News

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 and client team up to show that trust was irrevocable, and, therefore, assets in trust shouldn’t have been counted to deny resident’s Medicaid eligibility.

08/22/2022

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sb2 uses creative litigation strategy to get state to pay claims submitted by client for approved Medicaid applications dating back years.

08/16/2022

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After Board of Review agrees with sb2 that ALJ erred when he dismissed resident’s application for Medicaid, county issues approval with full retroactivity.

08/10/2022

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sb2 qualifies current resident for Medicaid back to October ’21, relying on state regulation that provides greater protections than CMS.

08/08/2022

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ALJ agrees with sb2 that Medicaid applicant’s resources were unavailable and orders county to approve benefits back to December ’21.

08/02/2022

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sb2 uses state regulation that provides greater benefits than CMS to qualify current resident for Medicaid.

07/25/2022

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After sb2 initiates CMS complaint process, southern state reaches out to resolve delays with processing level of care submissions.

07/22/2022

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sb2 uses CMS Complaint to push state to pause level of care screening process that has been costing providers significant Medicaid revenue.

07/18/2022

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After a three year battle, including a win at the OH state appellate court arguing constitutional violations, sb2 qualifies resident for Medicaid back to September ’16.

07/12/2022

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sb2 wins another state hearing appeal when judge agrees that MCO’s cut letter was issued against the available medical evidence of improved condition.

07/08/2022

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Applying CMS regulations, sb2 opens notice issued in January ’21 denying application for Medicaid and subsequently qualifies resident for Medicaid.

07/05/2022

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