Attachment 2 CMS Advance Letter_Community_English

DEPARTMENT OF HEALTH & HUMAN SERVICES
Centers for Medicare & Medicaid Services
7500 Security Boulevard
Baltimore, Maryland 21244-1850

[Month], [Year]
Dear [R First] [R Last]:
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.
Since 1991, we have conducted an important study called the Medicare Current Beneficiary Survey.
It is the nation’s primary source of information about how Medicare affects the people it serves.
Because we cannot interview everyone on Medicare, we selected a sample of enrollees to represent
all of those on Medicare. You have been selected as a result of a scientific process that ensures all
beneficiaries are represented in the survey.
In order to get an accurate picture of the needs of the Medicare population, we need to meet with all
selected beneficiaries. Through this study, we gather important information that cannot be obtained
in any other way. A few of the topics we would like to discuss with you include: your access to
health care services, your use of health care services, the rising cost of care, and your satisfaction
with the care you received.
As a participant in the study, you will represent thousands of other people similar to you. All of
your information will be strictly confidential as prescribed by The Federal Privacy Act of 1974.
Your participation is voluntary. Let me emphasize that your Medicare benefits cannot be
affected in any way by the answers that you provide, or by whether or not you choose to
participate. I hope you will decide to join us in this important study.
NORC at the University of Chicago, a respected social science research organization, has been
contracted to conduct the study. A professional interviewer will contact you in person or by phone
to setup a visit. If you agree to participate in the study, the interview will take about one hour.
If you have any questions about the study or would like to schedule an appointment to participate in
this important study, please call NORC toll-free at 1-877-389-3429, or email NORC at
[email protected]. Enclosed is a brochure that provides you with more information about the survey.
You can also visit the MCBS respondent website at www.mcbs.norc.org to learn more.
The Medicare Current Beneficiary Survey is important to the future of Medicare. Please help us in
this national effort to improve your Medicare program.
Sincerely,

Walter Stone
CMS Privacy Officer
Enclosure
OMB No. 0938-0568 | Expires 7/31/2017