Retroactive Removal of Sanctions

50.7 - Retroactive Removal of Sanctions (Rev. 4409, Issued: 10-04- 19, Effective: 11-05-19, Implementation: 11-05-19) PM AB-01-131 Occasionally, resolution between the State Agency and the SNF is reached after the payment ban has been imposed, and the ban is removed retroactive to its effective date. If bills were denied before notice was received that the ban had been reversed, they should be reprocessed and paid. When reprocessing bills, MDS assessments are needed to support the case-mix classification group billed. Beneficiaries and providers may request A/B MACs (A) to reopen and process bills denied as a result of a misunderstanding of the sanction requirements. These reopenings shall be done on a request basis only, and will be limited to service dates on and after January 1, 1999.