How to File a CMS FOIA Request
Step 1 -In order to make a FOIA request, simply e-mail FOIA_Request@cms.hhs.gov or write to the CMS FOIA Office or the appropriate CMS Regional Office. The addresses and fax numbers for the CMS FOIA Office and the addresses, fax numbers, and e-mail addresses for the CMS Regional Offices are available at the "Where to File" link below.
Step 2 -For the quickest possible handling, please mark both your letter and the envelope "Freedom of Information Act Request." You should identify the records that you seek as specifically as possible in order to increase the likelihood that the CMS will be able to locate them. Any facts that you can furnish about the time, place, authors, events, subjects, and other details of the records will be helpful to us in deciding where to search for the records that you seek. We have provided several sample FOIA request letters that you may want to use as a guide based on the type of information you are requesting from CMS.
Step 3 -Please note that if you are requesting medical records for someone other than yourself, you will need to complete a Medicare Authorization To Disclose Personal Health Information form along with your request. The Health Insurance Portability and Accountability Act (HIPAA) authorization form can be found in "Downloads" as Medicare Authorization To Disclose Personal Health Information. If the individual signing the valid authorization is not the beneficiary, then a Power of Attorney must be provided along with your request.
Step 4 -If you are requesting medical records for a deceased person, you must either A) include a copy of the document authenticating your authority as the executor, administrator, or other person authorized to act upon the behalf of the person for whom records are sought (such as probate court document, or orders of administration and/or executorship); or B) if you are not the executor of the estate, you must include a signed release authorization from the legal representative of the deceased, as well as the document authenticating the representative's authority (such as probate court document, or orders of administration and/or executorship).
- Sample FOIA Request Letter [PDF, 30KB]
- Sample FOIA Request Letter for Your Own Medical Records [PDF, 19KB]
- Sample FOIA Request Letter for Records on a Living Beneficiary from Someone Other Than the Beneficiary [PDF, 32KB]
- Sample FOIA Request Letter for Records on a Deceased Beneficiary [PDF, 33KB]
- Sample FOIA Appeal Letter [PDF, 19KB]
- FOIA Medicare Authorization [PDF, 127KB]
- Page last Modified: 04/16/2015 11:19 AM
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