reglab/statecodes huggingface dataset:
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart C - Licensing/Approval › Chapter 20 - LICENSURE OR APPROVAL OF FACILITIES AND AGENCIES › INSPECTION › Section 20.32 - Announced inspections

Current through Register Vol. 54, No. 28, July 13, 2024
The facility or agency will be advised in advance of the
						date of the annual inspection.
This section cited in 55 Pa. Code §
													2600.11 (relating to procedural
						  requirements for licensure or approval of personal care homes); 55 Pa. Code
						  §
													2800.11 (relating to procedural
						  requirements for licensure or approval of assisted living residences; special
						  care designation and dual licensure); 55 Pa. Code §
													3270.11 (relating to application
						  for and issuance of a certificate of compliance); 55 Pa. Code §
													3280.11 (relating to application
						  for and issuance of a certificate of compliance); and 55 Pa. Code §
													3290.11 (relating to application
						  for and issuance of a certificate of
						  compliance).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart C - Licensing/Approval › Chapter 20 - LICENSURE OR APPROVAL OF FACILITIES AND AGENCIES › INSPECTION › Section 20.33 - Other inspections

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The
					 facility or agency is subject to both announced and unannounced on-site
					 inspections.
(b) The facility or
					 agency is subject to complaint inspections.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart C - Licensing/Approval › Chapter 20 - LICENSURE OR APPROVAL OF FACILITIES AND AGENCIES › INSPECTION › Section 20.34 - Access

Current through Register Vol. 54, No. 28, July 13, 2024
The facility or agency shall provide to authorized agents
						of the Department full access to the facility or agency and its records during
						both announced and unannounced inspections. The facility or agency shall
						provide the opportunity for authorized agents of the Department to privately
						interview staff and clients.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart C - Licensing/Approval › Chapter 20 - LICENSURE OR APPROVAL OF FACILITIES AND AGENCIES › INSPECTION › Section 20.35 - Fire safety approval

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A
					 facility shall have written fire safety approval from either the Department of
					 Labor and Industry or the Department of Health of the Commonwealth-or the local
					 Department of Public Safety in the cities of Scranton and Pittsburgh or the
					 local Department of Licensing and Inspection in Philadelphia-if
					 applicable.
(b) A facility shall
					 have written fire safety approval, if applicable, prior to issuance of a
					 certificate of compliance. If fire safety authorities do not carry out their
					 mandated functions in a timely fashion, the Department, prior to fire safety
					 approval, may issue a certificate of compliance if the health and safety of the
					 clients are not in jeopardy.
(c)
					 Authorized agents of the Department will request additional fire safety
					 inspections by the appropriate agency if, during an inspection, an authorized
					 agent observes possible fire safety violations.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart C - Licensing/Approval › Chapter 20 - LICENSURE OR APPROVAL OF FACILITIES AND AGENCIES › INSPECTION › Section 20.36 - Civil rights compliance

Current through Register Vol. 54, No. 28, July 13, 2024
A facility shall comply with the following statutes and
						regulations that prohibit discrimination on the basis of race, color, religious
						creed, ancestry, sex, handicap, age or national origin:
(1) The Pennsylvania Human Relations Act
					 (43
					 P.S. §§
												951-962.2).
(2) The Age Discrimination Act of 1975,
					 42 U.S.C.A. §§
												6101-6107.
(3) Title VI of the Civil Rights Act of 1964,
					 42 U.S.C.A. §§
												2000d-2000d-4, if applicable.
(4) Section 504 of the Rehabilitation Act of
					 1973, 29 U.S.C.A. §
												794, if applicable.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart C - Licensing/Approval › Chapter 20 - LICENSURE OR APPROVAL OF FACILITIES AND AGENCIES › INSPECTION › Section 20.37 - Emergency removal of residents

Current through Register Vol. 54, No. 28, July 13, 2024
If the Department finds evidence of gross incompetence,
						negligence, misconduct in operating the facility or agency, or mistreatment or
						abuse of clients, likely to constitute an immediate and serious danger to the
						life or health of the clients, the Department will take immediate action to
						remove the clients from the facility or agency. If physical obstruction is
						offered to prevent removal of the clients the Department will request law
						enforcement authorities to assist in the removal of the clients.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart C - Licensing/Approval › Chapter 20 - LICENSURE OR APPROVAL OF FACILITIES AND AGENCIES › FEES › Section 20.41 - Payment of fees

Current through Register Vol. 54, No. 28, July 13, 2024
The legal entity shall pay the applicable fee, if any,
						prior to the issuance of a certificate of compliance.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart C - Licensing/Approval › Chapter 20 - LICENSURE OR APPROVAL OF FACILITIES AND AGENCIES › FEES › Section 20.42 - Amount of fees

