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OMB Control No: 0938-1065	ICR Reference No: 200906-0938-016
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: CHIPRA 2009, Dental Provider and Benefit Information Posted on Insure Kids Now! Website
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR: No
Type of Review Request: Emergency	Approval Requested By: 07/01/2009
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/06/2009
	Date Received in OIRA: 06/30/2009
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2010	6 Months From Approved
Responses	255	0	0
Time Burden (Hours)	9,180	0	0
Cost Burden (Dollars)	0	0	0

Abstract: Section 501 of CHIPRA requires 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. Section 501 also requires the Secretary shall ensure that such a list is updated at least quarterly and includes a description of the dental services provided under Medicaid or CHIP, whether the services are provided through a state plan or a waiver. The Secretary shall also post on the IKN website State specific information on available dental benefits. CMS is working closely with the Health Resources Services Administration (HRSA), which administers the IKN website, to implement this provision of CHIPRA within the statutory deadline of August 4, 2009, 6 months after the February 4, 2009 date of enactment. This PRA request is to allow the States to begin to collect the information on the dental providers and dental benefits in accordance with CHIPRA.

Emergency Justfication: Please see the attached Emergency Justification document.

Authorizing Statute(s): PL: Pub.L. 111 - 3 501 Name of Law: Children's Health Insurance Program Reauthorization Act of 2009

Citations for New Statutory Requirements: PL: Pub.L. 111 - 3 501 Name of Law: Children's Health Insurance Program Reauthorization Act of 2009

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 29700	06/23/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 29700	06/23/2009
Did the Agency receive public comments on this ICR? No

Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Collection of Dental Benefit Information
Collection of Dental Provider Information

ICR Summary of Burden

	Total Approved	Change Due to New Statute
Annual Number of Responses	255	255
Annual Time Burden (Hours)	9,180	9,180
Annual Cost Burden (Dollars)	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new information collection.

Annual Cost to Federal Government: $52,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

Agency Contact: Melissa Musotto 4107866962

View ICR - OIRA Conclusion