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’s constitutional arguments and overturns denial of Medicaid application because caseworker failed to properly notice verification requests.
06/08/2023
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sb2 intervenes on behalf of client and uses petition to force resident’s co-guardians to qualify her for Medicaid.
06/05/2023
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Despite alleged transfers of assets for less than FMV, sb2 quickly qualifies long-time resident for Medicaid.
05/25/2023
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sb2 convinces court to appoint an interim Medicaid authorized representative to qualify resident for Medicaid while a petition for guardianship pends
05/23/2023
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MCO agrees to pay nearly $20k in interest for not processing and paying client’s claims timely.
05/17/2023
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sb2 uses civil action filed on behalf of 6 residents to secure payment of long-pending claims submitted by client.
05/15/2023
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sb2 uses CMS assistance regulation to overturn Denial and obtain retroactive Medicaid benefits for resident.
05/12/2023
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ALJ agrees with sb2 that resident couldn’t fund QIT because pension benefits were unavailable, directing county to redetermine Medicaid eligibility effective date.
05/10/2023
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sb2 appeals denial of current resident’s Medicaid application secures eligibility back to April ’22.
05/03/2023
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sb2 appeals penalty period for current resident’s transfers of assets and secures 90% reduction of Medicaid ineligibility period.
04/27/2023
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sb2 pushes MCO to reopen and process $200k in claim denials going back years related to single case agreements.
04/25/2023
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