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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sb2 uses assignment of community spouse’s support obligation to qualify current resident for Medicaid, recovering $51k for client.
02/09/2023
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sb2 persuades federal court to recognize providers’ property interest in approved Medicaid applications and states obligation to adhere to CMS Regulations as a result.
02/07/2023
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sb2’s beats another MCO attempt to cut current resident’s Medicaid eligibility after proving that resident continues to need skilled nursing care.
02/02/2023
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sb2 wins Undue Hardship Waiver for the alleged transfer of assets solely for Medicaid planning purposes and secures Jan ’22 eligibility date for current resident.
01/27/2023
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sb2 uses CMS administrative complaint to force state’s compliance with administrative hearing requirements and timely disposition of appeals.
01/24/2023
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sb2 obtains Medicaid eligibility for 3 current residents for two providers after filing Inaction Appeals based on MCO’s failure to comply with state’s MCO master contract approved by CMS.
01/20/2023
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After Board of Review affirms that provider was entitled to notice and a hearing to dispute disenrollment of current resident, MCO settles matter for nearly $40k.
01/17/2023
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sb2 qualifies current resident for Medicaid effective June ’22 after appealing Medicaid denial and proving that missing verifications were unavailable.
01/12/2023
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sb2 uses CMS mandated provisions in State Master Contract to open MCO’s defective notice denying 8 months of Medicaid coverage for current resident.
01/09/2023
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sb2 qualifies current resident for Medicaid effective June ’22 after appealing Medicaid denial and proving that missing verifications were unavailable.
01/06/2023
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For large provider of laboratory pathology services, sb2 uses CARES Act to force MCO to pay rate published on provider’s website for COVID tests.
01/04/2023
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