Requesting an Appeal
The notice you received is required to instruct you on how to appeal. You should refer to the notice for the specific instructions on how to file your appeal. With over 280 issues, there are many different rules on where you send your appeal and how you must submit it that all depend on the type of issue or action you are appealing.
For the majority of appeals, you must send your appeal to the office, agency, or entity that took the action and sent you the notice. But if your notice tells you to send it somewhere else, follow those instructions.
Status of an Appeal
For many appeals, the appeal first is processed by the office, agency or entity that took the action. For example, for an appeal regarding Supplemental Nutrition Assistance Program (SNAP) benefits, the appeal is first processed by the County Assistance Office (CAO). After the CAO does their part, your appeal request along with other pertinent information (such as a copy of the adverse action notice), is forwarded to BHA by the CAO.
Once BHA receives the appeal, there are many things that can happen. BHA may issue orders that you must respond to, schedule pre-hearing conferences or mediation sessions with one of our judges, or deal with motions filed by you or the Department. But, for the vast majority of appeals, BHA will schedule your appeal for a hearing and send you a scheduling notice in the mail. This scheduling notice will inform you of the hearing date, time frame, and location (if not by phone) of your hearing.
Here is a general flow of the life of an appeal submitted to BHA. Remember, BHA deals with over 280 different issues, so this flow may not be accurate for your appeal.
Questions About Appeals
If BHA has not yet received your appeal from the office, agency or entity that took the action, BHA may not have any information about your appeal. Therefore, if you have not yet received any communication from BHA on your appeal, you should contact the office, agency or entity that took the action for questions regarding the status of your appeal.
When to call BHA
Once BHA receives your appeal, and sends you correspondence regarding your appeal, you can safely assume that BHA is aware of your appeal, and you can contact BHA with questions. Please ensure that you have your docket number close at hand, which is written on the communication you received, as this will assist BHA staff in locating the record of your appeal when you call. In general, BHA can only answer questions about your appeal to you, your authorized representative, or your attorney (who previously officially informed BHA that they represent you). If your chosen representative or attorney is not already listed on the appeal as an authorized representative (or for attorneys — if there is no entry of appearance on file), BHA may not discuss your appeal with that person.
Do you have legal questions?
BHA cannot provide you with legal advice. If you have legal questions, you are encouraged to speak with an attorney.
Contact BHA
Address:
2330 Vartan Way
Second Floor
Harrisburg, PA 17110-9721
Phone: 717-783-3950
Fax: 717-772-2769
or 717-346-1959
Additional Resources
BHA Common Forms
Common Use Forms
Formal Appeals Forms
Frequently Asked Questions
BHA reviews and decides on more than 280 issues for the departments of Human Services and Aging. The Bureau of Hearings and Appeals (BHA) reviews actions from the various offices, agencies, or entities in five major categories:
- Recipient Appeals — BHA reviews appeals on various benefits programs managed by the Departments, such as Medical Assistance (Medicaid), Supplemental Nutrition Assistance Program (SNAP), Cash Assistance, and Subsidized Child Care. As these are typically benefits that Pennsylvanian’s receive, we call these appeals “recipient appeals”. BHA also reviews actions by the various Health Maintenance Organizations (HMOs) and Managed Care Organizations (MCOs) that manage the benefits provided under the MA program. All “recipient” hearings are conducted in accordance with the regulations found at 55 Pa. Code Chapter 275. Appeal And Fair Hearing And Administrative Disqualification Hearings.
- Provider Appeals — BHA similarly reviews actions on “provider” issues. These are appeals filed by Medical Assistance Providers and related to their services provided to Pennsylvanians on Medical Assistance, as well as their ability to continue to provide services as an approved provider for the MA program. Medical Assistance Provider appeals are conducted in accordance with the regulations found at 55 Pa. Code Chapter 41. Medical Assistance Provider Appeal Procedures.
- Medical Assistance Provider appeals follow strict requirements for filing and procedure. These appeals require a lengthy prehearing process, unless the regulations require, or the parties agree, that the appeal may be expedited. Expedited appeals forego many of the prehearing formalities required under the regulations and allow the appeal to be scheduled for a hearing.
- Formal Appeals — BHA also reviews actions on all other types of DHS actions. These actions include Child Abuse Expunction requests, Day Care Center and Personal Care Home Licensing, Adoption and Foster Care Subsidies, Foster Home Approvals, and many others. These appeals are conducted in accordance with 1 Pa. Code Part II. General Rules Of Administrative Practice And Procedure. Child Abuse Expunction appeals also must follow the governing statute found at Section 6341.0 - Title 23 - DOMESTIC RELATIONS. Formal appeals are almost always conducted in-person and have a look and feel similar to that of a normal trial or court hearing you might see at your local county courthouse. Given the more formal nature of the process and the hearings, BHA calls these appeals “formal appeals."
