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CDPAP: April 2025 Transition to PPL as Single Fiscal Intermediary - Background & Archive

Background.  The 2024-25 NYS Budget required all 280,000 Medicaid recipients who have CDPAP services to switch their "Fiscal Intermediary" (FI") -- the agency that manages payroll and benefits for their Personal Assistants ("PA")-- to a new "single FI" called Public Partnerships LLC or "PPL."    FI's have contracts with MLTC plans, mainstream managed care plans, and  -- for those exempt from managed care -- county Dept. of Social Services (HRA in NYC).  The plans or DSS decide the number of hours of home care, and the FI pays the PA.  As the "single FI,"  PPL replaced the more than 600 FIs that formerly handled payroll and benefits for all PAs in CDPAP. 

The deadline for both consumers and PAs to finish registration with PPL was originally March 28, 2025 and  ewas xtended several times until the final deadline  of August 1, 2025.  See more below.   

This article contains the archives of the period before the transition on April 1, 2025 and in the months after.   Check this article for news, along with official websites here and https://nylag.org/engesser/ for information about the Engesser class action lawsuit.    

 ARCHIVE:  Press, advocacy, and litigation before and since the April 1, 2025  transition  (most recent is at the top)

 HIGHLIGHTS:  Jump to key events and topics


PRESS ABOUT PPL Health Insurance for PA's

Most recent Press

Sept. 23, 2025    Syracuse.com  Thousands of NY home-care workers get extension on health exam; new Syracuse site set

Sept. 18, 2025 Buffalo News  NY Department of Health to Allow Caregivers More Time to Complete Compliance for Home Care Program 

Late August 2025 - After Senate Hearing, PPL Admits that it Met with State Officals before getting Contract  - Contrary to its Testimony at Hearing

August  21, 2025  - NYS Senate Hearing On the Transition to PPL Held in NYC 

  •  Watch entire hearing in this  YouTube recording. Particular moments in the hearing include testimony of --
  •  Health Commissioner McDonald (here) and PPL exec Patty Byrnes (here) , who were unable to answer almost any question. 

  • CDPAP consumers and PAs (here) spoke movingly about the devastation of their experiences with PPL  (last witness at 8:30:25 - consumer and activist Nina Bakoyiannis)   

     Press coverage about hearing:

August 12, 2025 - Federal Court  grants provisional approval of Engesser Settlement  - Judge Frederic Block of the U.S. District Court for the Eastern District of New York provisionally approved a proposed settlement agreement in Engesser et al v. McDonald. The settlement will become final on Oct. 3, barring further objection under the Class Action Fairness Act.

You can read NYLAG's press release on the provisional approval of the settlement here.

August 5, 2025 Documented NY  Criticism Mounts Over CDPAP Overhaul as Immigrant Workers Go Unpaid

August 5, 2025 Albany Times Union Commentary: PPL is the solution to New York state's home care problem - Op Ed by the CEO of PPL 

July 23, 2025  Albany Times Union Lt. Gov. Delgado criticizes Hochul for 'failed' CDPAP transition

July 21, 2025  New York Focus  New York’s Health Companies Could Pocket Millions Meant for Low-Wage Care Aides

July 14, 2025 Albany Times-Union  Lawmakers question leadership swap at company managing CDPAP home care program

July 15, 2025  NY Post  Worker at Hochul’s hand-picked homecare payment firm allegedly siphons off cash meant for participants

July 14, 2025 Crain's NY Business PPL President Maria Perrin to resign  months into Shaky Transition |  

July 11, 2025  News10NBC Investigates: Caregivers face uphill battle getting health insurance through State’s new CDPAP program

July 8, 2025 NYState of Politics N.Y. lawmakers confident Health De­partment will testify at August CDPAP hearing -   

July 7, 2025  Capital Pressroom   CDPAP hearing postponed at request of Hochul administration  

July 7th,  2025- Judge Block preliminarily approved the Engesser settlement jointly proposed by the parties -- plaintiffs and the State Dept. of Health.   Because this is a class action, Judge Block held a fairness hearing on August 6, 2025 via Zoom to hear feedback on the settlement from class members.

As  described in NYLAG's press release, the key provisions of the settlement agreement include:

  1. DOH will order MLTC plans, Mainstream Managed Care plans and Local Districts of Social Services  (DSS) to send a letter to all CDPAP consumers who have registered with PPL. This letter will give CDPAP consumers information about how to get help if they are having problems using their CDPAP services.
     
  2. Facilitators will have the same access to PPL systems as PPL call center staff do and will have the ability to flag issues for expedited help. Consumers will get a form  to select a facilitator. Facilitators are able to assist consumers and their Personal Assistants (PAs) in enrollment, onboarding and training, and also by resolving day-to-day issues as they arise.
     
  3. For consumers who are not yet registered with PPL or whose PAs are not registered, or who is registered but did not use their CDPAP services in June --
    1. They will receive a letter telling them that their deadline for registering is August 1. This letter will explain all of the ways they can register and the resources that are available to assist.
       
