what we've done lately.
After commencing arbitration, sb2 recovers $1.6 mm from MCO for two of client’s behavioral healthcare facilities.
----
sb2 successfully fends off MCO’s attempt to unilaterally change daily rate for skilled nursing care, saving client approximately $11,000 per day.
----
sb2 uses proprietary strategy to recover $917,194.00 from MCO for long time client.
----
ALJ agrees with sb2’s constitutional arguments and qualifies current resident for Medicaid back to December ’20.
03/01/2022
----
For OH provider, sb2 appeals another LOC disenrollment by MCO and wins, recovering $85k for provider.
02/14/2022
----
Utilizing little known Illinois regulation, ALJ agrees with sb2 and orders DHS to qualify resident for Medicaid back to 2017.
02/09/2022
----
Prior to hearing on sb2’s appeal challenging availability of verification establishing OH resident’s eligibility for Medicaid, county issues NOE granting benefits.
02/04/2022
----
ALJ agrees with sb2 that denial of resident’s application for Medicaid was incorrect when missing verification was unavailable to resident and orders application reopened back to ’20.
01/31/2022
----
sb2 uses state regulations that are more generous than CMS’s to secure $45k, 10 months of retro Medicaid benefits, and prospective Medicaid eligibility for current resident.
01/24/2022
----
sb2 unwinds another penalty/restricted period based on the alleged transfer of assets for less than fair consideration, qualifying a current resident back to March ’21.
01/20/2022
----
During hearing on appeal challenging denial of resident’s application for Medicaid, agency agrees to rescind denial and grant Medicaid benefits back to January ’21.
01/18/2022
----
ALJ agrees with sb2 that denial of resident’s application for Medicaid was incorrect when missing verification was unavailable to resident and orders application reopened back to ’20.
01/14/2022
----
sb2 stops another state recoupment action when AG agrees to stop collection efforts for alleged overpayments after sb2 appeals to state court.
01/12/2022
----
After receiving sb2’s Complaint, CMS agrees to investigate why state deems alimony, federal garnishments, etc., as available income in contravention of the agency’s regulations.
12/28/2021
----