Attachment 9 IDEAL CMS Mailing Materials

Attachment 9 IDEAL CMS Mailing Materials.pdf

Recruitment and Screening for the Insight into Determination of Exceptional Aging and Longevity (IDEAL) Study (NIA)

Attachment 9 IDEAL CMS Mailing Materials

OMB: 0925-0631

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Attachment 9: IDEAL CMS Mailing Materials
Westat received approval from the CMS to send study materials to beneficiaries in order to invite them
to call in and be screened for IDEAL. Under the CMS process, the CMS Beneficiary Contact Service first
sends a letter of notification alerting recipients that they have be selected to receive a study mailing and
enabling them to opt out of receiving the mailing (Attachment 9a). Those who do not opt out within
three weeks are sent a study mailing comprising the following: a cover letter (Attachment 9b), insert
summarizing the IDEAL eligibility criteria (“Who can participate?”) (Attachment 9c), and Return Mail
Postcard (Attachment 9d).

[CMS Letterhead]


Dear : Sometimes researchers want people with Medicare to participate in research studies. These studies often help doctors and researchers find better ways to operate the Medicare program, or prevent, diagnose, or treat specific diseases. You have the opportunity to participate in one of these studies. You do not have to take part in this study. Your decision to take part or not to take part in this study will have no affect on your Medicare benefits. All information you provide is protected by the Privacy Act of 1974 (U.S.C. 552a). The Centers for Medicare and Medicaid Services (CMS) administers the Medicare program. CMS is cooperating with the National Institute on Aging regarding a study to learn more about the health care experiences and needs of older people. This study involves Medicare beneficiaries because they are in the age range needed for this research. You are one of approximately 44 million Americans with health insurance under the Medicare program. You are eligible to participate in this study because you are of the age to have Medicare coverage. If you do not want to participate in the study, mark the enclosed reply form that you do not want to be contacted and mail it back in the enclosed postage paid envelope. Medicare will make sure that if you do not want to participate in the study your name will be removed from the list. You can also call Todd Rockwood at Beneficiary Contact Services at the University of Minnesota (1-800-874-8636) if you have any questions about the study that may help you decide if you want to participate. If you want to talk to Medicare directly about this letter, please call 1-800-MEDICARE (1-800-633-4227). You can speak to a Customer Service Representative in English or Spanish. TTY users should call 1-877-486-2048. If the Beneficiary Contact Services at the University of Minnesota does not hear from you within 3 weeks from the date of this letter, then research staff from the National Institute on Aging will contact you about participating in the study. The National Institute on Aging will mail you a letter introducing the study and inviting you to call the study number or return the reply postcard to learn more about the study. When you receive the letter and reply postcard in the mail, you can still decide whether to take part in the study. If you want to take part in the study you should call or mail the completed reply postcard back to the National Institute on Aging. You will be contacted by telephone by the National Institute on Aging if you return a reply postcard, but you do not have to answer their questions. When you are called, you can still decide whether or not to take part in the study. Sincerely, Walter Stone CMS Privacy Officer [First Name] [Last Name] [Address 1] [City] [ST] [Zipcode] Dear [Title]. [Last Name] The National Institute on Aging, part of the National Institutes of Health, is sponsoring a study called the Insight into Determinants of Exceptional Aging and Longevity (IDEAL) Study. The purpose of IDEAL is to find out what is unique about people who live to be 80, 90 and older without significant physical or cognitive health problems. Identifying the differences between people who age in extraordinarily good health and other people of the same age, may lead to discoveries that will improve health outcomes as we get older. In order to unlock the secrets of “exceptional” aging, IDEAL is looking for healthy, active seniors, age 80 and older. Enclosed, is a fact sheet that provides further details about the study. Please look at the “Who Can Participate?” sheet in this package to determine whether you might be eligible. Unlike research projects involving illnesses, the IDEAL study is looking at wellness. There are no drugs or experimental procedures involved. If you qualify to be in IDEAL, every year you will receive a comprehensive physical exam, including tests of strength, stamina, and mental sharpness. Participation in this study is voluntary and there are no penalties for not participating. You may withdraw from the study at any time. Participation will not influence your relationship with any federal program such as Social Security or Medicare. All of the information you provide will be kept confidential as required by the law and will not be disclosed to anyone but the researchers conducting this study. No names or other identifying information will appear in any report of the study. The information will be combined for all study participants and reported as statistical summaries. If you have reviewed the enclosed information and think you may be eligible for this important health study, please return the enclosed postage-paid reply card, or call toll-free to speak to a study coordinator at 1-855-80 IDEAL (1-855-804-3325). If you have questions, feel free to contact us toll-free at our toll-free number or email us at IDEAL@westat.com. Sincerely, Luigi Ferrucci, MD, PhD Director and Principal Investigator Insight into the Determinants of Exceptional Aging and Longevity (IDEAL) National Institute on Aging National Institutes of Health [IDEAL Logo] WHO CAN PARTICIPATE? You may be eligible to participate in IDEAL if:  You are 80 years or older  You can walk a quarter mile without pain or shortness of breath  You have no severe memory or cognitive issues  You have no major medical conditions, such as: − Diabetes − Heart disease (heart attack, stents, or heart surgeries) − Chronic neurologic, gastrointestinal, kidney, liver, or musculoskeletal diseases or disorders − Cancer (active or recent history) − TIA or stroke − Mental illness  You have no medical conditions that require chronic drug treatment (NOTE: Drugs to treat high blood pressure, cholesterol, and osteoporosis are OK) Eligibility for IDEAL is determined with a preliminary telephone interview, followed by a physical exam and cognitive assessment at MedStar Harbor Hospital in Baltimore (transportation provided). For more information or to apply to IDEAL, Call toll-free at 1-855 80 IDEAL (1-855-804-3325). IDEAL CMS MAILING POSTCARD CONTENT FRONT Dear Friend: You have been invited to be part of the Insight into Determinants of Exceptional Aging and Longevity (IDEAL) Study – an important health study that will observe the aging process and identify the secrets of aging well. Identifying the differences between people who age in extraordinarily good health and other people of the same age may lead to discoveries to improve health outcomes as we get older. Thank you for your interest, Luigi Ferrucci, MD, PhD Principal Investigator BACK If you think you may be eligible for IDEAL and are interested in this important health study, please complete and mail back this card. No postage is needed. We will call you to answer any questions you may have. RETURNING THIS CARD WILL NOT OBLIGATE YOU IN ANY WAY. Please print your name, address, and the telephone number where you can be reached in the coming year. NAME ______________________________________________________________ STREET ____________________________________________________________ CITY _____________________________ STATE ___________ ZIP__________ HOME PHONE __________________ CELL PHONE __________________ BEST TIME TO CALL __________________ AM __________________ PM
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AuthorKate Torres
File Modified2014-05-05
File Created2014-02-25

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