Information Collection Request
[Medicaid] State Collection and Reporting of Dental Provider and Benefit Package Information on the Insure Kids Now! Website and Hotline (CMS-10291)
ICR 202404-0938-021 · OMB 0938-1065 · Received in OIRA
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form CMS-10291 Collection of Dental Benefit Information |
Form | Unchanged | Repair queued |
| Form CMS-10291 Collection of Dental Provider Information |
Form and Instruction | Modified | Repair queued |
 CMS-10291 - Supporting Statement A (2024 version 5).docx |
Supporting Statement A | Uploaded 2024-04-25 | Repair queued |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 189779 |  Collection of Dental Benefit Information |
Form | Unchanged | |
| 189778 | Collection of Dental Provider Information |
Form and Instruction | Modified |
ICR Details
| Status | Received in OIRA |
|---|---|
| Agency/Subagency | HHS/CMS |
| OMB Control No | 0938-1065 |
| Type of Information Collection | Revision of a currently approved collection |
| Previous ICR Reference No | 202101-0938-010 |
| Agency Tracking No | CMCS |
| Date Submitted to OIRA | 1969-12-31 |
| Requested Expiration Date | 1969-12-31 |