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The
					 following fees shall be paid for a regular certificate of compliance:
Type of Facility
Profit
Public or Nonprofit
Adult Day Care Center
$15
0
Maternity Home
$15
0
Community Residential Intellectual Disability
								  Facility or Agency
$50
0
Psychiatric Clinic
$50
0
Partial Hospitalization Programs
$50
0
Private Psychiatric Hospital
$50
0
Vocational Facility Serving Primarily Individuals
								  with Mental Illness or an Intellectual Disability, or Both
$50
0
(b) No fee is required for a facility or
					 agency not listed in subsection (a).
(c) The fee for a provisional certificate of
					 compliance is 1/12 of the fee for the annual certificate of compliance
					 multiplied by the number of months for which the certificate of compliance is
					 issued.
(d) The application fee for
					 personal care homes applies regardless of profit or nonprofit status and is
					 based on the number of beds licensed, as follows:
Number of Beds
Fee
0-20
$15
21-50
$20
51-100
$30
101 beds and over
$50
Fees for Personal Care Homes were changed by the act of
						  December 21, 1988 (P.L. 1885, No. 185).
The provisions of this §
													20.42 amended under sections 1006
						  and 1021 of the Public Welfare Code (62 P.S. §§
														1006 and
						  1021); and Articles IX and X
						  of the Human Services Code (62 P.S. §§
														901-922 and
						  1001-1088).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart C - Licensing/Approval › Chapter 20 - LICENSURE OR APPROVAL OF FACILITIES AND AGENCIES › CERTIFICATE OF COMPLIANCE › Section 20.51 - Issuance

Current through Register Vol. 54, No. 28, July 13, 2024
A certificate of compliance will be issued to the legal
						entity by the Department if, after an inspection by an authorized agent of the
						Department, it is determined that requirements for a certificate of compliance
						are met.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart C - Licensing/Approval › Chapter 20 - LICENSURE OR APPROVAL OF FACILITIES AND AGENCIES › CERTIFICATE OF COMPLIANCE › Section 20.52 - Plan of correction

Current through Register Vol. 54, No. 28, July 13, 2024
If, during an inspection, authorized agents of the
						Department observe items of noncompliance with licensure or approval
						regulations, the legal entity shall submit an acceptable written plan to
						correct each noncompliance item and shall establish an acceptable period of
						time to correct these items.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart C - Licensing/Approval › Chapter 20 - LICENSURE OR APPROVAL OF FACILITIES AND AGENCIES › CERTIFICATE OF COMPLIANCE › Section 20.53 - Regular certificate of compliance

Current through Register Vol. 54, No. 28, July 13, 2024
A regular certificate of compliance is issued if the
						facility or agency is in compliance with applicable statutes, ordinances and
						regulations.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart C - Licensing/Approval › Chapter 20 - LICENSURE OR APPROVAL OF FACILITIES AND AGENCIES › CERTIFICATE OF COMPLIANCE › Section 20.54 - Provisional certificate of compliance

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A provisional certificate of compliance
					 is issued if the facility or agency is in substantial, but not complete,
					 compliance with applicable statutes, ordinances, and regulations.
(b) A provisional certificate of compliance
					 is issued for a specified length of time, not to exceed 6 months.
(c) A maximum of four consecutive provisional
					 certificates of compliance may be issued to the legal entity for each specific
					 facility or agency.
This section cited in 55 Pa. Code §
													3290.11 (relating to application
						  for and issuance of a certificate of
						  compliance).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart C - Licensing/Approval › Chapter 20 - LICENSURE OR APPROVAL OF FACILITIES AND AGENCIES › CERTIFICATE OF COMPLIANCE › Section 20.55 - Preparation of certificate of compliance

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The certificate of compliance is issued
					 to the legal entity.
(b) The
					 certificate of compliance lists the name of the legal entity, the name and
					 address of the facility or agency, satellite sites, if applicable, type of
					 service provided, maximum capacity, title and chapter of applicable licensure
					 or approval regulations, the date the regulations were adopted, certificate
					 number, effective and expiration dates of the certificate, and restrictions, if
					 applicable.
(c) A provisional
					 certificate of compliance also contains the word "Provisional" and indicates
					 whether it is the first, second, third or fourth provisional certificate
					 issued.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart C - Licensing/Approval › Chapter 20 - LICENSURE OR APPROVAL OF FACILITIES AND AGENCIES › CERTIFICATE OF COMPLIANCE › Section 20.56 - Posting of the certificate of compliance

