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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Although county failed to file appeal summary or attend hearing, ALJ holds hearing and agrees with sb2 that denial of resident’s application was in error, granting full Medicaid retroactivity.
11/05/2024
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sb2 appeals long pending application and secures conditional Medicaid eligibility for current resident, erasing $60k Medicaid coverage gap.
10/31/2024
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Day before state hearing on appeal challenging denial of current resident’s Medicaid application, case worker issues notice of action approving benefits with full retroactivity.
10/29/2024
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sb2 helps client secure provisional eligibility for resident whose application for Medicaid pended longer than allowed by the applicable CMS regulation.
10/25/2024
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Board of review agrees to open dismissed appeal hearing based on sb2’s appeal challenging the constitutionality of the ALJ’s actions.
10/22/2024
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The day before appealing hearing, challenging the CAO’s failure to grant full Medicaid retroactivity, caseworker issues new notice of eligibility with proper effective date.
10/17/2024
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Administrative Law Judge agrees with sb2 and orders county to approve current resident’s application back to December 2023, based on violation of CMS Regulation.
10/15/2024
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For large assisted living provider and client for over 20 years, sb2 uses petition filed with the court to recover $38k.
10/09/2024
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In a first, trial court agrees with sb2 and denies hospital’s attempt to dismiss lawsuit seeking damages for not disclosing that resident was an undocumented migrant ineligible for Medicaid.
10/02/2024
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sb2 again uses CMS Regulations & Rehabilitation Act to qualify current resident for Medicaid benefits effective October ’23.
09/25/2024
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sb2 uses federal administrative complaints to force start processing delayed Medicaid applications, resulting in significant cash flow increase for client.
09/18/2024
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