OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

[Medicaid] Income and Eligibility Verification System Reporting and Supporting Regs. (CMS-R-74)

OMB 0938-0467 · HHS/CMS.

OMB 0938-0467

This collection is necessary to verify income and eligibility requirements for Medicaid recipients, as required by Section 1137 of the Social Security Act.

The latest form for [Medicaid] Income and Eligibility Verification System Reporting and Supporting Regs. (CMS-R-74) expires 2029-04-30 and is listed under ICR 202511-0938-019.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form CMS-R-74 Attachment 4.32-A: Income and Eligibility Verification System (IEVS) - PARIS SPA TemplateForm
Form CMS-R-74 Income and Eligibility Verification System Reporting and Supporting Regs.Form
CMS-R- 74 - Supporting Statement A (2025 version 5).docxSupporting Statement A
Comment - mhp-5qux-oqz7.pdf (document unavailable)Public Comments
Comment - mfl-82f8-lubf.pdfPublic Comments
CMS-R-74 comment response.docxSupplementary Document
CMS-R-74 comment response.docx Supplementary Document
Income and Eligibility Verification System Reporting and Supporting Regs. Form
Income and Eligibility Verification System Reporting and Supporting Regs. Form

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202511-0938-019 Extension without change of a currently approved collection 2025-11-26
202204-0938-011 Extension without change of a currently approved collection 2022-04-29 Approved without change
201901-0938-001 Extension without change of a currently approved collection 2019-01-29 Approved without change
201506-0938-014 Extension without change of a currently approved collection 2015-06-29 Approved with change
201203-0938-013 Revision of a currently approved collection 2012-03-28 Approved without change
200903-0938-001 Extension without change of a currently approved collection 2009-03-10 Approved without change
200601-0938-007 Extension without change of a currently approved collection 2006-01-17 Approved without change
200207-0938-011 Extension without change of a currently approved collection 2002-07-30 Approved without change
199909-0938-012 No material or nonsubstantive change to a currently approved collection 1999-09-30 Approved without change
199903-0938-003 Extension without change of a currently approved collection 1999-03-16 Approved without change
199602-0938-008 Reinstatement without change of a previously approved collection 1996-02-16 Approved without change
199207-0938-012 Reinstatement with change of a previously approved collection 1992-07-31 Approved without change
198904-0938-009 Revision of a currently approved collection 1989-04-06 Approved without change
198602-0938-004 New collection (Request for a new OMB Control Number) 1986-02-28 Approved without change