    2. DOH will order MLTC Plans to make additional efforts to contact CDPAP consumers who have not used their CDPAP services recently. This includes a letter, at least one home visit and reaching out to an authorized representative.
       
    3. Ultimately, every CDPAP consumer who does register with PPL, switches to another long-term service or begins using their CDPAP services through PPL by August 1 will be sent a notice explaining their right to a fair hearing.
       
  4. DOH will issue guidance that will help managed care organizations, local districts of social services and PPL understand some of the CDPAP program rules better.  These guidance documents should help consumers receive services without interruption.  This includes sending "authorizations" for CDPAP services promptly to PPL to ensure continuity of care.  

    • Around August 1 2025, DOH issued some of the guidance referenced here. See GIS 25 MA/08 - CDPAP Service Authorization Renewal Timelines  (requires local DSS to complete reassessments 14 days before the end of an authorization period and upload them 10 days before. 

    • Managed care and MLTC plans must also complete reassessments 14 days before the authorization expires and upload them 7 days before.  See Service Authorization Renewal Timelines  for Managed Care Plans (8/1/2025) 

    • See other policy documents here

  5. DOH CDPAP Transition Hotline will continue to operate in its current capacity through December 31 and will remain open in some form after that.

  6. Plaintiffs’ counsel will continue to have the ability to escalate individual cases for timely resolution.

June 27, 2025, Judge Block entered an Amended Preliminary Injunction, which would remain in place until August 15. The Amended Preliminary Injunction sets in motion a series of letters and notices to CDPAP consumers who have not yet registered with PPL. See  NYLAG Frequently Asked Questions about this injunction, and see the State's guidance implementing it here.   See  webpage about lawsuit here.   Press about settlement:

July 18 - 19 - Press coverage about NYS Senate public hearing scheduled for July 9th: Spectrum News June 18, 2025; New York Post June 19th, Finger Lakes.com  June 19th 

June 13, 2025 New York Focus  5 Key Takeaways From Our Investigation Into Health Insurer Leading Edge Administrators

June 12, 2025  New York Focus  ‘I Thought I Was In-Network’: The Insurance Scheme That Could Leave New Yorkers With Mountains of Debt  (see more about PPL health insurance here)

June 12, 2025  City & State PPL touts high customer satisfaction amid turbulent home care transition  (One advocate noted that people who dropped CDPAP, died, were forced into a hospital or nursing home can't respond to their satisfaction survey!) 

June 7, 2025  Finger Lakes.com  CDPAP update: Over $1B paid to caregivers across New York  (PPL says that as of 6/8/25, consumers will be able to see weekly authorization hours, including how many hours remain in the week).

June 6, 2025  CDPAP check-in: Where the state’s controversial home care consolidation stands | Crain's New York Business  

JUNE  6, 2025 NYS DOH and PPL REPORTs ON NUMBER TRANSITIONED --  NYS Dept. of Health last  updated its public data  on 5/19/25, and PPL last updated its data on June 6, 2025.   DOH stated on May 19th that 208,000  CDPAP consumers have "successfully registered" with Public Partnerships LLC (PPL),"  and 203,000 PAS have registered and are fully onboarded, out of 237,000 PAs identified by consumers as their PAs who need to register.   This was the first DOH update on the transition since April 14th.  

  • As of May 15th, DOH release says 198,000 PAs were paid based on submitting time cards.  DOH does not state how many of these payments were complete or correct.  However, PPL posted on June 6th that 191,000 PAs were paid in the 9th pay period - representing 98% of PAs submitting timecards.  PPL states, "The remaining 2% of timesheets are under review for being outside the consumer’s authorization or not meeting another program or Medicaid rule."

  • 75,000 CDPAP consumers -- out of the original 280,000 CDPAP consumers -- are in process of switching to traditional personal care rather than join PPL, per DOH 5/19/25 release.   This is up from 60,000 previously announced.  

  • The last regional breakdown DOH has provided was the April 4, 2025 release, showing the lowest percentage of CDPAP consumers who have started or completed registration was in NEW YORK CITY and WESTERN NY  - only 86-87%.  

  • DOH press releases about the status of the transition are posted here.    

May 30, 2025 - Calderon vs. PPL lawsuit - Amended complaint filed in Eastern District NY - for PAs  in NYC, Long Island, and Westchester.  See Legal Aid Society May 30th news release about the revised complaint, which adds violations of the NY Wage Parity Law to other claims under federal and state Labor Law. Plaintiffs are represented by The Legal Aid Society Employment Law Unit and pro bono firm Katz Banks Kumin LLP.   CONTACT:  PA's with payment problems should complete this survey - which asks for your contact information and details of payment problems.

May 20, 2025 In Engesser suit, Judge Block issued an order here that extended the current preliminary injunction from June 6, 2025 to June 20, 2025, urged the parties to negotiate and submit a schedule for motions.   Press covering extension:

May 17, 2025 -  After May 17, 2025, Personal Assistants may use paper timesheets (fill-in-able version here) only if they obtain an Exception from PPL.   Starting Sunday May 18th, PAs must log hours on Time4Care, PPL@Home, or Telephony  unless they obtain an Exception.  See more here.  

