The standoff between Albany Medical Center and insurer CDPHP continues.
The Albany Med Health System filed suit against health insurer CDPHP in October, and says it could drop CDPHP all together in the new year. Albany Medical Center President and CEO Dr. Dennis McKenna says CDPHP now owes nearly $40 million for services provided in 2024.
"That's money that as a not for profit, as an academic medical center, as a hospital that provides services that we and we alone, provide in the region, is obviously significant to us. And ultimately, what we went public about several weeks ago was our expectation that we be paid that money that we are owed in 2024 again, not a contract dispute. No one's denying that we're owed that money is just the mechanism by which we'll get it paid back," said McKenna.
CDPHP contends a change to the wage index by Medicare Advantage is to blame. CDPHP Vice President of Communications and External Affairs Ali Skinner says in the end everything will be sorted out.
"We know that the community needs Albany Medical Center. We greatly value the services that they provide to this community. We also know that this community needs CDPHP. We are 50% of Albany Medical Center's business," Skinner said.
Albany Med is simultaneously negotiating a new contract with CDPHP for 2025, which is typical for provider-payer agreements.
"Our contract is set to expire on December 31 however, we would head then into, if it does expire, we would head into what's called the cooling off period," said Skinner. "This is a regulatory time period. It is a 60-day window that allows both parties to come back to the table again, cooler heads to prevail, and then allows our members, their patients, to continue receiving services at Albany Medical Center and its affiliates. Also, if any member is in an ongoing course of treatment, that means you're currently under the care of an Albany Medical Center physician, you get an additional 30 days on top of that 60-day cooling off period. So we're really talking about April here, that we have to come to an agreement. And we firmly believe we will be able to do that."
Albany Med says no final decision has been made, but services in Albany and at Columbia Memorial, Glens Falls and Saratoga Hospitals could be affected – and considered out-of-network next year. Albany Med says terminating the contract would be a last resort. Skinner says CDPHP fully intends to reach agreements with Albany Med.
McKenna says any notion that Albany Med is bullying CDPHP and “putting patients in the middle” of the dispute is disingenuous.
"We're both morally and legally required to keep our patients updated and informed on the status of our negotiations. In point of fact, CDPHP has the same requirement, and so I just want to make sure that I say out loud that by going public with this, we're not doing this as a negotiation tactic. We're doing this just so individuals can make informed decisions," said McKenna.
The hospital is also negotiating with its unionized nurses, who have been working without a contract since July 31st.
Albany Med has also filed a lawsuit in the U.S. District Court's Northern District, asserting that the New York State Nurses Association's use of the internet domain name "AlbanyMedQualityCare.org" is misleading the public and unlawfully using the hospital's protected trademark on a website that advocates for safe staffing ratios.
"Obviously, at this point," Mckenna said, "Albany Med continues to have negotiations with New York State Nurses Association. In fact, we have another session set up for next week on the particular issue of the website. I think most of your listeners would recognize immediately, from a legal standpoint, this is a clear trademark violation."
The union says the lawsuit is meritless and an attempt to silence nurses.
Albany Med nurse Tonia Bazel argues the hospital is not being transparent about its violations of the state law regarding staffing ratios, which affects patient and nursing staff safety.
“That website is valuable and that it allows us to advocate for our patients by letting shedding a light on the true violations and how Albany Med is doing everything but doing what's right by the patients and the nursing staff at Albany Medical Center in regards to the state law, you know there, there's safe staffing is key for safe care with our patients, and unless the hospital is transparent. In regard to that we can never fix it. They want to keep sweeping it under the rug and hiding from the public the fact that we have violations, serious violations, that need to be taken care of. So, you know, we need to fix our staffing ratios.”
The website remains active, for now.
Albany Med and CDPHP have been WAMC underwriters.
