Obtain a Copy Of Your Case File

Every Medicare enrollee is entitled to a copy of his or her case file under the Freedom of Information Act and/or the Privacy Act of 1974. If you would like a copy of your file, please send your request to MAXIMUS Federal Services. MAXIMUS Federal Services will then send you the required forms to process the request.  

Drug Benefit Appeals LEP Appeals
MAXIMUS Federal Services
Part D QIC-Drug Appeals
3750 Monroe Avenue, Suite 703
Pittsford, NY 14534-1302
MAXIMUS Federal Services
Part D QIC-LEP Appeals
3750 Monroe Avenue, Suite 704
Pittsford, NY 14534-1302
Toll-Free Numbers:
Phone: (877) 456-5302
Fax: (866) 825-9507
Toll-Free Numbers:
Phone: (877) 456-5302
Fax: (866) 589-5241

 “Privacy Act Request” is defined as a request made by an individual for documents or information regarding an individual maintained within a system of records by a federal government agency or contractor. Examples of Privacy Act requests include: a) Enrollee requesting copy of his/her case file, and b) the Legal guardian of enrollee requesting a copy of enrollee’s case file.

 “FOIA Request” is defined as a request for records related to work for a federal agency or for information on an individual other than the requestor. Examples of a FOIA request include: a) a researcher looking for specific information such as number of appeals brought by individuals in Monroe County, New York, or b) a Medicare Part D Plan requesting a copy of one of its enrollee’s case file

 Click on the following links for more information:

 Privacy Act of 1974

 Freedom of Information Act

 Standards for Privacy of Individually Identifiable Health Info

For information about the availability of auxiliary aids and services, please visit:
http://www.medicare.gov/about-us/nondiscrimination/nondiscrimination-notice.html

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