May 14, 2025 - Bill S7954 (Rivera) / A8355 (Paulin) proposed that would require the State to contract with more FIs in addition to PPL, including Independent Living Centers that had previously been an FI for at least a year, and, at Governor's option, FIs selected to be "facilitators" by PPL.   PRESS COVERING BILL: 

April 23, 2025 Flanagan vs. PPL - lawsuit filed April 23, 2025 in Western District NY - covers PAs serving consumers upstate -- outside of NYC, Long Island, and Westchester. Plaintiffs represented by law firm Poricanin Law.   CONTACT:  Emina Poricanin at  emina@poricaninlaw.com See press:

April - May 2025 --Press & Advocates report payment problems for PAs

April 2025 - SURVEY of third PPL payroll by Caring Majority Rising found that half of those surveyed were not paid on the third payday, 40% are considering leaving their job, 43% of consumers who lost staff can no longer meet their needs.  Download the 3rd survey results here.   Results of their first survey are posted here. and the  2nd survey results are posted here.    Survey results reported in  Politico NY Health Newsletter 4/14/25.

APRIL 18th UPDATE:  Recent PRESS  reports many PAs not being paid.   Consumers Jose Hernandez and Jaiza Tejera confronted  the  DOH Commissioner at a conference  sponsored by EmblemHealth on improving access to health care in NYS see it on  Facebook, Instagram and Twitter.

Consumers and caregivers posted a video reporting difficulties with registering for and using PPL systems.  You can skip to any of the following  testimonies at these links:

Tara Murphy, Albany–area caregiver

“I got a pay stub in the mail for $0 for an EVV training…PPL is supposed to save money. And it's severe mismanagement and a gross waste of funds to print pay stubs for $0 and send checks for $0 to how many people? It's absolutely disgusting….I wasn't paid by PPL this week. I don't know if I'm going to be paid by the PPL…And if I don't make that payment next week, I lose my car.”

Dawn Meany, Long Island-area caregiver

“I made 19 phone calls with only zero being returned. I had six emails to PPL never returned. I have not received a paycheck….The anxiety it has caused him because he lost three staff members is insane. I have become his 24-7 care person because I couldn't get anybody else approved. I couldn’t even get him approved.”

Kim Conway, Long Island-area CDPAP user

“Now, this week is a whole different story. None of my overnight aides are being paid for their shifts. They work 12 or 16 hour shifts. Every one of them has been denied…At this point, unfortunately, I chose for my own and my aides' sanity and financially, we chose to have to move over to PCA services. And as of Monday, I'm no longer in the CDPAP program.”

Heather Burroughs, Rochester-area CDPAP user 

“Everybody's paperwork has been in for almost two months at this point. But guess what? Out of nine caregivers, one got paid. One, this pay period….This is quite literally the only program that my daughter qualifies for that can save her life. The only other option is to move her into a nursing home or a group home.”

Rebekah MacNeill, Rochester-area caregiver 

“I love this job so much, truly. I feel like this was my passion. I feel like this is what God put me on the earth to do is to help people. And it's devastating that I might have to walk away from this job just because this is happening….It's sad that this is happening in 2025. We're fighting for civil rights here….it makes me tear up because these are people and we're not treating them like they're people.”

April 29, 2025  DocumentedNY  Immigrant Caregivers Say State-Backed Home Care Agency Stole Their Wages

April 29, 2025 Queens Daily Eagle  PPL's Health Insurance is a Raw Deal for Workers -- The State Must Change That (at page 2 of the PDF)(Op Ed by Rebecca Antar, The Legal Aid Society and Michael Kinnucan, Fiscal Policy Institute)

April 28, 2025  CBS News  6 "Not enough training": Former PPL workers say poor training plagued CDPAP payroll shift

April 28, 2025 WTEN ABC News 10 Albany: NYS extends paper timesheet deadline for CDPAP personal assistants  and  online video version of story  

April 28, 2025  Albany Times-Union  CDPAP glitches continue with pay errors, lapsed health insurance 

April 28, 2025 NY FOCUS  Home Health Aides Are Getting New Insurance Coverage — From a Company With a History of Cutting It Off 

April 28, 2025 McKnight's Home Care  NY lawmakers to refine CDPAP through legislation 

April 26, 2025  Fingerlakes1.com: “CDPAP paper timesheet deadline extended to May 17

April 25, 2025  WTEN (ABC) - Albany  “News10 at 11PM”  (on extension of use of paper timesheets) 
April 23, 2025  New School Center for NYC Affairs Why Is the State Jeopardizing Health Insurance for Home Care Workers?  by Barbara Caress

April 22, 2025  New10 ABC Albany  Home care workers still concerned over paychecks from new company 

April 22, 2025  Spectrum News Lawmakers eye intervention in home care transition 'hiccups'

April 22, 2025 (updated) WIVB-TV (CBS) News 4 Buffalo  "Call 4 Action inundated with complaints on NY’s CDPAP system 

April 21, 2025  WHEC-TV NBC News 10 – Rochester, NY: “Governor: NYS and PPL working through “hiccups” in new CDPAP system

April 21, 2025  CRAIN"S NY Business Around 130,000 Workers  Have been Paid Amid State Consolidation (paywall) - Paychecks issued to 130,000 workers - just over half of the 250,000 workers who have started  the transition, and 80% of the workers who completed the transition.  PPL "..issued paychecks to a fraction of caregivers in its first two weeks of operation...." article cites data in PPL's own press release.   Excerpt:"... 'The payment challenges and current spending on workers' wages indicate that the state is far behind on its transition,' said Michael Kinnucan, health policy director at the think tank Fiscal Policy Institute.

