The letter was sent as a second request for repayment of a debt due the Medicare program.
What the letter means
If the debt is not fully resolved within 60 days, the matter will be referred to the Department of Treasury for further recovery action.
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.