Children's Health Insurance Program (CHIP)

Harris County, TX

Official Website: https://www.medicaid.gov/chip/index.html

Forms & Documents

Browse all Children's Health Insurance Program (CHIP) government forms

All 17 forms

Form Title Topics
CIB: Additional EVV Guidance – August 2019
CIB: Cures Act for Electronic Visit Verification - May 16, 2018
Department of Health and Human Services Centers for Medicare & Medicaid Services
Department of Health and Human Services Centers for Medicare & Medicaid Services Form CMS 64 Summary - Quarterly Medicaid Statement of Expenditures For the Medical Assistance Program Summary Sheet
DEPARTMENT OF HEALTH & HUMAN SERVICES DEPARTMENT OF AGRICULTURE September 21, 2000
Draft Model Renewal Form and Considerations for MAGI Medicaid/CHIP Renevals
EVV Requirements in the 21st Century Cures Act: NASUAD Conference Workshop - August 2018
EVV Requirements in the 21st Century Cures Act: NASUAD Pre-Conference Intensive - August 2018
EVV Update– August 2018
FAQs: Cures Act for Electronic Visit Verification - May 16, 2018
It is time to renew your Medicaid coverage
Line - Form Display Line - Definition
NATIONAL AVERAGE DRUG ACQUISITION COST (NADAC) REQUEST FOR MEDICAID REIMBURSEMENT REVIEW
Request Electronic Visit Verification Technical Assistance
Requests from States for Good Faith Effort Exemptions- May 2019
Section 12006 of the 21st Century CURES Act Electronic Visit Verification Systems - Session 1: Requirements, Implementation, Considerations, and State Survey Results – December 2017
Section 12006 of the 21st Century CURES Act Electronic Visit Verification Systems Session 2: Promising Practices for States Using EVV – January 2018

Contact Information & Office Locations

1 contact point

Centers for Medicare and Medicaid Services

Address:
7500 Security Boulevard
Baltimore, MD 21244

Phone numbers:
  • (877) 267-2323 (toll free)
  • (410) 786-3000 (local)
  • (800) 877-8339 (TTY)
  • (410) 786-0727 (tyy)
Emails:

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