Current through Register Vol. 54, No. 28, July 13, 2024
The facility or agency shall post the current certificate
						of compliance in a public place in the facility or agency.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart C - Licensing/Approval › Chapter 20 - LICENSURE OR APPROVAL OF FACILITIES AND AGENCIES › CERTIFICATE OF COMPLIANCE › Section 20.57 - Restrictions on certificate of compliance

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A certificate of compliance is issued to
					 a legal entity for a specific facility or agency and is not
					 transferrable.
(b) A certificate of
					 compliance is void without notice if one of the following conditions exist:
(1) There is a change in the ownership of the
					 legal entity of the facility or agency. A transfer of stock of a corporation
					 does not, for purposes of this chapter, constitute a change of ownership of a
					 legal entity.
(2) There is a change
					 in the name of the facility or agency.
(3) There is a change in the location of the
					 facility or agency.
(4) There is a
					 change in the profit or nonprofit status of the facility or agency.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart C - Licensing/Approval › Chapter 20 - LICENSURE OR APPROVAL OF FACILITIES AND AGENCIES › CERTIFICATE OF COMPLIANCE › Section 20.58 - Notification of change

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The
					 legal entity shall notify the Department at least 30 days in advance of the
					 intention to change the legal entity, name, location or profit or nonprofit
					 status of the facility or agency.
(b) If the facility or agency is to be
					 operated under a new legal entity, new name, new location, or different status,
					 the legal entity shall complete and submit a new application for a certificate
					 of compliance at least 30 days in advance of the change.
(c) If a change occurs which is not included
					 in subsections (a) and (b)-for example, change in responsible person-the legal
					 entity shall notify the Department within 30 days after the change
					 occurs.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart C - Licensing/Approval › Chapter 20 - LICENSURE OR APPROVAL OF FACILITIES AND AGENCIES › NEGATIVE SANCTIONS › Section 20.71 - Conditions for denial, nonrenewal or revocation

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The Department may deny, refuse to renew
					 or revoke a certificate of compliance for any of the following:
(1) Failure to comply with this
					 chapter.
(2) Noncompliance with the
					 Department's program licensure or approval regulations.
(3) Failure to submit an acceptable plan to
					 correct noncompliance items.
(4)
					 Failure to comply with the acceptable plan to correct noncompliance
					 items.
(5) Mistreatment or abuse of
					 clients being cared for in the facility or receiving service from the
					 agency.
(6) Gross incompetence,
					 negligence or misconduct in operating the facility or agency.
(7) Fraud or deceit in obtaining or
					 attempting to obtain a certificate of compliance.
(8) Lending, borrowing or using the
					 certificate of compliance of another facility or agency, or knowingly aiding or
					 abetting the improper granting of a certificate of compliance.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart C - Licensing/Approval › Chapter 20 - LICENSURE OR APPROVAL OF FACILITIES AND AGENCIES › APPEALS › Section 20.81 - Decisions that may be appealed

Current through Register Vol. 54, No. 28, July 13, 2024
The legal entity has the right to appeal any of the
						following:
(1) The denial of a
					 certificate of compliance.
(2) The
					 nonrenewal of a certificate of compliance.
(3) The revocation of a certificate of
					 compliance.
(4) The issuance of a
					 provisional certificate of compliance.
(5) The length of time for which a
					 provisional certificate of compliance is issued.
(6) The reduction in the maximum capacity of
					 the facility or agency.
(7) The
					 denial of an increase in the maximum capacity of the facility or
					 agency.
This section cited in 55 Pa. Code §
													20.82 (relating to written request
						  for appeal).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart C - Licensing/Approval › Chapter 20 - LICENSURE OR APPROVAL OF FACILITIES AND AGENCIES › APPEALS › Section 20.82 - Written request for appeal

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The
					 legal entity may appeal a Departmental decision specified in §
											20.81 (relating to decisions that
					 may be appealed) under
					 2
					 Pa.C.S. §§
												501-508 and
					 701-704 (relating to
					 Administrative Agency Law) and 1 Pa. Code Part II (relating to General Rules of
					 Administrative Practice and Procedure).
(b) Except for facilities licensed or
					 approved under Chapters 2600 and 3800 (relating to personal care home
					 licensing; and child residential and day treatment facilities), the legal
					 entity may appeal by filing a petition within 30 days after service of notice
					 of the action.
(c) Subsection (b)
					 supersedes the appeal period of 1 Pa. Code §
											35.20 (relating to appeals from
					 actions of the staff).
This section cited in 55 Pa. Code §
													20.2 (relating to
						  applicability).
APPENDIX .
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart C - Licensing/Approval › Chapter 20 - LICENSURE OR APPROVAL OF FACILITIES AND AGENCIES › APPEALS › Appendix A - CIVIL RIGHTS COMPLIANCE-STATEMENT OF POLICY

