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Filing Medicare Managed Care Appeals

Appeals for denials of items/services must be sent to Maximus Federal Services directly from the Medicare Health Plan.  Maximus Federal Services does not accept appeals sent to us directly from Medicare Health Plan Enrollees, Providers, or Representatives. The only exception to this is if a party wishes to appeal a Medicare Health Plan’s Notice of Dismissal of Appeal Request.

How to File An Appeal

How to File an Appeal of a Medicare Health Plan's Notice of Dismissal of Appeal Request:

These requests must be filed with Maximus Federal Services and must be submitted in writing in one of the following ways:

  • Via secure fax to 585-425-5292
  • Via mail to the following address: Maximus Federal Services, Inc.
    Medicare Managed Care & PACE Reconsideration Project
    3750 Monroe Avenue, Suite 702
    Pittsford, NY 14534-1302

In addition, if a party wishes to request an appeal of a Medicare Health Plan’s Notice of Dismissal of Appeal request, the request must include the following:

  • A copy of the Notice of Dismissal of Appeal Request
  • Any supporting documentation or information regarding your request
  • Any representative documentation (i.e., Appointment of Representation forms, Powers of Attorney, etc.) that may be applicable

Medicare Health Plans options for sending appeal cases to Maximus Federal Services include the following:

  • QIC Appeal Portal at https://qicappeals.cms.gov

    QIC Appeals Portal

  • Via mail to the following address:Maximus Federal Services, Inc.
    Medicare Managed Care & PACE Reconsideration Project
    3750 Monroe Avenue, Suite 702
    Pittsford, NY 14534-1302

Request a Duplicate Copy of a Decision Letter

If you’d like to request a copy of a decision letter, please click here to submit a request.