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

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

OMB: 0938-0193

IC ID: 7877

Documents and Forms

Document Name Document Type
Form CMS-179 State Plan Under Title XIX of the Social Security Act (Base plan pages) Form and Instruction
CMS-179 Transmittal and Notice of Approval of State Plan Materia CMS-179 508 (rev OSORA PRA).pdf Form and Instruction
CMS-179 2.1 - 2.7 (State) Exhibit A 508 (rev OSORA PRA).pdf Form
CMS-179 2.1 - 2.7 (Territory) Exhibit A1 508 (rev OSORA PRA).pdf Form
CMS-179 4.19(a) Exhibit AA 508 (rev OSORA PRA).pdf Form
CMS-179 4.19(e) Exhibit AB 508 (rev OSORA PRA).pdf Form
CMS-179 4.19(f) Exhibit AC 508 (rev OSORA PRA).pdf Form
CMS-179 4.19(g) Exhibit AD 508 (rev OSORA PRA).pdf Form
CMS-179 4.19(h) Exhibit AE 508 (rev OSORA PRA).pdf Form
CMS-179 4.19(i) Exhibit AF 508 (rev OSORA PRA).pdf Form
CMS-179 4.19 (k)(1) Exhibit AG 508 (rev OSORA PRA).pdf Form
CMS-179 Attachment 2.2 A and Supplements 1 - 3 Exhibit D and E 508 (rev OSORA PRA).pdf Form
CMS-179 4.19(b): Attachment 4.19 B Exhibit DP 508 (rev OSORA PRA).pdf Form
CMS-179 (State) Attachment 2.6 A and Supplements 1, 2, 3, 4, 5, Exhibit F and G 508 (rev OSORA PRA).pdf Form
CMS-179 (Territory) Attachment 2.6 A and Supplements 1, 2, 3, 4, Exhibit H and J 508 (rev OSORA PRA).pdf Form
CMS-179 Attachment 4.19-B, Section 24 Exhibit N 508 (rev OSORA PRA).pdf Form
CMS-179 Attachment 4.19 B, Supplement 1 Exhibit O 508 (rev OSORA PRA).pdf Form
CMS-179 4.19(c) Exhibit P 508 (rev OSORA PRA).pdf Form
CMS-179 4.19(d) Exhibit Y Revision 4-9-15 (rev OSORA PRA).pdf Form
CMS-179 4.31, 4.32, 4.33, and 4.34 Exhibits R S T U 508 (rev OSORA PRA).pdf Form