Attachment 101 -- MPC Hospital Cover Letter

	DEPARTMENT OF HEALTH & HUMAN SERVICES Agency for Healthcare Research and Quality

Dear [FILL PROVIDER NAME]:

We understand that one of our data collection specialists has talked to you about the Medical Provider Component of the Medical Expenditure Panel Survey. We are appreciative of the contributions you and your hospital are providing to this important study that is being conducted for the Agency for Healthcare Research and Quality (AHRQ) and the Centers for Disease Control and Prevention (CDC), both part of the U.S. Department of Health and Human Services. We wanted to take this opportunity to tell you more about the study.

The objective of the study is to provide accurate information to government policymakers and private researchers about the rapidly changing health care situation in this country. To accomplish this goal, we have collected data from a cross-section of American households on how they used and paid for health care during 2009. With the written permission of members of these households, we are now contacting their medical providers to determine the actual dates of service, the diagnoses/conditions, the services provided, the amount that was charged, the amount that was paid, and the sources of payment. One or more of your patients has given us written authorization to request this information from your medical and billing records.

The study materials enclosed with this letter include a list of your patients who have agreed to participate in the survey and an authorization form for each patient.

This survey is authorized by section 902(a) of the Public Health Services Act [42 U.S.C. 299a]. Participation is voluntary, but we are depending on you to help us toward a more complete understanding of the nation’s health care. The patient information we obtain will be used for research purposes only and will be released publicly only in summary form in which establishments or individuals cannot be identified. The confidentiality of patient information is protected by Federal Statute, Section 934(c) and Section 308(d) of the Public Health Service Act [42 U.S.C. 299c-3(c) and 242m(d)] and will be kept private to the extent permitted by law. This law prohibits the release outside of the sponsoring agencies or their contractors of information that would permit identification of a patient or establishment without first obtaining authorization from the patient or establishment who gave the information.

The U.S. Department of Health and Human Services has selected a new data collection team to administer the study - RTI International (RTI) and Social and Scientific Systems, Inc. (SSS).

A Data Collection Specialist from RTI-SSS will call shortly after you have received these materials to see if you have any questions and to arrange for the collection of these data. If you have questions about the forms or procedures, call RTI-SSS, toll-free at [FILL NUMBER: 1-800-XXX-XXXX].

Sincerely,

Carolyn Clancy, M.D. Director Agency for Healthcare Research and Quality	Edward J. Sondik, Ph.D. Director National Center for Health Statistics Centers for Disease Control and Prevention