Key facts
- PPL won a contract in September 2024 to manage New York's Medicaid home care transition.
- A DOJ complaint alleges PPL misrepresented its platform's existence and financial readiness.
- The state advanced $40.5 million to PPL, allegedly against contract terms.
- Internal concerns were raised by Department of Health employees regarding PPL's practices.
- PPL allegedly misreported consumer registration status and call center wait times.
New York's transition of its Medicaid home care program, managed by PPL, has been marred by allegations of mismanagement and misrepresentation, according to a Department of Justice complaint. PPL, which won the contract in September 2024, is accused of misleading state officials about the existence of its PPL@Home platform and its financial stability. Despite a proposal stating a plan for startup costs, the company requested large upfront payments and received $40.5 million in advance from the state in January 2025, contrary to contract terms that stipulated monthly payments based on consumer shifts.
Internal communications cited in the complaint reveal that Department of Health employees, including Medicaid director Bassiri, expressed significant concerns about PPL's actions, labeling its behavior as "opportunistic" and predicting negative repercussions for the state. The transition, which began in January 2025, involved shifting over 200,000 participants and their caregivers to PPL's system within a tight three-month deadline, a timeline that also drew internal criticism.
The Hochul administration reportedly resisted options to extend the April 1, 2025 deadline and directed the Department of Health to withhold data on registration progress. Further allegations suggest PPL inflated its progress by counting consumers who had not started registration as 'in progress' and downplayed average call center wait times, which internal data showed to be 62 minutes. A PPL staffer's comment, "Sometimes I think that people shouldn’t see how the sausage is made," reportedly referred to these call center issues.