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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For medical equipment provider, sb2 commences dispute resolution based on MCO’s failure to timely pay claims recovers $200k.
05/10/2022
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After filing appeals and commencing settlement negotiations, MCO approves denied claims on behalf of longtime client.
05/06/2022
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sb2 qualifies current resident for Medicaid back to May ’21 using federal constitutional arguments.
05/03/2022
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sb2 wins another Undue Hardship Waiver for a resident’s alleged transfer of assets for less than FMV, securing $57k and prospective Medicaid eligibility.
04/25/2022
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Appellate court agrees with sb2 that administrative law judge violated resident’s due process rights when he dismissed her Medicaid appeal.
04/20/2022
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After ALJ dismisses Medicaid appeal for standing, sb2 convinces the PA Secretary for DPW to reopen the case.
04/13/2022
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sb2 again uses CMS Regulations to convince ALJ to exempt resident’s excess resources, obtaining Medicaid eligibility back to October ’20.
04/05/2022
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sb2 wins another Undue Hardship Waiver case when ALJ agrees that resident did not transfer assets solely for Medicaid planning purposes.
04/05/2022
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sb2 uses CMS’s spousal right of refusal regulations to qualify current resident back to August ’21.
03/28/2022
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sb2 gets MCO to pay over $1 mm in claims submitted by client using the common law to persuade MCO that a contract did in fact exist between the parties.
03/17/2022
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sb2 turns to CMS to force MCOs to allow provider to OME/income deviate resident coverage gaps, resulting in $272k payment.
03/06/2022
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