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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