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 recovers $27k for assisted living provider after using legal strategy to uncover how POA used resident’s funds during his stay at facility.

10/19/2023

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After appealing Medicaid coverage cap caused solely by resident’s incapacity, caseworker issues new notice of eligibility dating back to resident’s admission.

10/16/2023

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sb2 uses creative litigation strategy to recover $177k of previously written off revenue for large provider.

10/13/2023

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sb2 works with state officials to fend off $3 mm recoupment set to begin in a few days and secures workable repayment plan for provider.

10/10/2023

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sb2 secures January ’17 Medicaid eligibility effective date for resident after federal judge agrees with the firm’s constitutional arguments.

10/06/2023

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In a first for this state, ALJ agrees with sb2 that resident wasn’t required to provide her community spouse’s financial information based on federal statute to qualify for Medicaid.

10/05/2023

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State agrees with sb2 that because of the express wording of State Plan Amendment, residents may OME/income deviate 3 months prior to each Medicaid application filed on their behalf.

10/02/2023

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In response to sb2’s civil action, state cures resident’s Medicaid coverage gap based on eligibility requirement that was never approved by CMS.

09/28/2023

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Based on sb2’s administrative complaint, CMS agrees to investigate state’s refusal to exclude unavailable income in current residents’ monthly patient pay obligation.

09/26/2023

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For assisted living provider, sb2 obtains payment of $50k and negotiates security interest to guarantee secure future payments.

09/22/2023

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sb2 uses CMS regulations and the Rehabilitation Act to secure conditional Medicaid benefits for resident who lacks capacity and an agent to qualify her for Medicaid.

09/20/2023

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