Important: CHP Government Rate Payments

July 8, 2020

As you know, the NYS Council has led our field for well  over a decade with strong and persistent advocacy related to timely and full payment of government set and other rates for behavioral health providers.  

For the last several months we have been working with the NYS DoH and several of our colleagues, seeking resolution to an ongoing and unacceptable situation in which some of our members have not been paid the APG government rate for services provided to Child Health Plus beneficiaries. 

The statute that contains the language we worked to achieve that set the CHP rate in line with other APG government rates was enacted in 2015, however we are aware of at least three health plans around the state that have skirted their responsibility to pay in full based on the law, as well as the terms of their contracts with both providers and the state.  

In anticipation of a resolution with DoH on this matter, the NYS Council began reaching out to our members several months ago, repeatedly encouraging them to let us know if they are experiencing this problem.  To date, six NYS Council members have let us know they have been impacted.  We think there may be additional agencies that have this problem. 

Attached is a spreadsheet for you to report (to DoH) the claims that have not been paid in accordance with the CHP APG government rate. According to DoH this information, along with information from the State’s encounter data, will be used to ensure you are appropriately paid for delivery of these services. 

Please complete the attached spreadsheet and submit to the following mailbox:   Please include your agency name and ‘CHP APG Payment’ in the subject line.   Please encrypt the excel file before submitting (steps below).

  1. In the document, click,  “File and Protect Workbook”
  2. Click Encrypt with password
  3. Enter a password for document (case sensitive)
  4. Submit encrypted excel file and password in separate e-mails.

 After submitting the information requested by DoH, PLEASE let us know that you have engaged with the state on this matter.  Just write me a note to let me know you have filed a spreadsheet with the state as well as the date you submitted it.