'PPL has issued $120 million in paychecks for the first two weeks of the program; a figure that, extended to a year, would total $3 billion – less than a third of what the state pays on the home care program now,' he said. 'Considering that some people have left the program, the company’s bi-weekly costs should add up to around $260 million,' Kinnucan said."They are paying a lot less than that,' he added, representing a "very large failure" to pay people."

April 20, 2025  Albany Times Union  OPINION DeWitt: 'Hochul can do better' with CDPAP -- For clients and caregivers, the changeover isn't a technical matter. It touches their lives and their livelihoods.

EXCERPT:  "... In New York politics, there’s always a union angle, and PPL has a friendly history with the health care workers union SEIU, where it has not impeded the unionization of home care workers in other states. New York’s 1199 SEIU backs the transition, saying it will save money.

The union is always seeking new categories of members. It has also helped make or break New York governors’ careers. Hochul, who is faring poorly in the polls, is up for reelection next year. The deal gave recipients and their caregivers a short window to transition to PPL, between January and April 1. Only around half made it in time.

Farrar, and numerous other disabled people who have documented their struggles, liken the chaos — phone calls unanswered, paperwork submissions unacknowledged — to DOGE-like federal policies.

Lolli Edinger, who lives in Ulster County, is a caregiver for a man who has quadriplegia. She is among several aides who say they were shorted money in their first paychecks — a potential violation of the state’s labor laws. She earns barely above minimum wage and is having “panic attacks.”

“A missed paycheck means we can’t pay the rent, buy groceries or cover transportation to continue providing care,” Edinger said.

April 18. 2025  WIVB News 4 Buffalo: Call 4 Action inundated with complaints on NY’s CDPAP system “ - also News 4 at 4pm

April 18, 2020 RochesterFirst.com  - WROC-TV 8 (CBS) - Rochester, NY  Local caregivers report delays with CDPAP payments since transition to new fiscal intermediary

April 18, 2025  FOX5NY Outcry after death of disability rights leader Jensen Caraballo  -- DOH denies any connection between his death and the PPL transition because he died several weeks before April 1, 2025, but advocates who knew him maintain that PA's quit during the run-up to April 1st because of problems with registering with PPL and fear of not getting paid.   His friends related that he chose not to call 911 when he was alone without assistance because he feared a hospital would transfer him to a nursing home -- which he refused to go back to, having lived in one for many year before successfully fighting to live in the community with CDPAP services.  

April 18, 2025 - NEWS 10  'It's just wrong': Caregivers' personal information exposed in troubled rollout of New York's new CDPAP system - WHEC.com 

April 18, 2025 New York NOW PBS - Full episode here and clip of segment with Sen. Gustavo Rivera talking about the CDPAP transition and PPL's health insurance plans for PAs 

April 18, 2025 Home Health Care News: New York Consumers, Home Care Workers Protest CDPAP “  

April 17, 2025 Albany Times-Union Commentary: For independent living centers, CDPAP is about care, not money  By Lindsay Miller, Executive Director of the New York Association on Independent Living.

April 16, 2025  WCNY (NPR – Albany) Capitol Press Room: Consumer directed home care program enters new chapter “   

April 16, 2025  WXXI News NPR  Disabilities Beat: Court sets new deadlines, changes for CDPAP transition (interview with Elizabeth Jois, NYLAG attorney that was conducted prior to preliminary injunction)

Apt. 15, 2025 WHEC (NBC) - Rochester: Desperate for help: Caregivers flood local disability rights center amid issues with New York's new payment system”

Aptr. 15th Crain’s New York Business: 30,000 CDPAP recipients missed re-enrollment deadline  [paywalled]  

Apr. 15th Buffalo News: “New deadlines, old anguish part of saga for home care program in New York State “ [paywalled]  

Apr. 14, 2025 Politico - Recent survey of 327 PAs  by Caring Majority Rising, a disability advocacy group  between Thursday and Saturday found that 70 percent of the workers  surveyed didn’t get paid on time, and 72 percent of workers who were paid received the wrong amount in their paycheck. The survey also found that 45 percent of respondents still can’t clock in the hours they worked.   (Politico NY Health Newsletter 4/14/25)

Apr. 14, 2025  WRGB (CBS) - Albany, NY: “CDPAP update: NYSDOH with 87% consumer registration reported, counter rally planned Monday

