Pennsylvania Code & Bulletin

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 52 Pa.B. 7348 (November 26, 2022).

55 Pa. Code § 2070.41. General requirements.


§ 2070.41. General requirements.

 (a)  Each applicant or client shall be notified of an eligibility determination or redetermination within 10 calendar days of the date of the decision.

 (b)  The applicant or client may be notified either orally or in writing of an eligibility determination or redetermination which is favorable to the applicant or client.

 (c)  Each applicant or client shall be notified by means of a Departmentally approved written notice form of a determination or redetermination of need resulting in a denial, reduction, or termination of service; except that the notification may be made orally if the requested service is either provided or continued without interruption through another funding source or if the client agrees with the termination.

 (d)  If a written notice is required, providers shall complete in triplicate applicable portions of the written notice form, including:

   (1)  A clear statement of the decision and the effective date.

   (2)  A full statement of the reasons for the decision.

   (3)  A citation and brief explanation of the regulations used as the basis for the decision.

   (4)  Pertinent information concerning the applicant’s or client’s right to appeal and request a Departmental fair hearing.

 (e)  Following the preparation of a written notice form, the provider shall:

   (1)  Promptly mail or hand-deliver the original and one copy to the applicant or client.

   (2)  Retain the final copy in either the client’s file or in a rejected application file, as appropriate.

 (f)  A county or prime contractor may require its providers to:

   (1)  Prepare and submit to the county or prime contractor for approval and mailing all written notices to applicants and clients.

   (2)  Submit an ‘‘information only’’ copy to the county or prime contractor of written notices prepared by the provider.

 (g)  If a county or prime contractor receives an appeal from an applicant or client, it shall:

   (1)  When a client is currently receiving services, continue service to the client if the request for appeal and fair hearing is postmarked within 10 days of the date the notice was mailed or hand delivered to the client.

   (2)  Forward the client’s applicant’s request for fair hearing to the Department’s Office of Hearing and Appeals within 72 hours of its receipt.

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