- Nursing Home Involuntary Discharge Appeals — BHA reviews actions from nursing homes that are also MA providers when the nursing home proposes to discharge a patient from the home without their consent (this is called an involuntary discharge). The Bureau has jurisdiction under state and federal regulations to determine whether the discharges comply with the law. These appeals are conducted in accordance with Appendix N of 55 Pa. Code Chapter 1181. Nursing Facility Care.
- Department of Aging Appeals — Finally, BHA reviews actions made by the Pennsylvania Department of Aging. Appeals from the Department of Aging involve PACE prescription benefits, adult day care services, and reports of elder abuse. All Department of Aging appeals are conducted in accordance with the regulations found at Pennsylvania Code - Title 6 Aging.
BHA deals with over 280 different types of issues. So, it is impossible to outline every rule and regulation that would apply to every different type of appeal. However, the basic procedures and rules that apply to appeals can be found below. If you have specific questions, you may wish to consult with an attorney, as BHA cannot give you with legal advice.
- Recipient Appeals (such as SNAP, MA, LIHEAP) — 55 Pa. Code Chapter 275. Appeal And Fair Hearing And Administrative Disqualification Hearings
- MA Provider Appeals — 55 Pa. Code Chapter 41. Medical Assistance Provider Appeal Procedures
- All Non-Recipient, Non-Provider appeals (BHA calls these Formal Appeals) — 1 Pa. Code Part II. General Rules Of Administrative Practice And Procedure
- Child Abuse Expunction Appeals — Section 6341.0 - Title 23 - DOMESTIC RELATIONS
- Department of Aging Appeals — Pennsylvania Code - Title 6 Aging
- Nursing Home Involuntary Discharge Appeals — Appendix N of 55 Pa. Code Chapter 1181. 55 Pa. Code Chapter 1181. Nursing Facility Care
Yes you can! For recipient appeals (such as SNAP, Medical Assistance, LIHEAP), you can have anyone of your choosing represent in a hearing with BHA. However, you must first authorize that person to represent you by sending BHA something that says you are allowing this person to represent you. (If your authorized representative filed your appeal on your behalf, this step is automatically completed.) Your authorized representative may be an attorney. But your authorized representative is not required to be an attorney.
In all other types of appeals, only an attorney may represent you before the BHA.
You may be eligible for free legal assistance from your local legal aid office. Click here to find free legal assistance.
Your hearing will be held on the date and time listed on your hearing scheduling notice. Your scheduling notice will be mailed to your address BHA has on file once a date has been assigned to your appeal.
Recipient hearings are often scheduled in groups. Meaning that your hearing scheduling notice will give you a timeframe, and you must be available for your hearing throughout the entirety of that time frame. For example, if your order states that your hearing will take place between 9:00 a.m. and 12:00 p.m., you must be available to take the judge’s phone call for the hearing anytime between that time frame.
Whether you are scheduled for a specific time, or for a group hearing time frame, if you are not available when your appeal is called, you may lose your appeal.
If you are unable to attend the hearing at the date and time you are assigned, you must request a change in the hearing date and time. This is called a continuance. This request must be requested in writing and in advance of the hearing, or if you appear for the hearing, at the time of the hearing in front of the judge. BHA may need more information regarding your request and reach out to you for documentation or other information related to your request. For example, if your BHA hearing is conflicting with an existing appointment or other court hearing, we may ask for a copy of an appointment card or a court scheduling order.
If the continuance is granted, BHA will assign a new hearing date and time and you will receive a new scheduling order.
You should not assume that your request to continue your case is being approved merely because you requested a continuance. If BHA does not tell you that your request is granted, then you should assume that your request is not approved, and you should show up or be available for your hearing. If you fail to appear or are not available when your appeal is called, you may lose your appeal.
If your request to continue is denied, you must appear for your hearing at the time, date, and location listed on your scheduling order. If you fail to appear or are not available when your appeal is called, you may lose your appeal.
BHA conducts hearings either in-person at one of BHA’s Offices (Pittsburgh, Erie, Harrisburg, Reading, Wilkes-Barre, and Philadelphia) or over the telephone. The majority of appeals are held over the telephone. (Formal appeals, including Child Abuse Expunction appeals, are almost always held in-person at one of BHA’s Offices.)
For recipient hearings, if you do not have a phone, but do not want to come to one of BHA’s office locations, you may choose to go to your local County Assistance Office (CAO), and they can provide you with a phone to participate in your hearing.
