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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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

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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

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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

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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

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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

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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

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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

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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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