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.

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
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

Information collection instruments
FormNameElectronic accessType
Form CMS-10291IKN Dental Provider Data Submission Technical InformationFillable PrintableForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.