A 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 written request to Maximus.

You may use the attached form to make your written request. Privacy Act Request Form

The Privacy Act of 1974 can be accessed through the CMS website at http://www.hhs.gov/foia/privacy/.

Information regarding the Freedom of Information Act can be accessed through the CMS website at https://www.cms.gov/About-CMS/Agency-Information/Aboutwebsite/FOIA.html.

Information regarding the Standards for Privacy of Individually Identifiable Health Info can be accessed through the HHS website at http://www.hhs.gov/ocr/privacy/.