New Yorkers with no medical experience will no longer be allowed to care for elderly or disabled relatives or friends under the $6 billion Medicaid program, which has been rife with fraud, abuse and abuse for years, officials said. The company is said to have the potential to earn more than $43,000 a year.
The Consumer Personal Assistance Program, known as CDPAP, exploded in popularity several years ago when state legislatures relaxed rules to make more people eligible for government cash.
Critics say CDPAP, which receives huge infusions of funding from state governments, has been allowed to expand rapidly with little oversight despite widespread signs of dysfunction and a waste of taxpayer money. claims.
“This program is growing many times faster than the senior population and shows no signs of slowing down,” said Bill Hammond, senior health policy fellow at the Empire Center, an Albany-based government watchdog, in a post. told the paper.
“It is long past time for state officials to take control of this program while protecting services for those who need it most.”
Statewide, 250,000 New Yorkers are currently enrolled in CDPAP, a significant increase from 140,000 in 2015, according to the latest Medicaid enrollment reporting data.
Home care workers in New York City who receive CDPAP funding can earn $21.09 per hour caring for relatives and friends, or $43,867.20 per year based on a 40-hour work week. On Long Island, CDPAP caregivers pay $20.22 per hour, compared to $17.55 per hour in the rest of the state.
The decades-old program was relatively small until a change in the law expanded eligibility to allow family members and friends of Medicaid recipients to become CDPAP aides.
The state Legislature passed the bill in 2015 under the leadership of then-Rep. Joe Morrell (currently a Democrat representing upstate New York’s 25th Congressional District), and it was enacted the following year by then-Governor Joe Morrell. Ta. Andrew Cuomo.
Morell said at the time that the changes, which allow parents of disabled adults to be employed as caregivers, would mean families would no longer have to worry about their financial security.
But experts warn that the program’s flaws run deep, with ambiguous qualification rules leading to abuse.
“Consumer-directed personal assistance is an important and life-changing benefit when used properly, but it is also highly vulnerable to overuse and fraud. New York’s program has all the warning lights flashing bright red. ,” Hammond said.
Under CDPAP, people can choose their own unlicensed caregivers to help them at home to avoid more expensive nursing homes or assisted living facilities.
However, while the number of people enrolling in the program has increased, the number of nursing home residents has not changed significantly.
On the other hand, the criteria for qualifying for CDPAP are somewhat vague.
For example, a person living in a nursing home seeking Medicaid coverage must review financial records from the past five years.
The list includes “bathing or showering, getting dressed, getting in and out of bed or a chair, walking, using the toilet, and eating,” according to the U.S. Centers for Medicare and Medicaid Services.
By contrast, there is no look back period for people applying for home care, which means they may be able to send cash to relatives or sell assets to qualify for Medicaid.
Currently, applicants must undergo an eligibility assessment, which includes whether they have any ongoing medical conditions, need for medical assistance, and need for long-term care.
However, one of the prerequisites requires you to demonstrate that you need help with only one category included in the “activities of daily living” list, essentially setting a very low barrier to entry. I am.
The list includes “bathing or showering, getting dressed, getting in and out of bed or a chair, walking, using the toilet, and eating,” according to the U.S. Centers for Medicare and Medicaid Services.
Businesses and nonprofit organizations known as fiscal intermediaries can act as intermediaries by collecting funds from Medicaid, which are then distributed to CDPAP supporters as salaries.
These intermediaries receive a portion of the funds but are not responsible for training or supervising aides.
According to the 1199 Service Employees International Medical Association, an international medical union representing home health aides, the law changes require financial intermediaries to help as many people as possible, including those with less serious but costly illnesses. It is said that they have started trying to get them to join.
Following the changes, the number of financial intermediaries has jumped from just seven to 700, the union added.
In 2020, the FBI busted a $1 million fraud ring based in Brooklyn in which CDPAP home health aides worked with financial intermediaries to actually work during vacations and social outings. It turned out that he had illegally billed the state for hours he should have spent.
Federal prosecutors say one of the caregivers was on a Caribbean cruise where she was supposed to care for a patient in Brooklyn, and the other was drinking at a vineyard in New Jersey.
“The people overseeing the program are like the fox in the henhouse,” Helen Schaub, the medical union’s political director, told the Post.
“This is not an effective use of taxpayers’ money, so the state should do that.”
stop. “
a federal audit According to 2018 estimates, the Empire State illegally filed approximately $75 million in fraudulent CDPAP claims on Medicaid between 2012 and 2016, before the program was expanded to allow relatives to act as caregivers. was charged.
Gov. Kathy Hochul is expected to unveil long-awaited reforms to the CDPAP program on Thursday, including ways to rein in unnecessary and unsustainable spending, the Post reported.
Details about how the state plans to better manage the program were not immediately clear.
“As health care costs continue to rise, Governor Hochul is committed to protecting taxpayer dollars in any way possible. This includes funding for CDPAP, a program that provides essential home care for many New Yorkers. With common sense fixes and minimal oversight, we’ve grown over 1,200% in just eight years. Our goal is to serve New Yorkers who truly need it most, while protecting against waste and abuse. to ensure the delivery of quality health care services,” Blake Washington, Hochul’s budget director, said in a statement Wednesday.
