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Formal Bureau of Hearings and Appeals Process
June 19, 2012

Many providers that receive funding from state departments are currently being notified regarding payment rates for Fiscal Year 2012/13. Agencies that question the amount of rates and fees or concerned regarding rates covering costs to provide services may file a formal appeal with the Department of Public Welfare’s Bureau of Hearings and Appeals.

Providers have 33 days after the date of notification of rates and fees to file a “Request for a Hearing.” The Office of Developmental Programs (ODP) issued Informational Memos regarding 2012/13 rates and fees to those providers it funds on May 25, which would indicate June 27 as the deadline to file a request for a hearing. PCPA has been told that ODP will issue formal rate letters to providers once the state budget is approved. If so, then the 33-day time frame will begin with the date of that official notice.

PCPA member Allen Warshaw, Rhoads Sinon, has developed a “Provider Appeal Process” document which overviews the steps involved in filling an appeal. The PCPA Membership Directory includes several associate and business members that are attorneys and available to assist members with filing formal appeals.

PCPA is interested in knowing the number of members filing an appeal and the final outcome of those filing. Please share this information, which will be held confidential, with Policy Specialist Linda Drummond.

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