Apr. 13, 2025  New York Post: “Hochul’s homecare program havoc leaves workers unpaid as federal court steps in “ by Vaughn Golden, April 13, 2025 

Apr. 13, 2025 Fox 5 New York: New York CDPAP: Some caregivers aren't getting paid “  

April 11, 2025 FOX 5 New York: “Caregivers say NY's CDPAP program is failing them “  

4/11/2025  News 10 NBC ‘Glitch after glitch’: Families of New Yorkers with disabilities say new CDPAP payment system is a ‘mess’

4/11/25 Albany Times-Union: “DOJ has ‘significant concerns’ as CDPAP legal fight continues,”  

4/10/25 POLITICO Pro: “US issues statement of interest in New York CDPAP lawsuit,”  

April 10, 2025 Preliminary Injunction issued extending until May 15th deadline for consumers to enroll with PPL and until June 6th for Personal Assistants. 

4/9/25  WRGB CBS 6 – Albany, NY: “CDPAP payments to start Thursday amid ongoing PPL transition confusion “  

4/8/2025   WTEN (ABC News 10) - Albany, NY: “News10 at 5:30” 

4/7/2025  Hell Gate (NYC): “Is Governor Hochul Fixing Home Care, or Using a 'DOGE Maneuver' to Destroy It? “  

4/7/205  Crain's Health Pulse  State's home care overhaul deadline in flux amid legal battle  (Behind paywall)(excerpt -- 

...As a part of its extension, the state promised to retroactively pay home care workers once they enrolled – a solution that advocates said was not an option for caregivers who are low-income and live paycheck-to-paycheck. The move raised concerns that caregivers would leave their jobs in search of other work to pay the bills, leaving consumers, some of whom have physical disabilities that require round-the-clock care, without services.  The state has blamed lagging registrations on misinformation spewed by companies that were set to go out of business. But some consumers said that the slow sign-ups were perpetuated by technical issues, alleging in the federal lawsuit that directions to register with PPL were not available in multiple languages, they faced long wait times to talk to a company representative and it took weeks to complete their paperwork.  

Jose Hernandez, a home care user who lives in the Bronx, said that he started registering with PPL in February, but didn’t get all of his paperwork approved until April 3. Hernandez, who uses a wheelchair and receives services from five caregivers, said that one of his personal assistants still has not received clearance from PPL and cannot be paid through the system.  After the publication of this story, the governor's office reached out to Crain's and said that the state addressed outstanding issues related to Hernandez's enrollment with PPL. Hernandez confirmed the fix. 

Attorneys for the state said in court on Friday that PPL has agreed to implement a team to expedite registrations and help consumers complete their paperwork. The company has also agreed to allow caregivers who cannot clock in to the company’s app to submit their timesheets on paper in the short term....

4/6/25 News 12 Long Island: Long Island caregivers frustrated over registration process for CDPAP

4/4/2025 Politico Pro Grim picture of CDPAP registration emerges amid tumultuous transition  -- The new consolidated Medicaid program launched Tuesday, but thousands are still working through a fraught transition.

4/4/2025   Albany Times Union  Editorial: A careless approach to care -- The home care program transition isn’t going well, and the state seems unable to admit it.

4/4/2025  WNYW-NY (FOX 5) - New York, NY “THE 5 O'CLOCK NEWS“  

4/3/2025  Binghamton Press & Sun-Bulletin: “CDPAP transition 'a nightmare' for Southern Tier agencies. What to know 

On April 4th,  the NYS Dept. of Health provided instructions for PAs not getting paid properly -- posted at  https://nylag.org/engesser/ and copied below.

  • Instructions for Personal Assistants who have NOT started registration with PPL:

    • The CDPAP Consumer should call their MCO (MLTC plan or other Managed Care health plan) or their Local DSS (HRA in NYC) - for those who receive CDPAP approved by the local DSS and who are not enrolled in a Plan.

      • EFLRP COMMENT: Home Care Services Program Central Intake is 929-221-8851, 929-221-8889.   

    • The New York State Department of Health suggests that you tell your MLTC plan, managed care plan or LDSS:

      “I am a consumer who has not yet started or completed my registration with Public Partnerships LLC and I wish to have my personal assistants stay with my prior FI. I understand that pursuant to the Temporary Restraining Order issued by a federal judge, that you must ensure my assistants are paid.”

  • FOR PA'S who are REGISTERED but not paid properly by PPL - Until May 17th, the PA could use a PPL Paper Timesheet, but after that date must use the electronic Timekeeping systems unless they obtain an Exception from PPL.  See here. 

4/2/25  CBS 6 NEWS NY’s home care payroll shift leaves aides struggling to log hours amidst app rollout   VIDEO segment here.

April 3, 2025 - NYS Dept. of Health issued an "update" that is apparently intended to comply with the TRO as modified on April 2, 2025.   

