“We are excited to have the opportunity to serve CDPAP consumers and personal assistants,” Maria Perrin, chief growth and strategy officer at PPL, 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.”

Through CDPAP, a Medicaid-funded home care program, people seeking care are allowed to hire a caregiver of their own choosing. This often means informal caregivers, which are paid for their services through the program.

Roughly 700 businesses currently serve as fiscal intermediaries, many of which are home care providers themselves. The state is looking to save $1 billion annually by appointing one administrator.

As part of the agreement, PPL must work with four local organizations, and a network of 30 home care agencies.

“Our approach to this was to make sure that we put together a partnership with existing CDPAP fiscal intermediaries and with the independent living centers,” Perrin said. “That would make sure there’s ample capacity from a volume standpoint and from a linguistic standpoint, making sure that people who are not english speakers continue to be served. That people who have disabilities, or cultural or religious considerations, would continue to be served. At this point, we have over 30 existing CDPAP fiscal intermediary partners that we’ve identified, in addition to the 11 independent living centers, who will continue their work.”

Perrin noted that with state approval, PPL is open to identifying and partnering with even more organizations.

PPL will also relocate its headquarters to New York. The move will create over 1,200 jobs, according to a press statement.

Additionally, The Chinese American Planning Council will aid in managing the program in Long Island, Westchester County and New York City.

Uncertainties around CDPAP

With these changes to CDPAP, Emina Poricanin, founder and managing attorney of the New York-based Poricanin Law, believes that many providers will be weighing their options.

“As far as the providers are concerned, this is just additional uncertainty about their future as a business,” she told HHCN. “A number of them are, even more expeditiously, exploring other lines of personal care services that they can offer in New York State because they have no choice but to pivot from this program.”

For some, this means transitioning patient care hours into a traditional licensed home care services setting and out of CDPAP, Poricanin noted.

In addition to fiscal intermediary restructuring, Poricanin pointed to the significant decrease in reimbursement rates as another area of concern for providers.

“[It] takes out, largely, any incentive for a provider to be in this program,” she said. “Irrespective of what happens with PPL, or any single statewide fiscal intermediary, there’s simply very little money in this program. Therefore providers, regardless of what happens with the single statewide [fiscal intermediary] restructuring, should and are looking long term into what they can do with this line of business.”

Poricanin also believes that the state may see additional lawsuits, specifically ones that challenge if the appointment was a true competitive bidding process.

“The number has not been released, but based on my own knowledge of the market, I assume there were at least 200 applications that were submitted to New York State, and yet they were able to turn those around from mid-August and send out rejection letters yesterday,” she said. “How did they get through all of those applications that quickly, if they were actually reviewing the applications and giving each applicant a fair opportunity to apply? That is probably going to be the subject of some litigation — that the process was not conducted fairly.”

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New York’s CDPAP has been in the headlines for months. Gov. Kathy Hochul deemed the home care program a “racket” and lawsuits protesting changes to the plan have mounted.

The Alpharetta, Georgia-based PPL is now aiming to secure the contract to be the sole administrator of New York’s program, which cost Medicaid $9 billion last year. The state plans to reduce the number of administrators from 700 to just one in order to save $1 billion a year. If finalized, the move is expected to phase out existing administrators in the next eight months.

Backed by the Park City, Utah-based DW Healthcare Partners and the Chicago-based Linden Capital Partners, PPL currently operates 49 self-directed programs with over 500,000 participants, according to its website.

Any company that becomes the exclusive administrator for New York’s CDPAP could secure a contract worth billions in revenue over the next five years.

PPL is strategically positioning itself at the forefront of the race by reaching out to existing fiscal intermediaries in New York and offering them potential subcontracts that could save their businesses once the state awards the contract on October 1.

The company is currently seeking a market implementation director to “oversee the New York market and consumer implementation function.” The director will be “responsible for supporting the stand up of a single financial management services program and enable the successful transition of consumers and caregivers into a singular operating platform.”

PPL is considered one of the few companies eligible for the contract because of its experience in operating as a statewide fiscal intermediary in other states. Companies interested in competing for the contract had to submit their bids by August 21.

Home Health Care News reached out to PPL, but the company’s leaders declined to comment during the ongoing selection process.

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