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A facility shall comply with the following statutes
						and regulations thereunder that prohibit discrimination on the basis of race,
						color, religious creed, disability, handicap, ancestry, national origin, age or
						sex:
(1) The Pennsylvania Human Relations Act (43 P. S.
						§§
												951-962.2).
(2) The Age Discrimination Act of 1975 (42 U.S.C.A. §§
												6101 -
						6107).
(3) Title VI of the Civil Rights Act of 1964
						(42 U.S.C.A. §§
												2000d-2000d-4), if applicable.
(4) Section 504 of the Rehabilitation Act of 1973
						(29 U.S.C.A. §
												794), if applicable.
(5) Title VII of the Civil Rights Act of 1964
						(42 U.S.C. §§
												2000e-2000e-17), if applicable.
(b) A Certificate of Compliance will not be granted to a
						provider unless there has been compliance with civil rights laws and applicable
						regulations.
(c) Applicants, clients or staff will not be
						discriminated against because of race, color, religious creed, disability,
						handicap, ancestry, national origin, age or sex and shall observe applicable
						State and Federal statutes and regulations.
(d) The facility shall develop and implement civil rights
						policies and procedures for clients and staff in accordance with applicable
						civil rights laws and regulations which include the following:
(1) A nondiscrimination policy which states that
						admissions, referrals, services and employment actions are provided without
						regard to race, sex, color, national origin, ancestry, religious creed,
						disability, handicap or age.
(2) Reasonable physical accommodations and program
						accessibility to staff or clients with physical disabilities.
(3) A procedure by which staff and clients can file
						complaints alleging discrimination and have their complaints investigated and
						resolved objectively which includes the name of the person assigned to
						investigate the complaint.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › GENERAL PROVISIONS › Section 41.1 - Scope

Current through Register Vol. 54, No. 28, July 13, 2024
(a) This chapter
					 governs the practice and procedures in MA provider appeals commencing on or
					 after November 25, 2006.
(b) In
					 addition to this chapter, GRAPP and other applicable Departmental regulations
					 apply to the practice and procedures in MA provider appeals, except as
					 specifically superseded in relevant sections of this chapter.
(c) This chapter does not apply to appeals
					 governed by Chapter 275 (relating to appeal and fair hearing and administrative
					 disqualification hearings).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › GENERAL PROVISIONS › Section 41.2 - Construction and application

Current through Register Vol. 54, No. 28, July 13, 2024
(a) This
					 chapter shall be liberally construed to secure the just, speedy and inexpensive
					 determination of provider appeals. At every stage of a provider appeal, the
					 Bureau may disregard any error or defect of procedure which does not affect the
					 substantial rights of the parties.
(b) To the extent that GRAPP applies in MA
					 provider appeals:
(i) The term "agency" as
					 used in 1 Pa. Code Part II means "Bureau."
(ii) The term "participant" as used in 1 Pa.
					 Code Part II means "party."
(iii)
					 The term "presiding officer" as used in 1 Pa. Code Part II means "presiding
					 officer."
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › GENERAL PROVISIONS › Section 41.4 - Amendments to regulation

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The
					 Department retains continuing jurisdiction under
					 67 Pa.C.S. §
												1106
					 (relating to regulations) to adopt and amend regulations establishing practice
					 and procedure as may be necessary to govern provider appeals.
(b) The Bureau may establish forms as may be
					 required to implement this chapter.
(c) Subsections (a) and (b) supersede 1 Pa.
					 Code §
											31.6 (relating to amendments to
					 rules).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › GENERAL PROVISIONS › Section 41.5 - Jurisdiction of the Bureau

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Except
					 as provided in subsections (b)-(d), the Bureau has exclusive original
					 jurisdiction over provider appeals.
(b) The Bureau has no jurisdiction to make a
					 final determination on a waiver request included in a request for hearing. The
					 Bureau will create a record and make a recommendation to the Secretary
					 regarding the waiver request as specified in §
											41.191(b)
					 (relating to determinations and recommendations by the Bureau).
(c) The Bureau has no jurisdiction to issue a
					 final determination on the merits of an issue properly raised in a petition for
					 relief.
(d) The Bureau's
					 jurisdiction in provider appeals is subject to §§
											41.211 and
					 41.212 (relating to
					 reconsideration of interlocutory orders; and review of Bureau
					 determinations).
(e) The Bureau has
					 no jurisdiction in a provider appeal involving an agency action if Federal law
					 or Federal regulations require the aggrieved provider to use Federal appeal
					 procedures in order to contest the agency action.
(f) Subsections (a)-(e) supersede 1 Pa. Code
					 §
											35.103 (relating to preliminary
					 notice to Department of Justice).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › GENERAL PROVISIONS › Section 41.6 - Timely filing required

