Albany Med, CDPHP Reach Agreement on New Contract, Outstanding Payments

• CDPHP to remain an accepted insurance plan for System hospitals
• New contract runs through 2026
• Insurer will pay health system back for services provided to members

The Albany Med Health System and CDPHP announced today the organizations have agreed on a new two-year contract which keeps the system in-network and avoids any disruption in care for CDPHP members. Separately, CDPHP has also agreed to reimburse the system for care provided to the insurance company’s members in 2024. The proposal was approved by the Albany Med Health System Board of Directors.

“We are grateful to reach an agreement that preserves our valued patients’ access to the high-quality care they expect and deserve,” said Albany Med Health System President and CEO Dennis P. McKenna, MD. “Many of the advanced services we offer cannot be found anywhere else locally. This agreement recognizes the indispensable role our Albany Med hospitals and health care teams hold in the health of our region. It also acknowledges what is required to provide that care to the people we serve.”

In August 2024, CDPHP notified Albany Med of its intent to begin withholding payments related to the Medicare Wage Index. The withhold related to a new federal rule, which after nearly 40 years of reimbursements at a lower rate for hospitals, increased Medicare payments to hospitals without a corresponding increase in Medicare Advantage payments received by CDPHP and other insurance providers. The rule created a new, unfunded mandate for small, regional health plans, like CDPHP, which provide coverage to patients under private Medicare Advantage plans. By December 2024, CDPHP had withheld $30 million in payments related to the wage index. As part of the agreement, CDPHP will pay Albany Med for the withheld amounts, and Albany Med has dropped its lawsuit against CDPHP.

CDPHP President and CEO Brian O’Grady said the insurer is committed to a contract that covers the necessary cost of care and to collaborating with the Albany Med Health System to maintain and elevate access to care moving forward.

“As a not-for-profit health plan with deep roots in our community, we are grateful to the Albany Med Health System for coming to the table and arriving at a solution that protects those who matter most – our members and their patients. This fair and equitable contract ensures uninterrupted access to critical health care services,” O’Grady said.

For media inquiries, contact:
Matt Markham
Albany Med Health System
518-262-3421
[email protected]

Natalia Burkart
CDPHP
518-542-8524
[email protected]