From: "health.sm.StatewideFI" <StatewideFI@health.ny.gov>
Date: April 3, 2025 at 4:55:45
PM EDT
To: "health.sm.StatewideFI" <StatewideFI@health.ny.gov>
Subject: {External} - Statewide Fiscal Intermediary Transition Update



On March 31, 2025, a federal court judge issued a Temporary Restraining Order that was limited in scope applying to changes in the Consumer Directed Personal Assistance Program (CDPAP) Statewide Fiscal Intermediary (FI) transition.  The judge clarified that order on April 2, 2025 and a hearing on a preliminary injunction is scheduled for April 4, 2025.  Until further notice:

  1. For consumers who have started or completed their registration with Public Partnerships LLC (PPL):
    1. PPL is instructed to pay every CDPAP personal assistant who has started or completed their registration with PPL weekly for all CDPAP time reported regardless of personal assistant registration status and regardless of authorization status.
    2. If the consumer has a CDPAP personal assistant that has not yet started registration with PPL, the Managed Care Organization (MCO) or Local Departments of Social Services (LDSS) must make best efforts to ensure the consumer’s personal assistant is paid, regardless of authorization status.
  1. For consumers who have not yet started their registration with PPL:
    1. If that consumer (or their designated representative) personally makes a request to the MCO or LDSS to stay with their prior FI, the MCO or LDSS must make best efforts to ensure the consumer’s personal assistant is paid, regardless of authorization status.  

ADVOCACY COMMENT:  At least for group 1 in the above April 3rd email, Personal Assistants can use this  paper TimeSheet to submit their weekly time records to PPL if they cannot log into the Time4Care app.  The TimeSheet, which was apparently created by a facilitator,  has an email address and fax number to submit to PPL.  The form must be signed by the consumer or designated rep.  It is not clear from this guidance how MLTC plans, other managed care plans, and LDSS will carry out this directive and ensure that all PAs get paid on a timely basis. 

April 2, 2025 - Federal Court issues Order Modifying the March 31, 2025 Temporary Restraining Order  --After NYLAG and Patterson Beklnap, counsel on the lawsuit, informed the Judge that DOH was violating the March 31st TRO, the Judge modified the TRO - (Exhibits AB, and C)

          WHEREAS the Court held an emergency telephone conference on April 2, 2025, to clarify its prior temporary restraining order (TRO), entered on March 31, 2025, ECF No. 37 , and to make it explicit that, with respect to the TRO, the State has a responsibility to ensure that all CDPAP consumers and PAs who participated in CDPAP before April 1, 2025, regardless of their individual circumstances and present registration status, shall continue to receive care from their existing PA, who shall be timely paid for their services.

           Based on the papers and the hearing, and for good cause shown, it is hereby:
           ORDERED that Defendant must ensure and take whatever action necessary to ensure that all CDPAP consumers and PAs who received care and payment before April 1, 2025, regardless of their present registration status, shall continue to receive care from their existing PAs, who shall be timely paid for their services.

Ordered by Judge Frederic Block on 4/2/2025. (MI) (Entered: 04/02/2025)

ADVOCACY COMMENT:  This modified Order implicitly REJECTS the State's interpretation of the original TRO that  the Department of Health communicated to MLTC and other managed care plans about the TRO.  DOH  had interpreted the Order to say that if a consumer has registered with PPL, they  cannot receive services paid for by their "old FI" even if each of their PA workers have  hit roadblocks in registering with PPL, or even if there are other barriers such as PPL not receiving the "authorization" for their services from the plan or Local DSS/HRA.   According to this slide, the PA workers must wait for back pay from PPL.   

See this FAQ from CDPAANYS on the TRO. 

Transition Update from CD Choices, one of the Facilitators that help consumers and PAs register with PPL 

March 31 -- Temporary Restraining Order issued in Lawsuit Filed by NYLAG and Patterson Belknap 

On March 31, 2025, Judge Frederick Block issued a Temporary Restraining Order [TRO] in Engesser et al v McDonald (E.D.N.Y.), a lawsuit filed by the New York Legal Assistance Group and Patterson Belknap Webb & Tyler LLP, which seeks to enjoin the state from implementing the April 1, 2025 date to move to a single Fiscal Intermediary for CDPAP.  

The lawsuit was filed on March 26, 2025, seeking to vindicate CDPAP recipients’ right to timely and adequate notice and an opportunity to be heard with aid continuing prior to the termination of their CDPAP services.  The TRO, which can be downloaded here, orders that the State Department of Health --

"... be immediately and temporarily restrained from implementing those sections of Part HH of Chapter 57 of the New York Session Laws of 2024  .... [that amended the NYS law to mandate transition to a single Fiscal Intermediary on April 1, 2025] 

Importantly, this Order does not prevent the Statewide Fiscal Intermediary (“PPL”) from operating, processing applications, servicing and paying CDPAP participants who have already registered with PPL. Rather, this Order restrains Defendant from disallowing other Fiscal Intermediaries from servicing those CDPAP participants who have not yet registered with PPL;.."

