2023 Pennsylvania Consolidated & Unconsolidated Statutes › Title 67 - PUBLIC WELFARE › Chapter 11 - Medical Assistance Hearings and Appeals › Section 1102 - Hearings before the bureau

§ 1102. Hearings before the bureau.
(a) General rule.--
A provider that is aggrieved by a decision of the department regarding the program may request a hearing before the bureau in accordance with this chapter.
(b) Filing.--
(1) Except as provided in paragraph (2), a provider must file a request for a hearing with the bureau in accordance with all of the following:
(i) The request must be in writing.
(ii) The request must be filed with the bureau:
(A) within 30 days of the date of the notice of the departmental action; or
(B) if notice was given by mail, within 33 days of the date of the notice of the departmental action.
(iii) If the request was filed by first-class mail, the United States postmark appearing upon the envelope in which the request was mailed shall be considered the filing date. The filing date of a request filed in any other manner or bearing a postmark other than a United States postmark shall be the date on which the request is received in the bureau.
(2) Paragraph (1) does not apply in the following cases:
(i) In a nunc pro tunc hearing under subsection (c).
(ii) To the extent set forth in the standing order of the bureau issued under subsection (g).
(iii) To the extent modified by regulations promulgated under section 1106 (relating to regulations).
(c) Hearings nunc pro tunc.--
The bureau, upon written request and for good cause shown, may grant leave for the filing of requests for hearing nunc pro tunc pursuant to the common law standards applicable in analogous cases in courts of original jurisdiction.
(d) Amendment.--
A request for a hearing may be amended as of right within 90 days after the date of filing of the request.
(e) Adjudication.--
(1) The bureau shall hold hearings and conduct adjudications regarding timely filed requests for hearing in accordance with 2 Pa.C.S. Ch. 5 Subch. A (relating to practice and procedure of Commonwealth agencies).
(2) Notwithstanding paragraph (1), in holding hearings and conducting adjudications, the bureau shall do all of the following:
(i) Act independently of employees or public officials of the department whose actions are subject to review before the bureau.
(ii) Not engage in ex parte communications concerning a hearing with any party to the hearing.
(iii) Promptly adjudicate timely filed requests for hearing.
(iv) Establish deadlines for interim and final actions by the bureau and parties to any proceeding before the bureau.
(v) Allow reasonable and necessary discovery in the form of interrogatories, requests for the production of documents, expert reports, requests for admissions and depositions of witnesses and designees of parties, subject to case management plans and limitations as necessary to facilitate the prompt and efficient issuance of adjudications.
(vi) Consider and, when appropriate, grant applications by affected parties to consolidate hearings involving substantially similar or materially related issues of law or fact.
(vii) Conduct de novo review of all factual and legal issues raised by a provider in the request for hearing based upon evidence presented to the bureau.
(viii) Except as prohibited by statute or regulation, index and publish at reasonable costs determinations issued by the bureau and final orders issued by the secretary adjudicating requests on or after the effective date of this section. By July 1, 2003, the bureau shall make the determinations, final orders and index available electronically without cost to the public.
(f) Mediation.--
The bureau may establish programs and procedures to promote the settlement of matters subject to its jurisdiction or to narrow issues subject to dispute through the use of mediation and arbitration.
(g) Standing order.--
By July 1, 2003, the bureau shall, after receiving comment by interested parties, issue a standing order establishing rules governing practice before the bureau. The standing order shall be published in the Pennsylvania Bulletin. The standing order of the bureau shall be effective until modified by regulation.
Cross References.
Section 1102 is referred to in section 1104 of this title.