OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

[Medicaid] Annual Report on §1915(c) Home and Community-Based Services Waivers (CMS-372(S))

OMB 0938-0272 · HHS/CMS.

OMB 0938-0272

States with an approved waiver under section 1915 (c) of the act are required to submit a report annually in order for CMS to: (1) Verify that State assurances regarding waiver cost-neutrality are met, and (2) determine the waiver's impact on the type, amount, and cost of services provided under the State Plan and health welfare of recipients.

The latest form for [Medicaid] Annual Report on §1915(c) Home and Community-Based Services Waivers (CMS-372(S)) expires 2028-06-30 and can be found here.

Latest Forms, Documents, and Supporting Material
Document
Name
Form
Supplementary Document
Supporting Statement A
All Historical Document Collections
 Revision of a currently approved collection 2024-09-20
Approved without change
 Revision of a currently approved collection 2021-10-21
Approved without change
 Revision of a currently approved collection 2018-06-29
Approved without change
 Extension without change of a currently approved collection 2015-05-26
Approved without change
 Reinstatement without change of a previously approved collection 2012-04-09
Approved without change
 Revision of a currently approved collection 2009-01-30
Approved without change
 Extension without change of a currently approved collection 2006-07-12
Approved without change
 Revision of a currently approved collection 2003-11-12
Approved without change
 Extension without change of a currently approved collection 2001-06-25
Approved without change
 Reinstatement without change of a previously approved collection 1998-06-17
Approved without change
 Revision of a currently approved collection 1995-11-28
Approved without change
 Extension without change of a currently approved collection 1992-10-21
Approved without change
 Revision of a currently approved collection 1991-08-29
Approved without change
 Revision of a currently approved collection 1988-08-30
Approved without change
 Reinstatement with change of a previously approved collection 1985-10-02
Approved without change
 Reinstatement with change of a previously approved collection 1985-03-22
Withdrawn
 Reinstatement without change of a previously approved collection 1985-01-11
Approved with change
 No material or nonsubstantive change to a currently approved collection 1984-09-28
Approved with change
 No material or nonsubstantive change to a currently approved collection 1984-08-13
Approved without change
 New collection (Request for a new OMB Control Number) 1982-12-02