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 uses proven strategy to push MCO to pay claims that were denied years ago and never appealed by client.
01/09/2024
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sb2 reduces MCO recoupment by nearly 50% and gets MCO to amend several provisions in provider agreement.
01/03/2024
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Using constitutional arguments and the ADA, sb2 secures Medicaid eligibility (with full retroactivity) for current resident without having to produce requisite financial documentation.
12/26/2023
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sb2 secures January ’17 Medicaid eligibility effective date for resident after federal judge agrees with the firm’s constitutional arguments.
12/21/2023
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sb2 uses state and federal regulations to qualify current resident back to Jan ’23 without producing requisite financial verification or spending down excess resources.
12/19/2023
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sb2 uses prehearing conference with ALJ to persuade county to open resident’s denied Medicaid application for failing to comply with federal regulations.
12/14/2023
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Using CMS regulations and the ADA, sb2 qualifies current resident for Medicaid back to Feb ’23.
12/11/2023
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For longtime client, sb2 wins UHW Request based on resident’s alleged transfer of assets for less than fair consideration & solely for Medicaid planning purposes.
12/07/2023
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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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