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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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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sb2 recovers $27k for assisted living provider after using legal strategy to uncover how POA used resident’s funds during his stay at facility.
10/19/2023
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After appealing Medicaid coverage cap caused solely by resident’s incapacity, caseworker issues new notice of eligibility dating back to resident’s admission.
10/16/2023
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sb2 uses creative litigation strategy to recover $177k of previously written off revenue for large provider.
10/13/2023
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sb2 works with state officials to fend off $3 mm recoupment set to begin in a few days and secures workable repayment plan for provider.
10/10/2023
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sb2 secures January ’17 Medicaid eligibility effective date for resident after federal judge agrees with the firm’s constitutional arguments.
10/06/2023
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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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