A burgeoning $6 billion Medicaid program allowing New Yorkers to get paid to take care of elderly adults — which critics say has been vulnerable to fraud and abuse for years — is in Gov. Kathy Hochul’s crosshairs.
Hochul, as part of this year’s budget negotiations, is proposing making changes to the program, such as setting limits on the number of hours those employed can work, that her administration estimates will save the state $100 million.
The Consumer Directed Personal Assistance Program (CDPAP) — which has exploded in popularity over recent years — has been criticized over lax eligibility requirements, lack of oversight, and abuse.
The governor’s amendment to this year’s proposed $233 billion state budget, submitted Thursday, would give the Department of Health expanded oversight and regulatory powers over the CDPAP.
The DOH would have broad regulatory authority to reign in fiscal middlemen trying to game the system, by setting a limit on the number of financial intermediaries that can operate in the state.
As part of the program, businesses and nonprofits can profit by essentially working as a payroll agent between Medicaid and the CDPAP caregivers.
In 2020, the FBI busted one such Brooklyn-based firm for a multi-million dollar fraud scheme in which the group manipulated the hours of CDPAP care workers in order to pocket state and federal Medicaid funds.
Federal investigators found one CDPAP caregiver was on a cruise while billing hours in taxpayer cash.
The firms are known to advertise on TV to enlist home health aides.
The program has also been the subject of one viral TikTok video that raised questions about possible fraud.
Critics, including unions for home health aides, have slammed the CDPAP over eligibility requirements, including that those getting paid as caregivers don’t need to have a healthcare background.
There are currently 250,000 New Yorkers enrolled in CDPAP across the state, the latest Medicaid enrollment report data show — up more than 78% from 140,000 in 2015.
Hochul’s budget chief, Blake Washington, said the program was something that needed to be “addressed,” during a Citizens Budget Commission forum Thursday morning.
“What we’re doing here by having widened the net so greatly, is we’re inviting abuses to the system. We’re hurting the program that we value for the consumers that need it the most,” he said.
“It’s something we’re very very concerned with. We won’t change it overnight, but it’s something that needs to be addressed.”
The administration estimates the proposed changes to the CDPAP will save the state around $100 million yearly, Washington told reporters after the forum.
Advocates for CDPAP push back against the notion that the program is dominated by fraud and emphasized the important role it plays in filling what they frame as a gap in personal assistance for needy New Yorkers.
Bryan O’Malley, Executive Director of the Consumer Directed Personal Assistance Association of New York State told the Post he supports measures to keep the “middlemen” firms honest and transparent, but the specifics should be spelled out in the law.
“Setting standards isn’t bad, clarifying what those standards are in law before everyone has to live by them is an important process of that though,” O’Malley said. “We want to root out the bad actors. We always wanted to root out the bad actors. We want to know what we have to live with before we have to live with it.”
O’Malley said he would be okay with a revised process to register those middlemen firms, but he slams any effort by the Health Department to use that process to slim down the number of those agencies like the Governor is proposing.
Hochul’s budget proposal has already floated cutting an additional $1.55 per hour boost that CDPAP home care workers in New York City as well Nassau, Suffolk, and Westchester counties receive on top of a minimum wage.
Eliminating that wage supplement would save the state around $200 million per year, according to the budget.