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Get Appeals Council Form 2009-2024

65 calendar days from the date on the decision or dismissal order, please explain why on a separate sheet. You must file your request for review in writing with the Medicare Appeals Council at: Department of Health and Human Services Departmental Appeals Board Medicare Appeals Council, MS 6127 Cohen Building Room G-644 330 Independence Ave., S.W. Washington, D.C. 20201 You may send the request for review by U.S. Mail, a common carrier such as FedEx, or by fax to (202) 565-0227. If you send a fa.

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