This two-part Form CMS-L328 (CMS-L328A) (Notice of Termination of Medical Insurance
Benefits) will be generated for INTPSC when insured beneficiaries in suspense status
or uninsured beneficiaries request termination of medical insurance coverage. The
Form CMS-L328 will be sent to the beneficiary and Form CMS-L328A (not shown) will
be filed on the left side of the folder for documentation. The form is printed and
released from INTPSC.
NOTE: All other program
service centers and ODO see Form CMS-L326.