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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Appeal Board agrees with sb2 that state regulation allows providers (in certain instances) to file Medicaid appeals without a DAR.
05/24/2021
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sb2 pushes state to pay out on several notices of Medicaid eligibility, one for $108k alone, that have languished in a CMS unapproved department.
05/21/2021
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sb2 uses CMS regulations to qualify current resident for Medicaid and recover $125k in retro benefits.
05/19/2021
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After stepping in and qualifying current resident, whose Medicaid application had pended for over 1 year, sb2 also obtains Undue Hardship Waiver for restricted period.
05/13/2021
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sb2 wins another state appellate court case when AG agrees that notice denying resident’s application for Medicaid was defective and authorizes approval of benefits back to ’18.
05/10/2021
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On remand from appellate court win, ALJ agrees with sb2 that assets putting resident over resource limit were unavailable and ordered county to grant Medicaid benefits.
04/30/2021
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sb2 files Undue Hardship Waiver challenging penalty/restricted period for alleged transfers of assets for less than FMV and wins, securing Medicaid eligibility for current resident.
04/27/2021
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IL’s largest provider retains sb2 to recover payment for backlogged MCO claims.
04/23/2021
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sb2 relies on federal regulations to unwind significant penalty period and spousal refusal to qualify current resident back to June ’20.
04/20/2021
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Arbitrator agrees with sb2 and denies MCO’s motion to dismiss 65 claims based on lack of documentation that MCO should have kept.
04/16/2021
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Even though current resident still hasn’t satisfied the resource limit for Medicaid eligibility, sb2 qualifies her back to the date admission, April ’20.
04/14/2021
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