[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

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 2021-06-30 and can be found here.

OMB Details

Collection of Dental Provider Information

Federal Enterprise Architecture: Health - Health Care Services

Form CMS-10291Provider Data Submission Technical InformationFillable PrintableForm and instruction

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


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