Current through Register Vol. 54, No. 28, July 13, 2024
(a)
					 Pleadings and legal documents required or permitted to be filed under this
					 chapter, the regulations of the Department or another provision of law must be
					 received for filing at the Bureau within the time limits permitted for the
					 filing.
(b) Except as provided in
					 §
											41.32(b) 
					 (relating to timeliness and perfection of requests for hearing), the filing
					 date is the date of receipt by the Bureau, and not the date of
					 mailing.
(c) Subsections (a) and
					 (b) supersede 1 Pa. Code §
											31.11 (relating to timely filing
					 required).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › GENERAL PROVISIONS › Section 41.7 - Extensions of time

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Except when
					 necessitated by the circumstances of the Bureau, no order or prehearing order
					 will continue a provider appeal or extend the time for doing an act required by
					 this chapter except upon written motion by a party filed in accordance with
					 this chapter.
(b) When this chapter
					 establishes a standard for an extension of time, a motion seeking an extension
					 shall be resolved by the application of that standard. If this chapter does not
					 otherwise establish a standard, the motion shall be resolved by the application
					 of 1 Pa. Code §
											31.15 (relating to extensions of
					 time).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › DOCUMENTARY FILINGS › Section 41.11 - Title of document

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Legal
					 documents in a provider appeal commenced by a request for hearing, other than
					 the initial pleading, shall display a caption at the top of the first page in
					 the following form:
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF HUMAN SERVICES BUREAU OF HEARINGS AND
						APPEALS
[Name of Provider] v. [Name of Program Office]
BHA I.D. No.:
Docket No.:
[Descriptive Title of Document]
(b) The descriptive title of a legal document
					 must identify the party on whose behalf the filing is made.
(c) Subsections (a) and (b) supersede 1 Pa.
					 Code § 33.1 (relating to title).
This section cited in 55 Pa. Code §
													41.92 (relating to expedited
						  disposition procedure for certain
						  appeals).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › DOCUMENTARY FILINGS › Section 41.12 - Form

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Printed
					 documents may not be less than 12-point font.
(b) An original hard copy of a pleading
					 bearing an original signature must be filed with the Bureau by personal
					 delivery or first-class mail.
(c) A
					 legal document may be filed with the Bureau in hard copy by first-class mail or
					 personal delivery.
(d) A legal
					 document may be filed by facsimile if the document does not exceed 20 pages in
					 length, including attachments and exhibits. An executed hard copy of a document
					 filed by facsimile shall be maintained by the filing party and produced at the
					 request of the Bureau or other party.
(e) Subsection (a) supersedes 1 Pa. Code
					 §
											33.2(b) (relating
					 to form) as it relates to font size of printed documents.
This section cited in 55 Pa. Code §
													41.92 (relating to expedited
						  disposition procedure for certain
						  appeals).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › DOCUMENTARY FILINGS › Section 41.13 - Incorporation by reference

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A
					 legal document on file with the Bureau in a provider appeal, and the exhibits
					 or attachments thereto, may be incorporated by reference into another legal
					 document that is subsequently filed in the same provider appeal.
(b) A document may be incorporated by
					 reference to the specific document and prior filing in which it was physically
					 filed, but not by reference to another document that incorporates it by
					 reference.
(c) Subsections (a) and
					 (b) supersede 1 Pa. Code §
											33.3 (relating to incorporation by
					 reference).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › DOCUMENTARY FILINGS › Section 41.14 - Verification

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A pleading or
					 legal document that contains an averment of fact not appearing of record or
					 that contains a denial of fact must be verified as specified in subsection
					 (b).
(b) A verification of a
					 pleading or legal document must substantially conform to the following:
I, (name of person signing verification), in my capacity
						as (title or statement describing relationship to the party submitting the
						document), hereby state that I am authorized to make this verification on
						behalf of (party submitting the document) and that the facts set forth in the
						(document being verified) filed in this matter are true and correct to the best
						of my knowledge, information, and belief, and that this verification is being
						made subject to
						18 Pa.C.S. §
													4904,
						(relating to unsworn falsification to authorities.)
(c) Subsections (a) and (b) supersede 1 Pa.
					 Code §
											33.12 (relating to
					 verification).
This section cited in 55 Pa. Code §
													41.92 (relating to expedited
						  disposition procedure for certain
						  appeals).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › DOCUMENTARY FILINGS › Section 41.15 - Copies of documents

