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 secures another state court appellate win challenging the constitutionality of actions taken by state officials applying state and federal Medicaid regulations.
10/04/2021
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After hearing before ALJ, AG agrees with sb2’s constitutional arguments and approves current resident’s Medicaid application back to June ’19.
09/30/2021
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In IL, sb2 files inaction appeal requesting approval of OME coverage gap, and caseworker instead adjusts Medicaid eligibility effective date to cure the gap.
09/27/2021
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Illinois hearing officer opens up Medicaid application for skilled nursing benefits filed in ’16 after finding that caseworker failed to give proper notice of Denial.
09/20/2021
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After commencing dispute resolution and preparing to file litigation, MCO agrees to pay nearly $400k to provider and stop including certain prescriptions in global rate.
09/20/2021
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sb2 and regional provider team up to stop state from retroactively recouping Medicaid benefits using regulations that were never approved by CMS and passed through the legislative process.
09/14/2021
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sb2 convinces ALJ that failure to assist incapacitated resident with securing needed verification to determine eligibility constitutes a violation of her federal rights.
09/02/2021
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After nearly 4 years of litigation, IL finally acknowledges in SPA submitted to CMS that skilled nursing residents have the right to OME/Income Deviate coverage gaps.
08/25/2021
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sb2 uses Undue Hardship Waiver to cure $100k period of Medicaid ineligibility imposed for transfer of resources for less than FMV.
08/23/2021
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sb2 qualifies current resident for Medicaid (effective Jan ’01) after winning $50k Undue Hardship Waiver.
08/17/2021
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sb2 wins another state appellate court case when attorney general agrees that administrative law judge’s decision was incorrect.
08/12/2021
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