News

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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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In a first for this state, ALJ agrees with sb2 that resident wasn’t required to provide her community spouse’s financial information based on federal statute to qualify for Medicaid.

10/05/2023

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State agrees with sb2 that because of the express wording of State Plan Amendment, residents may OME/income deviate 3 months prior to each Medicaid application filed on their behalf.

10/02/2023

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In response to sb2’s civil action, state cures resident’s Medicaid coverage gap based on eligibility requirement that was never approved by CMS.

09/28/2023

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Based on sb2’s administrative complaint, CMS agrees to investigate state’s refusal to exclude unavailable income in current residents’ monthly patient pay obligation.

09/26/2023

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For assisted living provider, sb2 obtains payment of $50k and negotiates security interest to guarantee secure future payments.

09/22/2023

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sb2 uses CMS regulations and the Rehabilitation Act to secure conditional Medicaid benefits for resident who lacks capacity and an agent to qualify her for Medicaid.

09/20/2023

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sb2 intervenes and secures conditional Medicaid approval for current resident after county denied client’s request.

09/14/2023

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Using CMS and favorable state regulations, sb2 qualifies current resident for Medicaid back to April ’22.

09/12/2023

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After sb2 files action requiring resident to qualify for Medicaid, state court judge calls resident, and resident immediately funds QIT and spends down excess resources.

09/06/2023

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For rapidly expanding provider with over 50 homes, sb2 recovers 29 months of retro Medicaid benefits for two residents.

08/31/2023

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sb2 uses Social Security Complaint Letter to clear backlog of Rep Payee requests submitted by client.

08/29/2023

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