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Unless
					 otherwise ordered by the Bureau, only the original of a pleading or a legal
					 document shall be filed with the Bureau.
(b) One copy of a pleading or legal document
					 filed with the Bureau will be served on each of the other parties to the
					 provider appeal unless otherwise specified in this chapter.
(c) A document filed with the Bureau in a
					 provider appeal is available for inspection and copying except that, if a
					 document contains information protected by law against public disclosure, the
					 document will not be available until the protected information has been
					 redacted. When redaction is required, the person seeking access to or a copy of
					 the document shall be required to pay the actual cost of redaction prior to the
					 document being made available.
(d)
					 Documents in the files of the Bureau may not be removed from the Bureau's
					 custody. At the discretion of the Bureau, a person provided with access to a
					 document under subsection (c) may make a copy using equipment available at the
					 Bureau, or the Bureau may make a copy and provide it to the person requesting
					 access. The rates for copies will be identical to the rates charged by the
					 Department under the Right-to-Know Law (65 P. S. §§
												66.1-66.4).
(e) Subsections (a)-(d) supersede 1 Pa. Code
					 §§ 33.15,
					 33.21, 33.22, 33.23 and
					 33.37.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › SERVICE AND AMENDMENT OF DOCUMENTS › Section 41.21 - Notice of agency actions

Current through Register Vol. 54, No. 28, July 13, 2024
(a) In the
					 absence of a Department regulation specifying the method in which notice of an
					 agency action is given, the Department or a program office may give notice of
					 an agency action by one of the following methods:
(1) Mailing a written notice of the action to
					 a provider at the provider's most recent business address on file with the
					 Department.
(2) Serving notice of
					 the action in the manner provided in Pa.R.C.P. Nos. 400-441.
(3) By publication in the
Pennsylvania Bulletin
if the agency action applies to a class
					 of providers or makes system-wide changes affecting more than a single
					 provider.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › SERVICE AND AMENDMENT OF DOCUMENTS › Section 41.21a - Clarification regarding the definition of "mailing"-statement of policy

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The term
					 "mailing" in §
											41.21(a)(1) 
					 (relating to notice of agency actions) means to deliver by United States or
					 commercial mail service or transmit through electronic communication.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › SERVICE AND AMENDMENT OF DOCUMENTS › Section 41.22 - Service of pleadings and legal documents

Current through Register Vol. 54, No. 28, July 13, 2024
Service of pleadings and legal documents must be made on
						the same day the pleading or legal document is filed with the Bureau as
						follows:
(1) Pleading. The provider
					 that files a pleading shall serve a copy on:
(i) The program office that initiated the
					 agency action in dispute.
(ii) The
					 Department's Office of General Counsel.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › SERVICE AND AMENDMENT OF DOCUMENTS › Section 41.23 - Proof of service

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A
					 certificate of service in the form prescribed in §
											41.24 (relating to certificate of
					 service) must accompany and be attached to a pleading or legal document filed
					 with the Bureau.
(b) Subsection (a)
					 supersedes 1 Pa. Code §§ 33.31,
					 33.32, 33.35 and 33.36.
This section cited in 55 Pa. Code §
													41.92 (relating to expedited
						  disposition procedure for certain
						  appeals).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › SERVICE AND AMENDMENT OF DOCUMENTS › Section 41.24 - Certificate of service

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Each
					 certificate of service must substantially conform to the following:
I hereby certify that I have this day served the
						foregoing document upon: (Identify name and address of each person served) by
						(Indicate method of service).
(b) Subsection (a) supersedes 1 Pa. Code
					 §§ 33.31,
					 33.32, 33.35 and 33.36.
This section cited in 55 Pa. Code §
													41.23 (relating to proof of
						  service); and 55 Pa. Code §
													41.92 (relating to expedited
						  disposition procedure for certain
						  appeals).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › SERVICE AND AMENDMENT OF DOCUMENTS › Section 41.25 - Amendment or withdrawal of legal documents

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A party may amend a legal document, other
					 than a position paper, by filing an amendment with the Bureau unless the Bureau
					 otherwise orders.
(1) An amendment to a legal
					 document will be deemed filed as of the date of receipt by the Bureau, unless
					 the Bureau otherwise orders.
(2) A
					 position paper may be amended as specified in §
												41.116 (relating to amendments to
					 position papers).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › REQUESTS FOR HEARING, PETITIONS FOR RELIEF AND OTHER PRELIMINARY MATTERS › Section 41.31 - Request for hearing

