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 has another MCO cut letter overturned by an ALJ, keeping the resident qualified for benefits indefinitely.
12/20/2021
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For longtime client, sb2 unwinds 8 month penalty period for alleged transfer of assets for less than FMV, qualifying resident to date of admission.
12/13/2021
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Using CMS Regulations to overcome Denial, sb2 qualifies current resident for Medicaid back to August ’20.
12/07/2021
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In federal court, sb2 challenges constitutionality of state regulation and qualifies resident back to November ’14.
11/21/2021
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sb2 qualifies current resident back to ’16 after federal court agrees that IL’s TAN requirement must in turn afford due process protections under the Constitution.
11/11/2021
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In response to a sb2’s administrative complaint, CMS commences investigation into how state calculates resident patient pay liability when there are federal garnishments, etc.
11/09/2021
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sb2 wins another level of care appeal when ALJ agrees that MCO should not have cut resident’s Medicaid eligibility.
11/04/2021
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sb2 wins another LOC dispute with MCO, recovering $34k and securing current resident’s Medicaid eligibility.
10/26/2021
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ALJ agrees with sb2 that MCO should not have discontinued resident’s Medicaid benefits because her LOC had not in fact improved.
10/19/2021
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sb2 uses state and federal regulations to zero out current resident’s monthly Patient Pay Liability mandated as a condition of Medicaid eligibility.
10/12/2021
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IN Board denies AG’s appeal to overturn sb2’s win on unavailability of excess resources based on CMS Regulations.
10/06/2021
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