The saga involving New York’s self-directed home care program has taken yet another turn. Last week, a home care company that was not chosen to be the fiscal intermediary for the program moving forward sued the state, alleging that the selection process was rigged.

The Consumer Directed Personal Assistance Program (CDPAP) has cost the state a lot of money in recent years, which led New York Gov. Kathy Hochul to direct an overhaul of the program. Instead of a slew of fiscal intermediaries in between the state and home care recipients, the goal was to get down to one.

That ended up being Public Partnerships LLC (PPL), which was recently awarded the contract.

The lawsuit was filed by Freedom Care LLC.

“[The Health Department] structured the process with an apparent eye toward PPL, imposing eligibility requirements that eliminated almost all of [Public Partnership’s] potential competitors — though, importantly, Freedom Care was able to jump through every hoop DOH erected,” Freedom Care argued in the lawsuit, which was filed against the Department of Health.

PPL is an Alpharetta, Georgia-based financial management services company. It is backed by the Park City, Utah-based DW Healthcare Partners and the Chicago-based Linden Capital Partners. Prior to winning the New York deal, the company operated 49 self-directed programs with over 500,000 participants, according to its website.

Last month, Hochul also announced a group of home care providers that PPL would be partnering with to help run the new version of the CDPAP program. Broadly, New Yorkers that need home care can choose their own caregiver – including family members – through CDPAP.

“We are excited to have the opportunity to serve CDPAP consumers and personal assistants,” Maria Perrin, chief growth and strategy officer at PPL, previously told Home Health Care News. “Consumer direction programs are all we do as a business. For years, we’ve not only been operating throughout several states, but we’ve made it our purpose and mission to advance access to consumer direction and make these programs stronger, sustainable and more culturally competent. This is a great opportunity for us, and we are really excited to be partnering with our [fiscal intermediary] partners.”

On its end, Freedom Care was one of the largest intermediaries of CDPAP prior to the program’s consolidation. Based in Long Island, New York, the company also operates in ten other states.

“This action challenges the New York State Department of Health’s (“DOH”) sham bidding process that resulted in a multibillion-dollar contract award to Public Partnerships LLC

(“PPL”) – an out-of-state company with no relevant prior experience in New York – to be the

Statewide Fiscal Intermediary, a position created pursuant to a recent amendment to New York’s

Consumer Directed Personal Assistance Program (“CDPAP”), a home personal care program for the chronically ill and physically disabled,” the lawsuit’s opening paragraph reads.

Prior to the PPL decision, the state was also sued for making changes to CDPAP in the first place. Consolidating the intermediaries means many businesses will lose out on a significant amount of revenue moving forward.

Freedom Care is one of those businesses.

“These services that we refer to as consumer directed, there’s some form of it in every state,” Emina Poricanin, founder and managing attorney of the New York-based Poricanin Law, told HHCN in August. “New York, obviously, with the population size and the Medicaid size, has probably one of the biggest consumer-directed programs. This is a bad way to go about restructuring, and putting some regulatory controls over this program.”

From the state’s perspective, however, a significant change needed to be made.

In July, Hochul said the program had become a “racket.” 

“I’m telling you right now, when you look on TikTok and you see ads of young people saying, ‘Guess what, you can make $37 an hour by sitting home with your Grandma. You know, here’s how you sign up,’ — it has become a racket,” she said.