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 secures UHW based on the transfer of resident’s home for LFMV, securing $170k in retroactive Medicaid payments plus prospective benefits for client.
07/25/2024
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ALJ agrees with sb2 and rescinds another Medicaid denial for current resident because county violated resident’s due process rights by not giving proper notice.
07/23/2024
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After sb2 appealed waiver program’s policy for calculating a current resident’s shortened Medicaid eligibility date, agency grants eligibility effective the date of resident’s admission.
07/18/2024
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sb2 and client successfully argue on appeal that sb2’s fees are a reimbursable expense on client’s cost report.
07/16/2024
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For new FL client, sb2 uses CMS Regs, State Master Contract, and administrative complaints to stop excessive MCO audits and obtain the return of recouped payments.
07/11/2024
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After filing an appeal with state appellate court, department agrees to open resident’s denied application for Medicaid and grant all but two weeks of eligibility.
07/09/2024
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sb2 secures rare UHW for the alleged transfer of assets solely for Medicaid planning purposes for longtime client, resulting in $60k benefit.
07/05/2024
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After appealing two ALJ dismissals of administrative Medicaid appeals to the court of appeals, state subsequently agrees to open both denied applications with full Medicaid retroactivity.
07/02/2024
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sb2 uses CMS Regulation and Rehabilitation Act to qualify current resident for Medicaid effective Jan ’23.
06/27/2024
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For IL provider, sb2 recovers nearly $1 mm for client based on MCOs failure to comply with state regulation governing single case agreements.
06/25/2024
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sb2 uses federal regulations to qualify current resident for Medicaid back to August ’23 without establishing QIT or producing community spouse’s verification.
06/20/2024
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