Updated
Updated · POLITICO · Jun 16
DOJ Sues New York Over $10 Million Medicaid Home Care Deal, Seeking PPL Revenue Freeze
Updated
Updated · POLITICO · Jun 16

DOJ Sues New York Over $10 Million Medicaid Home Care Deal, Seeking PPL Revenue Freeze

3 articles · Updated · POLITICO · Jun 16

Summary

  • The Justice Department sued New York over its consumer-directed Medicaid home care overhaul, calling the state’s selection and oversight of Public Partnerships LLC an unlawful scheme and asking the court to freeze PPL revenue.
  • The case centers on a 2024 plan to save about $500 million a year by shifting CDPAP administration from hundreds of intermediaries to a single contractor; PPL won the role in September 2024 and the transition began in 2025.
  • DOJ alleges the process was a sham backroom deal and that state officials failed to police PPL despite contract violations, while the lawsuit also seeks a receiver for the company.
  • Hochul’s administration rejects the claims as baseless and political, saying the transition cut state Medicaid costs by $1.2 billion and federal matching payments by another $1 billion, though lawmakers have questioned those savings.

Insights

As New York faces a massive fraud lawsuit, what can other states learn from its costly managed care experiment?
With red flags ignored and costs soaring, how did oversight of a billion-dollar Medicaid program allegedly collapse so completely?