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A
					 provider that is aggrieved by an agency action may appeal and obtain review of
					 that action by the Bureau by filing a request for hearing in accordance with
					 this chapter.
(b) A provider is
					 aggrieved by an agency action if the action adversely affects the personal or
					 property rights, privileges, immunities, duties, liabilities or obligations of
					 the provider.
(c) When a provider
					 files a request for hearing to contest an agency action, the program office
					 that issued the notice of the agency action is a party to the provider
					 appeal.
(d) A request for hearing
					 must include the following:
(1) The name,
					 address and telephone number of the provider.
(2) Detailed reasons why the provider
					 believes the agency action is factually or legally erroneous.
(3) Identification of the specific issues
					 that the provider will raise in its provider appeal.
(4) Specification of the relief that the
					 provider is seeking.
(i) If the provider is
					 challenging the validity of a regulation or statement of policy in its provider
					 appeal, the provider shall state the challenge expressly and with particularity
					 and identify the regulation or statement of policy involved.
(ii) If the provider is seeking relief from
					 an agency action, in whole or in part, through waiver of the application of a
					 regulation, the provider shall state its waiver request expressly and with
					 particularity and identify the regulation involved.
(iii) A provider may not request a
					 declaratory order or an order that the Department should be required to
					 promulgate, amend or repeal a regulation as relief in a request for hearing.
					 The requests shall be set forth in a petition for relief in accordance with 1
					 Pa. Code §§
													35.18 and
					 35.19 (relating to petitions for
					 issuance, amendment, waiver or deletion of regulations; and petitions for
					 declaratory orders).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › REQUESTS FOR HEARING, PETITIONS FOR RELIEF AND OTHER PRELIMINARY MATTERS › Section 41.32 - Timeliness and perfection of requests for hearing

Current through Register Vol. 54, No. 28, July 13, 2024
(a) Except as permitted in §
											41.33 (relating to appeals nunc
					 pro tunc), the Bureau lacks jurisdiction to hear a request for hearing unless
					 the request for hearing is in writing and is filed with the Bureau in a timely
					 manner, as follows:
(1) If the program office
					 gives notice of an agency action by mailing the notice to the provider, the
					 provider shall file its request for hearing with the Bureau within 33 days of
					 the date of the written notice of the agency action.
(2) If written notice of an agency action is
					 given in a manner other than by mailing the notice to the provider, a provider
					 shall file its request for hearing with the Bureau within 30 days of the date
					 of the written notice of the agency action.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › REQUESTS FOR HEARING, PETITIONS FOR RELIEF AND OTHER PRELIMINARY MATTERS › Section 41.32a - Clarification regarding the definition of "mailing"-statement of policy

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The term
					 "mailing" in §
											41.32(a)(1) and
					 (2) (relating to timeliness and perfection of
					 requests for hearing) means to deliver by United States or commercial mail
					 service or transmit through electronic communication.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › REQUESTS FOR HEARING, PETITIONS FOR RELIEF AND OTHER PRELIMINARY MATTERS › Section 41.33 - Appeals nunc pro tunc

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The Bureau,
					 upon written motion and for good cause shown, may grant leave to a provider to
					 file a request for hearing nunc pro tunc under the common law standard
					 applicable in analogous cases in courts of original jurisdiction.
(b) The Bureau, upon written motion and for
					 good cause shown, may grant leave to a provider to file an amendment to a
					 request for hearing nunc pro tunc under the common law standard applicable in
					 analogous cases in courts of original jurisdiction.
(c) The Secretary, upon written motion and
					 for good cause shown, may grant leave to a party to file a request for review
					 of a Bureau determination by the Secretary nunc pro tunc under the common law
					 standard applicable in analogous cases in courts of original
					 jurisdiction.
(d) Subsections
					 (a)-(c) supersede 1 Pa. Code §§
											35.1,
					 35.2,
					 35.5-35.7 and
					 35.9-35.11 and, to the extent that they
					 would otherwise apply to the time for filing appeals with the Bureau,
					 §§
											1187.1(d) and
					 6210.14(b)
					 (relating to policy; and time extensions).
This section cited in 55 Pa. Code §
													41.32 (relating to timeliness and
						  perfection of requests for hearing); 55 Pa. Code §
													41.82 (relating to amendments of
						  requests for hearing); and 55 Pa. Code §
													41.212 (relating to review of
						  Bureau determinations).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › PETITIONS › Section 41.41 - Waiver request

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A
					 provider may include a waiver request in a petition for relief only if the
					 regulation that is the subject of the waiver request is not a basis for an
					 agency action involving the provider.
(b) If an agency action involving the
					 provider depends, in whole or in part, upon the application of a regulation of
					 the Department, a provider aggrieved by that agency action may only present a
					 waiver request pertaining to that regulation in the context of a request for
					 hearing filed in accordance with §
											41.31 (relating to request for
					 hearing).
(c) To the extent that
					 the waiver sought by a provider in a petition for relief has been or could have
					 been included in a request for hearing, the Bureau will dismiss the petition
					 for relief.
(d) Subsections (a)-(c)
					 supersede 1 Pa. Code §
											35.18 (relating to petitions for
					 issuance, amendment, waiver or deletion of regulations) to the extent that an
					 appealable agency action is involved.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › PETITIONS › Section 41.42 - Request for declaratory relief

