The Albany Med Health System is suing health insurer CDPHP.
The hospital says the insurer withheld at least $50 million from Albany Medical Center for care it provided to CDPHP customers. The hospital says it has not received a formal response from CDPHP.
The hospital says it has not experienced similar practices with other insurance companies.
CDPHP acknowledges the withholding of payments and blames a federal change to the Medicare Wage Index for hospitals.
The Centers for Medicare and Medicaid Services approved significant payment increases that affected several hospitals in New York, with rate increases ranging between 20 and 43 percent, according to CDPHP.
At the same time, CDPHP says CMS failed to align private Medicare Advantage premiums with the adjustment, effectively leaving the insurance provider with “a significant unfunded mandate that will result in nearly $150 million in losses over the next two years.”
Albany Med says it has “not yet decided to drop CDPHP as an accepted insurance plan, but it will not negotiate next year’s contract until the insurance company fulfills its outstanding obligations.”