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 convinces ALJ to overturn denial of resident’s Medicaid application because case worker failed to assist resident with obtaining missing verification.
07/11/2023
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MCO agrees to cover residents stay even after resident no longer met LOC because MCO failed to follow state master contract before terming eligibility.
07/07/2023
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Using CMS and state regulations on unavailability of assets & what constitutes reasonable efforts, sb2 qualifies resident, with excess resources, for Medicaid.
07/03/2023
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Using CMS Regulations and the ADA, sb2 qualifies current resident back to November ’22.
06/30/2023
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sb2 appeals state’s rejection of client’s OME/PEME requests and recovers over $47k.
06/27/2023
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sb2 uses state regulations more favorable than CMS’s to secure 11 months of retroactive Medicaid benefits for deceased resident.
06/23/2023
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Client and sb2 team up to secure conditional Medicaid benefits for resident whose POA has repeatedly breached his fiduciary duties.
06/19/2023
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sb2 secures Medicaid eligibility for current resident even though she owns real estate in another state putting her over the resource limit.
06/16/2023
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sb2 helps client timely perfect claim against former resident’s estate in another state and recovers $40k.
06/13/2023
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ALJ agrees with sb2’s constitutional arguments and overturns denial of Medicaid application because caseworker failed to properly notice verification requests.
06/08/2023
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sb2 intervenes on behalf of client and uses petition to force resident’s co-guardians to qualify her for Medicaid.
06/05/2023
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