OMB control number
[Medicaid] State Collection and Reporting of Dental Provider and Benefit Package Information on the Insure Kids Now! Website and Hotline (CMS-10291)
OMB 0938-1065 · HHS/CMS.
OMB 0938-1065
Section 501 of CHIPRA required the Secretary to work with States, pediatric dentists, and other dental providers to include, no later than August 4, 2009, on the Insure Kids Now (IKN) website (http://www.insurekidsnow.gov/) and hotline (1-877-KIDS-NOW), a current and accurate list of all such dentists and providers within each State that provide dental services to children enrolled in the State plan (or waiver) under Medicaid or the State child health plan (or waiver) under CHIP, and that States update the information on the dental providers quarterly and the information on their benefit package annually thereafter. CMS works closely with the Health Resources Services Administration (HRSA), which administers the IKN website, to implement this provision of CHIPRA. Collection of data from States commenced in 2009.
The latest form for [Medicaid] State Collection and Reporting of Dental Provider and Benefit Package Information on the Insure Kids Now! Website and Hotline (CMS-10291) expires 2027-08-31 and is listed under ICR 202404-0938-021.
Latest Forms, Documents, and Supporting Material
| Document | Type |
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| Form | |
| Form and Instruction | |
| Supporting Statement A | |
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All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202404-0938-021 | Revision of a currently approved collection | 2024-04-25 | Approved without change | |
| 202101-0938-010 | Revision of a currently approved collection | 2021-01-27 | Approved without change | |
| 201801-0938-006 | Revision of a currently approved collection | 2018-01-23 | Approved with change | |
| 201411-0938-011 | Revision of a currently approved collection | 2014-12-03 | Approved with change | |
| 201111-0938-006 | Revision of a currently approved collection | 2011-11-08 | Approved without change | |
| 201001-0938-006 | Extension without change of a currently approved collection | 2010-01-25 | Approved without change | |
| 200906-0938-016 | New collection (Request for a new OMB Control Number) | 2009-06-30 | Approved without change |
OMB Details
Collection of Dental Provider Information
Federal Enterprise Architecture: Health - Health Care Services
| Form | Name | Electronic access | Type |
|---|---|---|---|
| Form CMS-10291 | IKN Dental Provider Data Submission Technical Information | Fillable Printable | Form and instruction |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.