SSO Report of State Buy-in Problems

Social Security Office (SSO) Report of State Buy-in Problems (CMS-1957)

OMB: 0938-0035

IC ID: 221460

Information Collection (IC) Details

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SSO Report of State Buy-in Problems CMS-1957
 
No Modified
 
Mandatory
 
42 CFR 407.40

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form CMS-1957 SSO Report of State Buy-In Problem CMS-1957-508_UpdatedCleanInstrument.pdf Yes Yes Fillable Fileable

Health Health Care Services

 

3,936 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 3,936 0 0 0 0 3,936
Annual IC Time Burden (Hours) 1,312 0 0 0 0 1,312
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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