OMB control number

Medicaid State Plan Base Plan Pages (CMS-179)

OMB 0938-0193 ยท HHS/CMS.

OMB 0938-0193

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.

The latest form for Medicaid State Plan Base Plan Pages (CMS-179) expires 2028-03-31 and is listed under ICR 202409-0938-017.

Latest Forms, Documents, and Supporting Material

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202409-0938-017 Extension without change of a currently approved collection 2024-09-16
202108-0938-008 Revision of a currently approved collection 2021-08-25 Approved without change
201902-0938-011 Reinstatement without change of a previously approved collection 2019-02-26 Approved without change
201506-0938-016 Revision of a currently approved collection 2015-06-30 Approved without change
201305-0938-023 No material or nonsubstantive change to a currently approved collection 2013-05-28 Approved without change
201203-0938-014 Revision of a currently approved collection 2012-03-29 Approved with change
200902-0938-006 Revision of a currently approved collection 2009-02-09 Approved without change
200711-0938-009 No material or nonsubstantive change to a currently approved collection 2007-11-19 Approved without change
200707-0938-007 Extension without change of a currently approved collection 2007-07-25 Approved without change
200405-0938-004 Extension without change of a currently approved collection 2004-05-10 Approved without change
200104-0938-002 Extension without change of a currently approved collection 2001-04-02 Approved without change
199802-0938-007 Revision of a currently approved collection 1998-02-25 Approved without change
199501-0938-005 Revision of a currently approved collection 1995-01-30 Approved without change
199112-0938-004 Revision of a currently approved collection 1991-12-18 Approved without change
199106-0938-006 Reinstatement with change of a previously approved collection 1991-06-13 Approved without change
198702-0938-004 Revision of a currently approved collection 1987-02-27 Approved without change
198508-0938-014 Revision of a currently approved collection 1985-08-28 Disapproved and continue
198410-0938-008 Revision of a currently approved collection 1984-10-26 Approved without change
198408-0938-013 Revision of a currently approved collection 1984-08-17 Approved without change
198301-0938-005 Revision of a currently approved collection 1983-01-17 Approved without change
198210-0938-004 Revision of a currently approved collection 1982-10-19 Approved without change
198110-0938-001 Revision of a currently approved collection 1981-10-13 Approved without change
198109-0938-004 Revision of a currently approved collection 1981-09-24 Approved without change
198109-0938-002 New collection (Request for a new OMB Control Number) 1981-09-15 Approved without change