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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Even though resident had an application Medicaid pending, sb2 successfully wins discharge hearing overcoming regulation mandating opposite result.
09/12/2022
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sb2 wins another LOC appeal when MCO pays coverage gap and reinstates resident’s Medicaid eligibility.
09/09/2022
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For Illinois client, sb2 qualifies resident back to January ’20 after winning appeal to Circuit Court.
09/06/2022
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sb2 files grievance challenging MCO’s discontinuance of resident’s benefits, and MCO agrees to pay coverage gap.
08/29/2022
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sb2 and client team up to show that trust was irrevocable, and, therefore, assets in trust shouldn’t have been counted to deny resident’s Medicaid eligibility.
08/22/2022
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sb2 uses creative litigation strategy to get state to pay claims submitted by client for approved Medicaid applications dating back years.
08/16/2022
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After Board of Review agrees with sb2 that ALJ erred when he dismissed resident’s application for Medicaid, county issues approval with full retroactivity.
08/10/2022
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sb2 qualifies current resident for Medicaid back to October ’21, relying on state regulation that provides greater protections than CMS.
08/08/2022
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ALJ agrees with sb2 that Medicaid applicant’s resources were unavailable and orders county to approve benefits back to December ’21.
08/02/2022
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sb2 uses state regulation that provides greater benefits than CMS to qualify current resident for Medicaid.
07/25/2022
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After sb2 initiates CMS complaint process, southern state reaches out to resolve delays with processing level of care submissions.
07/22/2022
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