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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Using CMS Regs, sb2 secures 19 months of Medicaid eligibility for resident at one of long-time client’s PA facilities.

06/04/2024

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Client realizes multi-million-dollar benefit after engaging sb2 to resolve outstanding MCO issues.

05/31/2024

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Prior to hearing before ALJ, MCO agrees that discontinuance letter sent to resident was defective, resulting in $70k payment to client.

05/28/2024

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After appealing denial of current resident’s Medicaid appeal, sb2 secures Medicaid eligibility effective July ’23.

05/23/2024

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Immediately following ALJ’s Order opening current resident’s denied application for Medicaid, county grants application with full Medicaid retroactivity.

05/21/2024

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After caseworker refused to process client’s conditional Medicaid eligibility request for current resident, sb2 filed appeal, and caseworker granted resident’s application.

05/16/2024

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After Board affirmed the denial of client’s appeal, sb2 appealed to state court, and county subsequently approved resident’s application for Medicaid without any coverage gaps.

05/14/2024

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sb2 convinces Board of Review to overturn ALJ’s imposition of $139k ineligibility period for the alleged transfer of real estate for less than FMV.

05/09/2024

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After filing an appeal because of the failure to process resident’s program change, case worker grants Medicaid eligibility with full retroactivity the day before hearing.

05/07/2024

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sb2 uses inaction appeal, citing CMS Regulation, to qualify resident for Medicaid back to March ’23.

05/03/2024

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ALJ agrees with sb2 that that assets which can’t be liquidated due to disability are not countable for Medicaid eligibility purposes, opening denied application.

04/30/2024

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