55 Pa. Code § 41.191 - Determinations and recommendations by the Bureau
(a) The Bureau will conduct a de novo review
of the factual and legal issues that are timely raised and properly preserved
in a provider appeal . Except as provided in subsection (b), the Bureau will
issue a determination adjudicating the contested issues of law and fact within
its jurisdiction, and issue an appropriate order, decree or decision.
(b) If a request for hearing includes a
waiver request , the Bureau will make a written recommendation for consideration
by the Secretary proposing that the waiver be either granted or denied and
stating the Bureau 's reasoning in support of its position. If the request for
hearing raises factual and legal issues in addition to the waiver request , the
Bureau will issue its written recommendation together with its final
determination adjudicating the remaining factual and legal issues, as specified
in subsection (c). If the request for hearing does not raise other issues, the
Bureau 's written recommendation on the waiver request will be issued within the
time limits and served on the parties as specified in subsection (c).
(c) The Bureau will issue a determination in
a provider appeal within 30 days of the filing of the posthearing briefs, or,
if the parties waive the filing of posthearing briefs, within 30 days of the
close of the record or receipt of the transcript, whichever is later. The
Bureau will serve a copy of its determination on the parties to the proceeding
or their representatives.
(d) A
party aggrieved by a determination of the Bureau may request the Secretary to
review the determination under §
41.212 (relating to review of
Bureau determinations). For purposes of this section, a program office will be
deemed to be aggrieved if the Bureau determination does one or more of the
following:
(1) Sustains the provider 's appeal
in whole or in part.
(2) Interprets
a statute, regulation, statement of policy or bulletin applied by the program
office in a manner inconsistent with the interpretation of that
office.
(3) Alters a policy of the
program office or purports to impose a new or different rule or policy on the
program office.
(e) The
Secretary will review written recommendations of the Bureau issued under
subsection (b) or (c) under §
41.213 (relating to review of
bureau recommendations).
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