Hearings & Appeals Stakeholders
An individual or provider who appeals a decision made by DHS or PA Department of Aging (PDA) regarding services, benefits, or agency actions. The Appellant is the applicant or recipient appealing a determination of benefits. The Appellant role may include, but is not limited, to the following alternate actors:
- Appellant Representative (Individual/Participant)
- Family members
- Registered Community Partner
- Authorized Representative (e.g. Attorney, Power of Attorney, etc.)
The Commonwealth Court is one of Pennsylvania's two statewide intermediate appellate courts. It was established in 1968 and its jurisdiction is generally limited to legal matters involving state and local government and regulatory agencies. Appellants can appeal to the Commonwealth Court who may perform a Judicial Review related to the appeal and issue a decision.
Community Partners are registered community-based agencies, organizations, coalitions, hospitals, church groups and other groups that wish to help Pennsylvanians submit applications and appeals for health and human services.
Pennsylvania Department of Aging (PDA)
PDA works to ensure older adults across Pennsylvania have access to quality services and supports that help them age and live well.
Program Office Hearings and Appeals Staff
Representatives from DHS and Aging Program Offices who support the Hearings and Appeals processes.
Pennsylvania Department of Human Services, Office of the Secretary (Reconsideration Unit)
The appellant may request Reconsideration of the Bureau of Hearing and Appeals' (BHA) final decision. This decision does not have to be the decision resulting from a hearing. If BHA dismisses an appeal, the Appellant will receive Reconsideration rights. The Office of the DHS Secretary reviews the appeal file that has been sent for reconsideration and determines if reconsideration will be granted.
Secretary of the PA Department of Aging (Chief Counsel designee)
In a Department of Aging appeal, the Administrative Law Judge writes an adjudication and the Secretary of the Department of Aging (or Chief Counsel designee) reviews the appeal file and adjudication in the form of a proposed report and issues a Final Order to accept the proposed report or reverse it.
PA DHS Providers
An individual or entity that is engaged in the delivery of medical or professional services, or ordering or referring for those services, and is legally authorized to do so by the Commonwealth or State in which it delivers the services.
Office of Income Maintenance County Assistance Office (CAO) Staff
CAO Clerks are employees that perform clerical support for appeals processing. This role may also be known as an Appeals Clerk and may include the clerk supervisor classification. The Income Maintenance Case Worker (IMCW) within the CAO makes benefit determinations and participates in the appeals process. This role may also be performed by an IMCW Supervisor. The IMCW or IMCW Supervisor must include everything that is part of making a determination like why the Appellant is appealing, basis to appeal, due dates, etc.
Program Office or Designee Staff
An authorized user from any DHS Program Offices, PDA, or their designee's staff. This does not include BHA.
Commonwealth or Designee Staff
An authorized user from any of DHS Program Offices, PDA, BHA or their designee or vendor's staff.
BHA Vendor Staff
An entity/vendor of the Bureau of Hearings and Appeals.
Federal Hearings and Appeals (FHA)
FHA is an independent provider of administrative fair hearing and medical appeals services.
FHA is currently contracted to provide hearing and appeals services on behalf of BHA to the Northeast area of the state, in addition to other cases as assigned by BHA
Food and Nutrition Services (FNS)
FNS is an agency of the United States Department of Agriculture (USDA).
Third parties may participate in hearings. Examples of third parties include interpreters and witnesses.