RESOLUTION NO. 206
AUTHORIZING AN AGREEMENT WITH CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN REGARDING RECONCILIATION OF PAYMENTS TO THE ALBANY COUNTY DEPARTMENT OF MENTAL HEALTH FOR AMBULATORY BEHAVIORAL HEALTH SERVICES AND AMENDING THE 2022 DEPARTMENT OF MENTAL HEALTH BUDGET
Introduced: 6/13/22
By Health Committee:
WHEREAS, The Director of the Albany County Department of Mental Health (ACDMH) has requested authorization to enter into an agreement with Capital District Physicians' Health Plan (CDPHP) regarding the reconciliation of payments made for Ambulatory Behavioral Health Services in the amount of $52,843, and
WHEREAS, The Albany County Department of Mental Health is a New York Municipality and operator of a New York State Office of Mental Health licensed clinic which provides Ambulatory Behavioral Health Services pursuant to Article 28 of the Public Health Law, and
WHEREAS, The Ambulatory Patient Group (APG) rate-setting methodology was established by New York State statute and applicable to behavioral health services provided on or after April 1, 2015, and
WHEREAS, The New York State Department of Health (DOH) did not issue final guidance or regulations necessary to allow health plans to determine the equivalent fees under APG methodology and CDPHP continued to pay the ACDMH for Child Health Plus services at the contract rates during the period from April 1, 2015 to December 31, 2021, and
WHEREAS, The DOH has directed health plans to reimburse providers licensed pursuant to Article 28 of the Public Health Law for paid and settled claims for ambulatory behavioral health services provided by licensed professionals to Child Health Plus Members, the difference between the rates payable under the APG methodology, and the contract rates during the period from April 1, 2015 to December 31, 2021, and
WHEREAS, CDPHP and the ACDMH have agreed to modify the CDPHP Ancillary Provider Agreement to allow ...
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