Workforce Recruitment and Retention Innovation Grant
Effective Period:
Not specified
Approval Date:
Not specified
Amendment Date:
Not specified
Jurisdiction:
State of Wisconsin
Issuing body:
Wisconsin Department of Health Services
Division:
Division of Medicaid Services
Program:
ForwardHealth
Legal reference:
Wis. Admin. Code § DHS 107.10(2)
Form number:
F-01430
Form version date:
December 2021
Document type:
Prior authorization medical form
Subject matter:
Prescription authorization for Xyrem and Xywav
Medical conditions referenced:
Narcolepsy with cataplexy, narcolepsy without cataplexy, idiopathic hypersomnia
Intended users:
Prescribers and pharmacy providers
Required attachments:
Medical records, sleep study results, ESS, MWT, MSLT
Regulatory requirement:
Xyrem and Xywav REMS Program compliance
Signature requirement:
Prescriber signature and date
Year:
[Insert year]
Region / City:
[Insert region or city]
Topic:
Procurement, Bidding Process
Document Type:
Instructional Guide
Organization:
Crown Commercial Service (CCS)
Author:
[Insert author name if available]
Target Audience:
Organizations participating in the bidding process
Period of validity:
[Insert period if applicable]
Approval Date:
[Insert approval date]
Modification Date:
[Insert modification date if applicable]
Year:
Not specified
Region / city:
Not specified
Topic:
Environmental Protection, Construction Site Management
Document Type:
Draft / Technical Requirement
Authority / Organization:
Not specified
Author:
Not specified
Target Audience:
Dischargers, Construction Site Operators
Effective Period:
Not specified
Approval Date:
Not specified
Amendment Date:
Not specified
Year:
2026
Region / City:
United States
Topic:
Environmental regulation
Document Type:
Official guideline
Organization / Institution:
State Water Board
Author:
Not specified
Target Audience:
Construction companies, legal and environmental professionals
Validity Period:
Ongoing as per General Permit regulations
Approval Date:
Not specified
Amendment Date:
Not specified
Year:
2021
Region / City:
Oklahoma
Theme:
Correctional Services
Document Type:
Request for Proposal (RFP)
Organ / Institution:
Oklahoma Department of Corrections (ODOC)
Author:
Oklahoma Department of Corrections
Target Audience:
Suppliers, Contractors
Period of Action:
From contract start date, renewable for up to 9 years
Approval Date:
Not specified
Date of Changes:
Not specified