(The Center Square) – Medicaid fraud is in the $10 billion home care program for New York, says a lawsuit filed by the U.S. Department of Justice against the state.
The complaint says the state Health Department is on the hook for failing to prevent it and protect the money of taxpayers.
A lawsuit filed in U.S. District Court on Tuesday says the New York Department of Health awarded Georgia-based Public Partnerships LLC a lucrative contract to run the state’s Consumer Directed Personal Assistant Program after conducting a “sham bid” process.
It also says the state agency failed to take action to “hold the company accountable and protect public funds from misuse” after learning that it planned to deviate from its contractual obligations.
The Justice Department asks a federal judge “to enjoin all defendants from making further misrepresentations about the CDPAP program and from charging American taxpayers millions of dollars unauthorized by the contract.”
“New York’s backroom deal with PPL has cost taxpayers millions of dollars and cast countless Medicaid patients to the curb,” Assistant Attorney General Colin M. McDonald with the Justice Department’s National Fraud Enforcement Division said in a statement.
The federally funded program provides home care services through lay caregivers, including family members, to Medicaid patients with disabilities or significant medical needs.
It is also New York’s largest health benefit program. Annual cost is more than $10 billion, and there are more than 250,000 patients and 300,000 caregivers, according to state figures.
The lawsuit says while New York claimed to conduct a fair bidding process in 2024 to select a vendor to operate the program, state officials “pre-selected” PPL for the billion-dollar contract by “conducting a sham bid process that resulted in PPL being awarded the contract.”
“Instead of ensuring that PPL complied with the contract and protecting the American taxpayers, New York has permitted PPL to raid the CDPAP program of millions of dollars in excess revenues, billing at hourly rates in excess of those anticipated by New York prior to the contract award,” the complaint states.
“As a result of PPL’s self-dealing and New York’s failure to require it to comply with the terms of the contract, the purported cost savings that the CDPAP transition was to provide largely have been erased.”
The complaint also says Public Partnerships made false statements about costs and used the program to “extract improper profits” while causing disruptions to caregivers and medically vulnerable patients.
In a statement, Public Partnerships said it was selected “through a transparent, competitive process to strengthen and modernize New York’s CDPAP program” and that its oversight has provided “greater accountability, consistency and support for the hundreds of thousands of New Yorkers who rely on it.”
“We have worked alongside the New York State Department of Health throughout the transition and at every step cooperated transparently with our state partners,” the company said. “We are proud of what we have achieved with the state of New York and stand by our performance.”
