ALBANY, N.Y. ( NEWS10 )– Albany Med Health System has filed legal action against the Capital Region Physicians Health Plan, Inc. (CDPHP) for refusing to give the hospital roughly $27 million for provided care. Hospital officials said the insurance company allegedly defrauded 16,225 claims since Aug. 8, and approximately $8 million of additional obligations have been held from the hospital since January.
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Albany Medical Center notified the New York State Department of Financial Services on Monday, Sept. 16, of its belief that CDPHP was violating state insurance laws. On Tuesday, a pay complaint was filed for the insurance company that did not meet the hospital’s contract terms.
Albany Med Health System President and CEO Dennis McKenna said the insurance company’s decisions threaten local healthcare. “Patients should be able to trust that their insurance company is being managed in a fiscally responsible way, because it impacts access to the care they need,” McKenna said.