As an additional alternative in recipient appeals, you may also have your hearing at one of BHA’s Offices, but you can permit the representative of the office, agency, or entity that took the action to appear over the phone.
You need to file with BHA a request for a subpoena. A subpoena is a formal demand for someone to come to BHA and provide evidence (documents, items, or testimony). Sometimes the subpoena is just a demand to supply documents without the need to come to BHA. A BHA Judge must approve of your subpoena request before you can give it to (serve it on) the person who you want to provide testimony or evidence.
Here are forms that will help you request a subpoena:
By the time of your hearing, you may not need your appeal because you and the office, agency, or entity that took the action worked out the problem, or your benefits were approved. This happens more often than you might realize. When this occurs, you need to inform BHA that a hearing is no longer needed because you have resolved the problem. You, or your authorized representative or attorney, must inform BHA that you want to withdraw your appeal. (Do not assume that telling your caseworker that you want to withdraw actually withdraws your appeal. The caseworker is not your authorized representative, and they cannot withdraw your appeal, even if you asked them to do so.)
By withdrawing your appeal, you agree to allow BHA to end your appeal without conducting a hearing or making a decision. BHA will not enter any type of order telling the office, agency, or entity that took the action to do anything.
You may withdraw your appeal for any reason, and BHA will not demand or ask why. So, if you withdraw, make sure that is what you want to do before filing your withdrawal request.
You may withdraw your appeal in any of the following manners:
- Send a written document to BHA or the office, agency, or entity that took the action. On that document, you must indicate that you wish to withdraw your appeal. A form you can use to withdraw your appeal can be found here: Appeal Withdrawal. (Spanish version: Appeal Withdrawal (Spanish).) If you send the written document to the office, agency, or entity that took the action, that office, agency, or entity will forward your document to BHA.
- You and your caseworker call BHA’s withdrawal hotline, an automated system where you can place your withdrawal on a recording which will allow BHA to mark your appeal withdrawn.
- Call BHA and ask to withdraw your appeal. You will be placed on the phone with a Judge who will take your withdrawal over the phone and on the record.
- Appear for your hearing (either in-person or on the telephone) and withdraw your appeal at the hearing with the Judge and on the record.
Once your withdrawal is processed, you will receive a notification that it has been processed and your appeal closed.
BHA does NOT have access to the records kept by the office, agency or entity that took the action. For example, BHA cannot look up the status of your benefits, and we do not know what level of benefits are currently active for your or your family. We cannot assist you with questions that should be directed to the office, agency or entity that took the action.
BHA also cannot help you with complaints regarding how employees or caseworkers of the office, agency or entity that took the action treated you or your family. This is because BHA does not have oversight over employee interactions with you. There may be other ways for you to complain about an employee with the office, agency or entity that took the action. You will need to contact that office to complain about one of their employees.
Yes you can. You can file a request for Reconsideration to the Department’s Secretary. You can also file an appeal with the Pennsylvania Commonwealth Court. And you can file for both at the same time. Notice: All parties should follow appeal timelines associated with the Reconsideration process and the Commonwealth Court as outlined in the Final Orders issued by BHA. All language on the website is meant to serve as a guide and does not replace the written Orders issued by BHA.
- Reconsideration — You have fifteen (15) calendar days from the date of the decision to request reconsideration by the Secretary of the Department. To seek reconsideration, you must fully complete the application/petition for reconsideration included with the adjudication. The application/petition shall be addressed to the Secretary, but delivered to the Director, Bureau of Hearings and Appeals, P.O. Box 2675, Harrisburg, Pennsylvania, 17105-2675, and must be received in the Bureau of Hearings and Appeals within fifteen (15) calendar days from the date of the Order. This action does not stop the time within which an appeal must be filed to Commonwealth Court. The Applicant/Petitioner shall serve a copy of the application/petition on the opposing party(ies).
- Commonwealth Court — The appropriate party(ies), where permitted, may take issue with the Adjudication, and Order, and may appeal to the Commonwealth Court of Pennsylvania, within thirty (30) days from the date of the order. This appeal must be filed with the Clerk of Commonwealth Court of Pennsylvania, 601 Commonwealth Avenue, Suite 2100, P.O. Box 69185, Harrisburg, PA 17106-9185.
If you file an appeal with the Commonwealth Court, a copy of the appeal must be served on the government unit which made the determination in accordance with Pa. R.A.P. 1514. In this appeal, service must be made to:
Department of Human Services
Bureau of Hearings and Appeals
2330 Vartan Way, 2nd Floor
Harrisburg, PA 17110-9721
AND
Department of Human Services
Office of General Counsel
625 Forster Street, 3rd Floor West
Health & Human Services Building
Harrisburg, PA 17120