OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

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

OMB 0938-0035 · HHS/CMS.

OMB 0938-0035

The CMS-1957 is issued to facilitate communications among the Social Security District Offices, Medicaid State Agencies and CMS Central Office in the resolution of beneficiary entitlement under State Buy-in. It's used when a problem arises which cannot be resolved through the normal data exchange.

The latest form for Social Security Office (SSO) Report of State Buy-in Problems (CMS-1957) expires 2029-07-31 and is listed under ICR 202605-0938-017.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form CMS-1957 SSO Report of State Buy-In Problem (email-based template and instructions)Form and Instruction
CMS-1957 - Supporting Statement Part A (2026 version 10).docxSupporting Statement A
SSO Report of State Buy-in Problems Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202605-0938-017 Revision of a currently approved collection 2026-05-29
202212-0938-008 Reinstatement without change of a previously approved collection 2022-12-07 Approved without change
201908-0938-014 Reinstatement without change of a previously approved collection 2019-08-29 Approved without change
201808-0938-011 No material or nonsubstantive change to a currently approved collection 2018-08-24 Approved without change
201605-0938-009 Extension without change of a currently approved collection 2016-05-12 Approved with change
201305-0938-008 Reinstatement without change of a previously approved collection 2013-05-16 Approved without change
200912-0938-004 Reinstatement without change of a previously approved collection 2009-12-10 Approved without change
200606-0938-006 Extension without change of a currently approved collection 2006-06-21 Approved without change
200305-0938-003 Extension without change of a currently approved collection 2003-05-14 Approved without change
200004-0938-007 Extension without change of a currently approved collection 2000-04-26 Approved without change
199706-0938-016 No material or nonsubstantive change to a currently approved collection 1997-06-24 Approved without change
199703-0938-006 Reinstatement without change of a previously approved collection 1997-03-28 Approved without change
199309-0938-003 Reinstatement with change of a previously approved collection 1993-09-08 Approved without change
199006-0938-002 Reinstatement with change of a previously approved collection 1990-06-18 Approved without change
198604-0938-010 Revision of a currently approved collection 1986-04-16 Approved without change
198304-0938-004 Revision of a currently approved collection 1983-04-26 Approved without change
197808-0938-006 No material or nonsubstantive change to a currently approved collection 1978-08-04 Approved with change
197806-0938-001 Revision of a currently approved collection 1978-06-16 Approved without change
197802-0938-004 No material or nonsubstantive change to a currently approved collection 1978-02-01 Approved with change
197712-0938-005 No material or nonsubstantive change to a currently approved collection 1977-12-06 Approved with change
197710-0938-001 Revision of a currently approved collection 1977-10-14 Approved without change