Advance Letter

04-CMS Advance Letter with letterhead.pdf

Medicare Current Beneficiary Survey (MCBS)

Advance Letter

OMB: 0938-0568

Document [pdf]
Download: pdf | pdf
DEPARTMENT OF HEALTH & HUMAN SERVICES

Centers for Medicare & Medicaid Service

Administrator
Washington, DC 20201

The Centers for Medicare and Medicaid Services (CMS), part of the U.S. Department of Health and
Human Services, would like you to help us better understand the needs of Americans enrolled in
Medicare.
We are conducting an important ongoing study, the Medicare Current Beneficiary Survey, which is
one of the Nation’s primary sources of information about how Medicare affects the people it serves.
We gather information on more than 16,000 Medicare enrollees who have been scientifically selected
to represent all Medicare beneficiaries.
We have chosen you as a result of our sampling. Your participation, however, is voluntary. Let me
emphasize that your Medicare benefits will not be affected in any way by the answers that you
provide, or by whether or not you participate.
I hope you will decide to join us in this important study. You will represent thousands of other people
similar to you. All of your information will be strictly confidential. Information is protected by The
Federal Privacy Act of 1974.
Westat, Inc., (a research company in Rockville, Maryland) has been contracted to conduct the study.
A professional interviewer will visit you within the next few weeks. If you agree to participate in the
study, the interview will take about 1 hour of your time. Enclosed is a brochure that provides more
information about the study.
If you have any questions about the study, please call Westat Inc., at 1-800-937-8286 (toll free)
between 9:00 a.m. and 5:00 p.m. Eastern Standard Time.
The Medicare Current Beneficiary Survey is important. Please help us in this national effort to
improve your Medicare program.
Sincerely,

Mark B. McClellan, M.D., Ph.D
Administrator
Centers for Medicare & Medicaid Services

Enclosure


File Typeapplication/pdf
File TitleMicrosoft Word - 2006 CMS Community Advance Letter with letterhead.doc
Authormf46
File Modified2006-10-26
File Created2006-10-26

© 2024 OMB.report | Privacy Policy