CMS-179 4.19(h)

Medicaid State Plan Base Plan Pages (CMS-179)

Exhibit AE 508 (2021 version 1)

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

OMB: 0938-0193

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Form Approved CMS-179
OMB No. 0938-0193
64
Revision:

HCFA-AT-80-60 (BPP)
August 12, 1980
State:

Citation
42 CFR 447.201
42 CFR 447.203
AT-78-90

4.19(h)The Medicaid agency meets the requirements
of 42 CFR 447.203 for documentation and
availability of payment rates.

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AuthorCMS
File Modified2021-03-05
File Created2018-09-21

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