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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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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For NJ client, sb2 works with OPG to secure Medicaid eligibility for current resident back to May ’19.
08/11/2021
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Using CMS Regulations, sb2 intervenes and qualifies current resident, who had a $170k outstanding balance, for Medicaid benefits.
08/04/2021
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sb2 challenges skilled nursing care resident’s LOC determination and wins, resulting in nearly 18 months of retro-Medicaid benefits.
07/29/2021
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ALJ agrees with sb2 that resident cannot be denied Medicaid eligibility because another state refuses to “turn off” his Medicaid benefits there.
07/27/2021
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