DOJ Sues New York DOH and PPL Over CDPAP Fiscal Intermediary Fraud Allegations
The U.S. Department of Justice filed a lawsuit Tuesday against the New York Department of Health and Public Partnerships LLC (PPL), alleging fraud in the state's transition of the Consumer Directed Personal Assistance Program (CDPAP) to a single fiscal intermediary. DOJ claims the arrangement was designed to extract millions from New York's Medicaid program through improper payments. The lawsuit targets both the state agency that selected PPL and the fiscal intermediary itself. CDPAP allows Medicaid beneficiaries to direct their own long-term care services, with fiscal intermediaries handling payroll and administrative functions.
Managed care organizations operating in New York with CDPAP members or LTSS contracts face potential operational disruption, increased federal scrutiny of fiscal intermediary arrangements, and possible retroactive claims adjustments if DOJ prevails.
LTSS · Managed Care
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