what we've done lately.
After commencing arbitration, sb2 recovers $1.6 mm from MCO for two of client’s behavioral healthcare facilities.
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sb2 successfully fends off MCO’s attempt to unilaterally change daily rate for skilled nursing care, saving client approximately $11,000 per day.
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sb2 uses proprietary strategy to recover $917,194.00 from MCO for long time client.
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sb2 appeals to federal & state administrative courts to force MCO to load new provider agreements and pay claims pending since the beginning of ’25.
09/16/2025
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For new NJ client, sb2 secures their first ever UHW for the transfer of assets done solely for Medicaid purposes, curing a $130k Medicaid coverage gap.
09/11/2025
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sb2 uses writ of mandamus to secure Medicaid eligibility for current resident retroactive to June ’23.
09/09/2025
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ALJ agrees with sb2 that resident’s recently appointed guardian did not have access to excess resources, ordering county to approve Medicaid application.
09/02/2025
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sb2 unwinds $630,000 active recoupment even though MCO had previously stated that client had exhausted its administrative remedies.
08/25/2025
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sb2 qualifies another current resident for Medicaid using CMS Regulations and county’s lack of compliance with them.
08/19/2025
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After an appeal to state appellate court, and subsequently prevailing before an ALJ, sb2 qualifies deceased resident for Medicaid.
08/12/2025
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sb2 uses administrative complaints to fully recover unpaid claims from MCO, even though provider untimely submitted the claims for payment.
08/05/2025
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ALJ agrees with sb2 and reopens resident’s Medicaid application filed in April ’25 based on evidence that resident lacked capacity to assist with her eligibility.
07/29/2025
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sb2 secures priority lien on real property located in the Bahamas after qualifying undocumented migrant for Medicaid.
07/22/2025
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After 6 years of litigation, including two appellate court wins, ALJ orders county to grant resident’s application for Medicaid filed March ’19.
07/15/2025
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