State Plan Under Title XIX of the Social Security Act (Base plan pages, Attachments, Supplements to Attachments) (CMS-179)

ICR 201902-0938-011

OMB: 0938-0193

Federal Form Document

Forms and Documents
IC Document Collections
ICR Details
0938-0193 201902-0938-011
Active 201506-0938-016
HHS/CMS CMCS
State Plan Under Title XIX of the Social Security Act (Base plan pages, Attachments, Supplements to Attachments) (CMS-179)
Reinstatement without change of a previously approved collection   No
Regular
Approved without change 04/09/2019
Retrieve Notice of Action (NOA) 02/26/2019
  Inventory as of this Action Requested Previously Approved
04/30/2022 36 Months From Approved
1,120 0 0
22,400 0 0
0 0 0

The Medicaid State base plan pages and attachments are documents utilized by State and territorial agencies which have the responsibility for administering the Medicaid program. The Medicaid State plan is comprised of "pages" and organized by subject matter which include Medicaid eligibility (Section 2), services (Section 3), payment for services (Section 4), and general, financial and personnel administration (Sections 1, 5, 6, 7). When States or territories seek to change selected pages of their State plans, the page(s) are transmitted to the Centers for Medicare & Medicaid Services (CMS) for review and approval by the CMS Central and Regional Offices prior to amending its State plan. Associated with the "CMS-179", a one page cover page that is included in every State plan amendment, the base State plan pages contain approximately 150 documents, and the Attachments and Supplements contain approximately 500 documents that correspond to implementing regulations in the CFR and statutes in the Social Security Act. The base and plan page documents have the same OMB approval number as the CMS-179. The present revision of the current collection is to revise and update selected pages to comply with Federal laws and regulations.

US Code: 42 USC 1936 Name of Law: Social Security Act
  
None

Not associated with rulemaking

  83 FR 60873 11/27/2018
84 FR 5446 02/21/2019
No

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,120 0 0 0 0 1,120
Annual Time Burden (Hours) 22,400 0 0 0 0 22,400
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$333,043
No
    No
    No
No
No
No
Uncollected
Mitch Bryman 410 786-5258 Mitch.Bryman@cms.hhs.gov

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
02/26/2019


© 2024 OMB.report | Privacy Policy