Document Index

Application Form

• Attachment A - RIF Application

Data Management Plan

• Data Management Plan Self-Attestation Questionnaire (DMP SAQ)

Data Use Agreements (DUAs)

• Data Use Agreement (DUA) Signature Addendum
• QE Data Use Agreement (DUA)
• RIF Data Use Agreement (DUA)
• RIF Data Use Agreement (DUA) - Amendment Request
• Update to Existing Data Use Agreement (DUA) - For Qualified Entity (QE) requesters only

Required Approvals

• Evidence of CAHPS Pre-Approval
• Evidence of HEDIS Pre-Approval
• Evidence of HOS Pre-Approval
• Evidence of HRS Approval
• Evidence of NHATS Approval
• IRB Common Rule and HIPAA Waiver Approval

Specifications Worksheets

• QE Specifications Worksheet
• RIF Specifications Worksheet
• State Specifications Worksheet

Supplement Forms

• CMS Innovator Program Supplement
• Collaborating Organization Supplement
• Key Personnel Supplement
• State Agency Supplement

Variable Selection and Justification Worksheets

• Part D Variable Justification Worksheet