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 quickly settles significant recoupment appeal, so client can timely close on sale of skilled nursing facility.
12/05/2023
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After ALJ agrees with sb2 that availability and not ownership determines countability of assets, county opts to grant pending Medicaid application, with full retroactivity, instead of appealing.
11/30/2023
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Using strategies highlighted in last month’s Virtual Conference, sb2 gets MCO to pay 3-year-old denied claims totaling $37.5k that weren’t appealed by client.
11/27/2023
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True to its PHE Wind Up promises, CMS responds to sb2’s complaint by directing state to comply with the agency’s regulations, resulting in numerous Medicaid application approvals for client.
11/22/2023
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Three providers with nearly 75 facilities hire sb2 to train staff and handle Medicare/Medicaid eligibility & reimbursement issues.
11/20/2023
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ALJ agrees with sb2 and orders county to reopen resident’s application for Medicaid because caseworker failed to comply with CMS assistance regulations.
11/14/2023
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Employing equitable trust, sb2 takes control of real estate sale proceeds to compensate client over $30k for skilled nursing services rendered to deceased resident.
11/08/2023
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sb2 uses CMS regulations and constitutional arguments to secure Medicaid eligibility back to Oct ’22 for current resident.
11/01/2023
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ALJ agrees with sb2 that county failed to properly assess resident’s request for an Undue Hardship Waiver for the alleged transfer of $100k in assets for less than FMV.
10/27/2023
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sb2 uses new state policy to qualify unlawful migrant for Medicaid to cover skilled nursing care being provided by client.
10/26/2023
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In a first for this state, Judge explicitly adopts CMS regulations that read not all assets owned by a resident are available when counting assets for Medicaid eligibility.
10/24/2023
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