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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After winning appeal before ALJ, sb2 secures UHW for alleged transfers of assets for no consideration on behalf of current resident and full Medicaid retroactivity.
12/28/2022
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Appellate Court agrees with sb2’s constitutional arguments and overrules state hearing board’s refusal to give resident a hearing to determine if Medicaid denials were defective.
12/20/2022
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sb2 recovers $52k for assisted living facility using petition filed with the Probate Court, opting not to pursue a civil action seeking collections.
12/13/2022
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Using new state policy on conditional Medicaid approval, county offers to settle sb2’s pending appeal, agreeing to approve all but one month of coverage gap.
12/08/2022
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Prior to hearing on appeal filed by sb2, county agrees that resident was in fact a resident of that state even though she still owned a home in another.
12/01/2022
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sb2 uses CMS regulations and constitutional arguments to unwind penalty period, recovering $120k for longtime client.
11/28/2022
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sb2 uses CMS complaint letter to force MCO to properly determine residents’ actual Medicaid eligibility date.
11/22/2022
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After commencing arbitration, MCO and sb2’s client settle, with sb2 recovering nearly $1.5 mm of $1.6mm and securing a new provider agreement.
11/16/2022
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sb2 recovers 93% of pending unpaid claims and secures corrected billing practices after settling arbitration with MCO.
11/08/2022
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sb2 appeals resident’s Medicaid approval to cure coverage gap for longtime client and wins.
11/03/2022
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sb2 uses federal action to open admit pack denied in ‘19 and secure Medicaid payment for longtime IL client.
11/01/2022
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