Critics are furious over a new plan by Gov. Kathy Hochul and State Assembly Speaker Carl Heastie to crack down on New York City’s $8 billion Medicaid home health program amid allegations of fraud.
The governor and Sen. Heastie (D-Bronx) have agreed to overhaul the consumer-directed personal assistance program that allows New Yorkers to get paid to care for loved ones as part of ongoing state budget talks. It is said that
The program currently operates using hundreds of companies and nonprofit organizations that essentially act as payroll agents between Medicaid and CDPAP caregivers with minimal oversight.
The proposal, said to have been proposed by Mr. Hochul and Mr. Heastie, would eliminate unchecked middlemen known as financial intermediaries and replace them with one company hand-picked by the state Department of Health.
But home care advocates and some lawmakers are furious that this will do nothing to stop reported fraud and abuse, and say it will do nothing to save the massively expanding program. He doubted whether it would lead to this.
“Instead of solving the problem, they are taking an extreme response,” Rep. Ron Kim (D-Queens) told the Post on Thursday.
“States should not try to repair broken markets (that they have created) by creating systems of giant monopolies.” Kim told X.
“Picking just one winner sounds like a recipe for corruption.”
PPL, which describes itself on its website as a “financial management services company,” is in serious discussions as a potential successor as the sole financial intermediary for Medicaid billing and payments, more than a half-dozen people familiar with the matter said. Admitted. CDPAP Caregiver.
The company did not respond to requests for comment.
“Despite repeated evidence that tens of thousands of workers will go without pay and tens of thousands of disabled and elderly New Yorkers will lose services, they will continue to move to a single financial institution. ,” said Brian O’Malley, executive director of consumer affairs. New York’s Directed Action sent a statement to the Post.
People familiar with New York health care policy believe it is possible for the DOH to award the contract to a company it nominates without a public bidding process.
Critics questioned the ethics of entrusting oversight of billions of dollars to a single company without going through the procurement process.
The program has grown to $7.5 billion in 2022, split evenly between the state and federal governments, according to DOH statistics.
In his budget proposal earlier this year, Hochul laid out measures aimed at curbing the program’s steep price increases.
He was pushing for a process that would require fiscal intermediaries, estimated to number more than 700, to first be approved and subject to DOH oversight.
The governor also wanted to reduce the additional state-mandated raises that CDPAP care workers receive on top of the minimum wage, but sources said Hochul said that as part of the negotiations. , agreed to drop proposed cuts that would have saved an estimated $200 million.
Home health care advocates rallied at the Capitol and stayed in good spirits after lawmakers finished work Thursday, camping outside Hochul’s office and demanding a rejection of the proposal.
“We’re looking at ways to run our programs more efficiently and make sure people get the care they need,” Heastie said, along with Hochul and state Senate leader Andrea Stewart-Cousins. He told the Post after finishing a meeting with the general secretary.