3/27/25  State workers asked to volunteer to assist with CDPAP transition  (Albany Times-Union) NY's Department of Health asked for employee help, even as the agency has signed a multimillion-dollar contract with a private vendor for the same work. Comment: By recruiting so-called volunteers, the state is acknowledging that its timeline was impossible to meet and that PPL cannot meet it.  Spokesperson says,  "Team will be reviewing CDPAP worker paperwork, running key information through federal process checks, and documenting the results,” the directive reads, adding that employees who volunteer would be given virtual training." 

3/26/25 - NYLAG filed a  lawsuit complaint  called Engesser in federal court in Brooklyn 

3/24/25 City and State  Department of Health and PPL: CDPAP transition issues are not our fault - report from press conference in which DOH announced the "grace period" of one month

3/24/25 - Spectrum News - Interview with DOH COmmissioner McDonald - denies having seen the New York Focus expose about Leading Edge, which runs the  sham health insurance plans offered by PPL.  See more on the health insurance scam exposed by the Fiscal Policy Institute. Yet he says "This is people's health care, vulnerable New Yorkers' health care.... I think healthcare really is one of the most important things." 

3/24/25 Politico  Officials defend contentious CDPAP transition -- State Health Commissioner James McDonald and Public Partnerships President Maria Perrin announced a month-long grace period, but said this is not a delay. (behind paywall)  DOH Commissioner McDonald said they decided to create a grace period to ensure consumers and their workers are not burdened when PPL takes over the program's administrative system. He insisted the move does not constitute a delay, since FIs are still expected to cease their operations on April 1, as planned. “The misinformation that I've seen is unlike anything I've seen in my life,” McDonald told reporters Monday. “So we could have worked like crazy in the last week to try to get everybody into (the new system). I don't want anyone left behind though, it's too important a group. So that's why we did the late registration window.”

McDonald was joined by PPL President Maria Perrin, who refuted claims of problems with the program's online portal. She said workers and consumers should be able to register with the online system within roughly one hour. Additionally, when asked about calls by 1199SEIU and workers to reconsider the company's benefits package, Perrin said the new plan affords most workers greater benefits.

Hochul told reporters Monday that “the truth is on our side,” when referring to a campaign of alleged misinformation from fiscal intermediaries who are expected to cease operations on April 1, when PPL takes over. “We are not changing that deadline for companies, they don't deserve it because they are the reason we are in this situation,” Hochul said of the fiscal intermediaries that currently run the program. “They have been digging their heels in, refusing to turn over legally obligated information about who the patients are and who the caregivers are. I'm not letting them off the hook. Hell no.”

3/24/25  One-Month Grace PeriodCDPAP registration deadline extended through April 30 - report in press:

Jan. to March 2025 - CALLS TO DELAY DEADLINE TO TRANSITION PAST APRIL 1, 2025

“With over 100,000 workers who still need to start their registration process, there must be immediate and urgent action to mitigate disruption for consumers and the workers who care for them,” 1199SEIU President George Gresham said in a statement.  The union is urging Gov. Kathy Hochul to sign an executive order extending the deadline, allowing at least some fiscal intermediaries besides PPL to continue operating.

That would buy time to focus on engaging consumers with high needs and in certain ZIP codes with high numbers of unreached consumers, such as Flushing and Elmhurst in Queens, the union wrote in a letter Thursday to the health department.

The union also asked that PPL delay enrollment in employer-sponsored health insurance to ensure that CDPAP workers will have access to high quality and affordable benefits — seemingly alluding to an analysis by the Fiscal Policy Institute that found many personal assistants would lose their existing health insurance and have to enroll in a plan that does not cover basic services.

March 19, 2025  NYStateofPolitics.com  As CDPAP deadline nears, calls for an extension grow  (also on Spectrum News 1 with video - with Sen.. Gustavo Rivera,  Sen. Leroy Comrie and Fiscal Policy Institute Health Policy Director Michale Kinnucan) 

March 19, 2025 - QNS.com  Sen. John Liu urges extension of April 1 CDPAP transition deadline to prevent care disruptions

"We do not agree with the state’s choice of PPL to manage New York’s personal assistance program. However, if the state insists on moving forward, they have an obligation to do it responsibly. They must take the time needed to form a comprehensive plan that will ensure a smooth transition. The 280,000 older and disabled New Yorkers who rely on CDPAP to live at home, and their caregivers, deserve nothing less."

JANUARY 2025 updates

NY Post Jan. 23, 2025   Hochul’s pro-union home care program overhaul promises $500M in savings but it’s off to a rocky start

Spectrum News  Jan. 23, 2025  Possible fight brewing over CDPAP transition in New York

By January 15, 2025 - all current FI's were required to turn over lists of all of their consumers and PA's to the MLTC and managed care plans, which in turn must turn the lists over to PPL.  See CDPAP Statewide Fiscal Intermediary Transition Policy for Medicaid Managed Care Plans.  See below regarding a lawsuit by some FI's claiming that HIPPA prevents them from transferring this information.   

By Feb. 15, 2025 - FI's that are not one of the 37 Facilitators should have sent one of these notices to their members that CDPAP services will end March 28, 2025.     Option 1 - Option 2.  

