
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 that sb2’s DAR survives death of resident overruling county’s jurisdictional challenges.
12/06/2024
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sb2 uses civil litigation to force resident’s POA to qualify resident for Medicaid and turn over monthly patient pay liability.
12/04/2024
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In response to issues raised by sb2, CMS agrees to investigate whether state’s redetermination denials comply with federal law.
11/29/2024
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Days before hearing on sb2’s appeal, contesting denial of resident’s Medicaid application for failing to provide requisite verification, county approves application with full retroactivity.
11/27/2024
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Probate Court agrees with sb2 and blocks beneficiaries of estate from pursuing alleged fraudulent billing claims against client.
11/26/2024
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sb2 relies on CMS Regulations to overcome excess resources to qualify current resident for Medicaid effective June ’24.
11/26/2024
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sb2 uses Undue Hardship Waiver (UHW) to unwind $125k period of ineligibility based on alleged transfer of assets for Medicaid planning purposes.
11/20/2024
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Appellate court again agrees with sb2 that client has standing to represent current resident, rebuffing AG’s attempt to dismiss the firm’s most recent Medicaid appeal.
11/15/2024
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In response to sb2’s CMS administrative complaint, state employs additional resources to clear backlog of long-pending applications for Medicaid.
11/13/2024
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Although county failed to file appeal summary or attend hearing, ALJ holds hearing and agrees with sb2 that denial of resident’s application was in error, granting full Medicaid retroactivity.
11/05/2024
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sb2 appeals long pending application and secures conditional Medicaid eligibility for current resident, erasing $60k Medicaid coverage gap.
10/31/2024
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