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

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 2022-11-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form CMS-1957 SSO Report of State Buy-in Problems Form
CMS-1957.Supporting Statement Part A (30-day).docx Supporting Statement A
SSO Report of State Buy-in Problems Form

All Historical Document Collections

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