CMS-179 4.19(g)

Medicaid State Plan Base Plan Pages (CMS-179)

Exhibit AD 508 (2021 version 1)

State Plan Under Title XIX of the Social Security Act (Base plan pages)

OMB: 0938-0193

Document [pdf]
Download: pdf | pdf
Form Approved CMS-179
OMB No. 0938-0193
63
Revision:

HCFA-AT-80-38(BPP)
May 22, 1980
State:

Citation
42 CFR 447.201
42 CFR 447.202
AT-78-90

4.19(g)The Medicaid agency assures appropriate
audit of records when payment is based on
costs of services or on a fee plus
cost of materials.

______________________________________________________________________________
TN No.
Supersedes
Approval Date
Effective Date
TN No.
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collectio n of information unless it displays a valid OMB control number.
The valid OMB number for this information collection is 0938-0193 (Expires: TBD). The time required to complete this information collection is estimated to
average 1 hour per response, including the time to review instructions, searching existing data resources, gather the data needed, and complete and review the
information colle ction. If

you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please writ e to: CMS, Attn: PRA Reports Clearance
Officer, 7500 Security Boulevard, Baltimore, Maryland 21224-1850.


File Typeapplication/pdf
AuthorCMS
File Modified2021-03-05
File Created2018-09-21

© 2024 OMB.report | Privacy Policy