New York State
CDPAP transition could move forward after preliminary injunction agreement
The state Department of Health and New York Legal Assistance Group are now awaiting approval from a judge.
State Health Department Commissioner James McDonald and Gov. Kathy Hochul could be closing the book on the CDPAP transition. Don Pollard/Office of Gov. Kathy Hochul
The contentious fight over New York’s transition to a single fiscal intermediary to administer a popular Medicaid home health care program could soon come to an end. The state Department of Health and the New York Legal Assistance Group have agreed to a proposed preliminary injunction that would extend the deadline for patients to register with Public Partnership LLC, while permitting home care workers to continue getting paid by other companies until fully registered with PPL.
As a means to address alleged fraud in the Consumer Directed Personal Assistance Program, Gov. Kathy Hochul and state lawmakers agreed to transition from over 600 fiscal intermediaries to just one. Under the program, Medicaid recipients can choose their home care workers, including friends and families, and fiscal intermediaries handle payments to the workers. The state chose Public Partnership LLC as the new, single administrator, and the three-month transition officially started in January.
Home care advocates and existing fiscal intermediaries opposed the transition, and as it continued, many raised the alarm that the state would be unable to fully register the roughly 250,000 people in the program before the April 1 deadline. Nearly a dozen lawsuits were filed to postpone the deadline or attempt to overturn the law. The new agreement extends the deadline to complete registration to May 15 for consumers, and June 6 for workers. More notably, it would allow workers to continue getting paid by their current fiscal intermediary until they fully register with PPL. Previously, the Department of Health announced a 30-day “grace period” to allow consumers and workers to finish registration, but workers would only get retroactive pay from PPL after the fact.
The proposed agreement, which still needs approval by a judge, would not completely stop the transition. PPL will still be the sole fiscal intermediary, and other companies will not be permitted to operate at the state once the transition is completed.
The Hochul administration claimed victory with the proposed preliminary injunction. “The $10 million dark money campaign by shady business groups has failed to stop New York state’s much-needed CDPAP reforms, which will protect CDPAP for people who need it and put an end to runaway bureaucratic spending in this taxpayer-funded program,” said Hochul spokesperson Sam Spokony. He was referencing spending by the group Alliance to Protect Home Care, which was one of the biggest lobbyists in the state last year with its spending against the transition. “This proposed agreement supports the state’s ongoing CDPAP transition and ensures our reforms will proceed in full,” Spokony said.
On the other side, advocates were a little more muted, suggesting that the proposal will offer needed relief to consumers and workers alike for whom the transition has been causing stress. “Plaintiffs’ counsel believes that this joint proposal will make a huge difference to CDPAP participants,” said Elizabeth Jois, a supervising attorney in New York Legal Assistance Group’s Special Litigation Unit who represents the plaintiffs. “We know this has been an incredibly stressful time (for) CDPAP participants, and we believe this is a critical step forward in maintaining access to care.”
The advocacy group Caring Majority Rising similarly expressed a degree of relief over the proposed agreement, while saying that the transition as a whole still has issues. “Today’s injunction provides some relief for the hundreds of thousands of New Yorkers who have been facing confusion, chaos, and fear for weeks,” said Ilana Berger, the group’s political director. “Yet the transition to PPL continues to be fundamentally flawed.” She added that PPL has “never been equipped” for the job they’ve been given, and called on Hochul to use the injunction as an opportunity to “build a new plan” for CDPAP.
Meanwhile, the Alliance to Protect Home Care viewed the agreement as vindication that the state bit off more than it could chew, while continuing to criticize the state. “The Department of Health is fully admitting that PPL is not up to the job and that thousands of consumers are facing disruption of care,” said Bryan O’Malley, the group’s executive director. “Considering PPL has screwed this up since the beginning, what makes anyone believe this will be any different with another two months?”