State and Local Governments

Appendix D.6: State Cost Survey Follow Up Interview Email

OMB #: 0584-xxxx

Expiration Date: xx/xx/20xx

From: Joshua Leftin
Sent: [DATE]
To: [STATE CN OR MEDICAID REPRESENTATIVE]
Cc: Anne Gordon
Subject: DC-Medicaid Evaluation Cost Survey Request – [STATE]

Greetings. Thank you for your participation in the DC-Medicaid Evaluation Cost Survey. Please let me know if you will be available on [DATE] at [TIME] for a telephone call. The purposes of the phone call are to follow up on your responses (clarifying any questions we have) and to give you a chance to provide feedback (so that we can make the workbook easier to use in future quarters).

You may want to review your responses before the call.

Thanks,

Josh

_____________
Joshua Leftin
Research Analyst
Mathematica Policy Research
1100 1st Street, NE, 12th Floor
Washington, D.C.  20002-4221
Tel:  202-250-3531
Fax: 202-863-1763

[email protected]

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-XXXX. The time required to complete this information collection is estimated to average 2 minutes per response.

D.1