OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Report of Medicaid State Office on Beneficiary's Buy-In Status

OMB 3220-0185 · RRB.

OMB 3220-0185

Under the Railroad Retirement Act, the Railroad Retirement Board administers the Medicare program for persons covered by the railroad retirement system. The collection obtains the information needed to determine if certain railroad beneficiaries are entitled to receive Supplemental Medical Insurance program coverage under a state buy-in agreement in states in which they reside.

The latest form for Report of Medicaid State Office on Beneficiary's Buy-In Status expires 2027-01-31 and can be found here.

Latest Forms, Documents, and Supporting Material
Document
Name
Form
Supporting Statement A
All Historical Document Collections
Approved without change
 Revision of a currently approved collection 2023-11-30
Approved without change
 Revision of a currently approved collection 2020-06-23
Approved without change
 Extension without change of a currently approved collection 2017-04-28
Approved without change
 Extension without change of a currently approved collection 2014-03-26
Approved without change
 Extension without change of a currently approved collection 2011-02-22
Approved without change
 Revision of a currently approved collection 2007-12-18
Approved without change
 Extension without change of a currently approved collection 2004-11-08
Approved without change
 Extension without change of a currently approved collection 2001-10-02
Approved without change
 Extension without change of a currently approved collection 1998-07-16
Approved without change
 Extension without change of a currently approved collection 1995-06-26
Approved without change
 New collection (Request for a new OMB Control Number) 1992-07-10