The 37 FI's selected as Facilitators should have been sending notices to their consumers rolled out by geographic region starting upstate in January and then in NYC on Feb. 10, 2025.  Notice is here FI to Consumer.  See schedule on page 4 of  the CDPAP Statewide Fiscal Intermediary Transition Policy for Medicaid Managed Care Plans.

Politico Pro Jan. 10, 2025  NY's CDPAP Transition HIts a Rocky Start (behind paywall)

Capital Confidential Jan. 10, 2025   CDPAP contract winner accused of hiding conflict while DOH starts hitting back (behind paywall)

Spectrum News Jan. 9, 2025  Court Ruling Throws Wrench in  Medicaid Home Care Program Transition .   Read about some of the lawsuits here

CBS 6 Albany Jan. 10, 2025 Faith leaders urge pause in NY Medicaid home care switch as NY vows no disruptions

Jan. 8, 2025 - Medicaid Matters NY Coalition sent  a letter  to Governor Hochul to urge a delay of the transition to a single statewide fiscal intermediary for CDPAP in light of serious problems with implementation and the threat of disruption of services. 

Over 1,000 callers hit new Medicaid home care transition hotline - Kate LIsa, NYS of Politics and Spectrum News recording  Jan. 7, 2025 (NYLAG note - hotline should have capacity to handle 1000 calls given that 240,000 consumers must transition by March 31, 2025

Albany Times Union Jan. 7, 2025 What to Know as NY Begins CDPAP Transition in Legal Limbo

Jan. 7, 2025 - Trade organizations representing managed care plans and home care agencies in NYS sent a letter to Amir Bassiri, the NYS Medicaid Director, protesting demands by PPL for prepayments at higher rates than they currently pay for CDPAP. If they do not contract with PPL by Feb. 1, the organizations could face penalties, including new enrollment suspension, the Health Department recently warned.

Lawsuits fiiled by former FIs and some consumers in early 2025 did not achieve any e statewide  injunction. See for example Times Union report here, Spectrum report here, and more in press described in this article.  THis is just two of many lawsuits filed by FIs. 

  • On Jan. 27, 2025,  a state court in Nassau County issued a Temporary Restraining Order in "Caring Professionals & CDPAANYS vs. NYS DOH and PPL"  that prohibits the State from enforcing directives of Dec. 6 and  Dec. 23, 2024  requiring all FIs to turn over Protected Health Information to the new single FI PPL about all of their employees and consumer enrollees by Jan. 15th.  The State's memo imposes severe sanctions on the FIs that failed to turn over info.  THe injunction is based on violations of HIPPA.  The motion is scheduled for Court on March 4, 2025.  Note that the injunction only protectedt he FI's who are plaintiffs in the lawsuit - Caring Professionals, Inc. and members of the trade organization CDPAANYS.  Download court filings here. The  lawsuit was later dismissed. 

  • On Jan. 8, 2025, a state court issued a Temporary Restraining Order   that stems from a petition filed Monday Jan. 6th by All-American Homecare, a Rochester-based fiscal intermediary, which accuses the Health Department of violating health privacy laws by requiring companies like theirs to hand over data on the CDPAP consumers they serve and the personal assistants who care for them.  

    • This TRO was lifted less than a week after it was issued.  

    • This TRO was cited in a separate lawsuit by a different FI, in support of a request for a similar restraining order.  The lawsuit was later dismissed.

January 6, 2025 - The new single Fiscal Intermediary (FI)  Public Partnerships LLC ("PPL") selected by NYS opened its customer service line to begin taking requests from 240,000 CDPAP recipients to transfer their CDPAP serrvices to this new FI -- will replace all 600+ FI's that currently provide CDPAP in NYS.   .

2024

Sept. 30, 2024 - Gov. Hochul announced that NYS awarded the single FI contract to PPL, a private company backed by private equity.  See Spectrum news coverage.   

  • What is Public Partnerships LLC (PPL) and why was it chosen?  The NYS budget law said that the new single FI must have served as a single Statewide FI in another state.  This meant no existing FI in NYS could qualify. 

  • PPL did not previously provide CDPAP services in NYS, though it did have at least one other contract with NYS DOH unrelated to CDPAP (administering the housing subsidy for the TBI waiver).  PPI has run CDPAP programs in some other states but none as big as NYS's.   Advocates have raised concerns about its capacity to handle the huge job of transitioning 240,000 consumers and 400,000 workers. 

  • Advocates from Pennsylvania and other states reported serious problems when PPL became the single FI in those states, including disruptions in care and delays in payment.  20,000 Pennsylvania home care workers went unpaid, costing the state $7 million annually.  The Commonwealth of Pennsylvania's audit of the transition to PPL in 2013 identified numerous serious problems with the roll-out that could have been prevented.  

NY Post Powerful nurses union scheming to make bank off Hochul’s changes to NY’s $9B Medicaid program  (Sept. 19, 2024)

APRIL 2024 - NYS Budget enacted requiring transition to SIngle Fiscal Intermediary 


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