Myth and Reality about CDPAP amidst the PPL takeover

This is a reprint of a press release jointly issued by the New York Association of Independent Living and The Caring Majority.


A City & State story on the CDPAP transition today cited a PPL study on fraud under the previous system of multiple FIs, revealing 30 instances of fraud under the previous system.


This story requires additional context - because the data actually undermine the case for PPL:

 

  • City & State: The previous CDPAP system was riddled with fraud - 30 different cases!
  • REALITY: 
    • This shows fraud in CDPAP is extremely low: 30 cases of fraud in a program serving 280,000+ consumers and 425,000 workers is extraordinarily low - amounting to a less than 0.001% fraud rate overall.
    • Audits of CDPAP have found consistently low rates of fraud: The low figures track with other independent studies of fraud in CDPAP: 
    • No dollar figures provided: The story doesn’t state the scale of this alleged fraud. These 30+ cases could involve $100 or $100,000 - we simply don't know.

 

  • DOH: “Fraud will be much harder to commit with just one system administering claims”
  • REALITY: PPL's fraud already dwarfs anything from the previous system, with tens of thousands of consumers and workers paying the costs:
    • NYS Focus: PPL leading a scheme to skim $100 million from CDPAP workers by forcing them into unusable health benefits
    • NY Post: A PPL employee stole wages from 10,000 workers
    • News10: CDPAP caregivers sue PPL, claiming weeks of underpayment

 

  • DOH: “This transition has reduced administrative costs – saving taxpayers over $1 billion per year”
  • REALITY: Hochul has presented no evidence to back up this claim - and in fact, the transition will likely cost taxpayers more:
    • PPL’s broken enrollment systems have forced 75,000+ CDPAP consumers into more expensive home care options.
    • As consumers lose care and experience health impacts, they’ll turn to emergency rooms for care.


  • DOH: “The Department is using enhanced monitoring tools to protect program integrity”
  • REALITY: DOH has systematically failed to invest in meaningful monitoring of CDPAP and other Medicaid systems, despite repeatedly being warned to:
    • HHS Inspector General, 2018: “We recommend that New York…improve its monitoring of the CDPAP to ensure compliance with CDPAP requirements.”
    • NYS Office of the Comptroller, 2024: “You have to improve the controls over the program so that you decrease fraud, waste and abuse and improve the quality of services going forward.”


The data in this story inadvertently make the case against the PPL transition: minimal, manageable fraud was replaced by systematic, industrial-scale theft - exactly the opposite of what was promised.

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