Medicaid State Plan Base Plan Pages (CMS-179)

ICR 202409-0938-017

OMB: 0938-0193

Federal Form Document

Forms and Documents
IC Document Collections
ICR Details
0938-0193 202409-0938-017
Received in OIRA 202108-0938-008
HHS/CMS CMCS
Medicaid State Plan Base Plan Pages (CMS-179)
Extension without change of a currently approved collection   No
Regular 09/16/2024
  Requested Previously Approved
36 Months From Approved 09/30/2024
1,120 1,120
22,400 22,400
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

  89 FR 54002 06/28/2024
89 FR 71283 09/03/2024
No

  Total Request 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 1,120 0 0 0 0
Annual Time Burden (Hours) 22,400 22,400 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$405,149
No
    No
    No
No
No
No
No
Mitch Bryman 410 786-5258 [email protected]

  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.
09/16/2024


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