The letter was sent to the beneficiary to advise that the MSPRC will not accept payment in monthly installments
What the letter means
The full amount of the overpayment plus any accrued interest must be paid to Medicare
A check should be sent to the MSPRC for the "total amount due" as quoted in the letter. If you have previously mailed a payment you will receive a letter acknowledging that payment has been applied to the debt and further advise you of any debt owed to Medicare. If a refund is due you will receive a check in a subsequent mailing.