Form 1342 Antiviral Agents for Hepatitis C Virus Initial Request " Standard Pa Addendum (Medicaid) - Texas

Notification Icon This version of the form is not currently in use and is provided for reference only. Download this version of Form 1342 for the current year.

Form 1342 Antiviral Agents for Hepatitis C Virus Initial Request " Standard Pa Addendum (Medicaid) - Texas

What Is Form 1342?

This is a legal form that was released by the Texas Health and Human Services - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form 1342?
A: Form 1342 is a document used for requesting antiviral agents for Hepatitis C Virus.

Q: What is the purpose of Form 1342?
A: The purpose of Form 1342 is to request antiviral agents for the treatment of Hepatitis C Virus.

Q: What is an antiviral agent?
A: An antiviral agent is a medication used to treat viral infections, such as Hepatitis C Virus.

Q: What is Hepatitis C Virus?
A: Hepatitis C Virus is a viral infection that affects the liver and can cause liver damage.

Q: Who can use Form 1342?
A: Form 1342 is specifically for Medicaid patients in Texas who need antiviral agents for Hepatitis C Virus.

Q: What is the Standard PA Addendum?
A: The Standard PA Addendum refers to the additional documentation required for the approval of antiviral agents for Hepatitis C Virus treatment under Medicaid in Texas.

ADVERTISEMENT

Form Details:

  • Released on April 1, 2018;
  • The latest edition provided by the Texas Health and Human Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 1342 by clicking the link below or browse more documents and templates provided by the Texas Health and Human Services.

Download Form 1342 Antiviral Agents for Hepatitis C Virus Initial Request " Standard Pa Addendum (Medicaid) - Texas

4.3 of 5 (10 votes)
  • Form 1342 Antiviral Agents for Hepatitis C Virus Initial Request " Standard Pa Addendum (Medicaid) - Texas

    1

  • Form 1342 Antiviral Agents for Hepatitis C Virus Initial Request " Standard Pa Addendum (Medicaid) - Texas, Page 2

    2

  • Form 1342 Antiviral Agents for Hepatitis C Virus Initial Request " Standard Pa Addendum (Medicaid) - Texas, Page 3

    3

  • Form 1342 Antiviral Agents for Hepatitis C Virus Initial Request " Standard Pa Addendum (Medicaid) - Texas, Page 4

    4

  • Form 1342 Antiviral Agents for Hepatitis C Virus Initial Request " Standard Pa Addendum (Medicaid) - Texas, Page 5

    5

  • Form 1342 Antiviral Agents for Hepatitis C Virus Initial Request " Standard Pa Addendum (Medicaid) - Texas, Page 6

    6

  • Form 1342 Antiviral Agents for Hepatitis C Virus Initial Request  Standard Pa Addendum (Medicaid) - Texas, Page 1
  • Form 1342 Antiviral Agents for Hepatitis C Virus Initial Request  Standard Pa Addendum (Medicaid) - Texas, Page 2
  • Form 1342 Antiviral Agents for Hepatitis C Virus Initial Request  Standard Pa Addendum (Medicaid) - Texas, Page 3
  • Form 1342 Antiviral Agents for Hepatitis C Virus Initial Request  Standard Pa Addendum (Medicaid) - Texas, Page 4
  • Form 1342 Antiviral Agents for Hepatitis C Virus Initial Request  Standard Pa Addendum (Medicaid) - Texas, Page 5
  • Form 1342 Antiviral Agents for Hepatitis C Virus Initial Request  Standard Pa Addendum (Medicaid) - Texas, Page 6
Prev 1 2 3 4 5 6 Next
ADVERTISEMENT