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A provider may include a request for
					 declaratory relief in a petition for relief only if the relief sought by the
					 provider would not modify or alter an agency action involving the
					 provider.
(b) If the requested
					 relief would modify an agency action involving the provider, the provider may
					 only seek the relief in the context of a request for hearing filed in
					 accordance with §
											41.31 (relating to request for
					 hearing).
(c) To the extent that a
					 request for declaratory relief sought by a provider in a petition for relief
					 has been or could have been included in a request for hearing, the Bureau will
					 dismiss the petition for relief.
(d) Subsections (a)-(c) supersede 1 Pa. Code
					 §
											35.19 (relating to petitions for
					 declaratory orders) to the extent that an appealable agency action is
					 involved.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › PETITIONS › Section 41.43 - Request for issuance, amendment or deletion of regulations

Current through Register Vol. 54, No. 28, July 13, 2024
The sole means by which a provider may formally petition
						the Department for the issuance, amendment or deletion of a regulation or
						statement of policy is by filing a petition for relief under 1 Pa. Code §
											35.18 (relating to petitions for
						issuance, amendment, waiver or deletion of regulations).
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › PETITIONS › Section 41.44 - Transfer of petition for relief

Current through Register Vol. 54, No. 28, July 13, 2024
(a) If a provider filed a petition for relief
					 prior to the date of an agency action in which it has sought relief in
					 connection with or relating to that agency action, the provider may file a
					 motion to have the petition for relief transferred to the Bureau and deemed a
					 request for hearing. The motion shall be filed within the time allowed for the
					 filing of a request for a hearing specified in §
											41.32(a)
					 (relating to timeliness and perfection of requests for hearing).
(b) Subsection (a) supersedes 1 Pa. Code
					 §
											35.17 (relating to petitions
					 generally) to the extent that an appealable agency action is
					 involved.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › SUPERSEDEAS › Section 41.51 - General

Current through Register Vol. 54, No. 28, July 13, 2024
(a) The filing of a
					 request for hearing does not act as an automatic supersedeas. However, a
					 provider who has filed a request for hearing may petition the Bureau to grant a
					 supersedeas of the agency action. The Bureau may, upon good cause shown, grant
					 a provider's petition for supersedeas in accordance with §
											41.53 (relating to circumstances
					 affecting grant or denial).
(b) A
					 petition for supersedeas must be set forth in writing and may be filed during a
					 provider appeal.
(c) The Bureau
					 will not issue a supersedeas without first conducting a hearing, but a hearing
					 may be limited under subsection (e). The Bureau, upon motion or sua sponte, may
					 direct that a prehearing conference be held before scheduling or holding a
					 hearing on a supersedeas.
(d) A
					 hearing on a supersedeas, if necessary, will be held expeditiously, if feasible
					 within 2 weeks of the filing of the petition. In scheduling the hearing the
					 Bureau will take into account the availability of the presiding officer and
					 program office staff and the urgency and seriousness of the problem to which
					 the order or action of the Department applies. If good cause is shown, the
					 hearing will be held as soon as possible after the filing of the
					 petition.
(e) If necessary to
					 ensure prompt disposition, and at the discretion of the Bureau, a supersedeas
					 hearing may be limited in time and format, with parties given a fixed amount of
					 time to present their entire case, and with restricted rights of discovery or
					 of cross-examination.
(f) The
					 Bureau may impose costs or other appropriate sanctions on a party that files a
					 petition for supersedeas in bad faith or on frivolous grounds.
Pennsylvania Code › Title 55 - HUMAN SERVICES › Part I - Department of Human Services › Subpart D - Hearings and Appeals › Chapter 41 - MEDICAL ASSISTANCE PROVIDER APPEAL PROCEDURES › SUPERSEDEAS › Section 41.52 - Contents of petition for supersedeas

Current through Register Vol. 54, No. 28, July 13, 2024
(a) A petition for supersedeas must plead
					 facts with particularity and be supported by one of the following:
(1) Affidavits prepared as specified in
					 Pa.R.C.P. Nos. 76 and 1035.4 (relating to definitions; and motion for summary
					 judgment), setting forth facts upon which issuance of the supersedeas may
					 depend.
(2) An explanation of why
					 affidavits have not accompanied the petition if no supporting affidavit is
					 submitted with the petition for supersedeas.