New York accused of rigging CDPAP contract in lawsuit

ALBANY — A home health company that failed to win a contract to run a multibillion-dollar Medicaid program in New York claims in a lawsuit filed this week that the state rigged the bidding process in favor of the winner.

That winner, Public Partnerships, LLC, is a Georgia-based company that the state selected in September to take over the fiscal side of a popular but expensive Medicaid program.

The Consumer Directed Personal Assistance Program, or CDPAP, allows people who need help with daily tasks to choose their own help, including someone they know, rather than being assigned a person .

The lawsuit was filed by Freedom Care LLC, a home health care company, against the state’s Department of Health and Public Partnerships, claiming they colluded to hijack the contract from other applicants.

“(The Department of Health) structured the process with an apparent eye toward the PPL, imposing eligibility requirements that eliminated almost all potential competitors (from the public partnership) – although, more importantly, Freedom Care was able to overcome all obstacles erected by the DOH,” the lawsuit says.

The company is represented by the Gibson Dunn law firm in this litigation. A spokesperson for Gov. Kathy Hochul said the civil complaint was “rife with false statements.”

“But the facts here are simple. The qualification terms were approved by the state Legislature and the (request for proposal) was put out to public bidding,” said Sam Spokony, a spokesperson for the governor. “At the end of this process, (the public partnerships) had the highest score and were selected.”

The transition is expected to begin in January and be completed by April, Spokony said.

The conflict began in April, when Hochul and Parliament decided to change how the fiscal aspect of the home care program would be handled.

This is currently done through hundreds of so-called tax intermediaries. These are companies that serve as intermediaries between Medicaid and the aides who participate in the program. The companies then take a portion of these funds as payment.

But state spending on the program has increased from $2.5 billion to $9 billion over the past five years, and that figure is expected to rise as enrollment increases, state budget officials said. ‘State.

That led Hochul and lawmakers to decide, as part of this year’s state budget, to replace the current roster of fiscal intermediaries with a single statewide administrator. This would reduce the cost of the program, they argued, and reduce fraud.

“I want to make sure the money goes not to them, but rather to the people who need these services,” Hochul said in October. “I want to make sure the program is financially sustainable.”

That was after the state Department of Health announced that Public Partnerships had won the contract.

The agency in June issued a request for proposals to become the state’s new fiscal intermediary for the program. Public Partnerships was one of 136 companies that applied for the contract.

Freedom Care claims in its lawsuit that the criteria the state sought in that application imposed restrictions on domestic entities that did not apply to out-of-state applicants, such as public partnerships.

“Specifically, (the Department of Health) introduced a conflict provision in (the RFP) that prohibits the statewide fiscal intermediary from being owned or controlled by a licensed home health services agency in New York State, but has not imposed this restriction on based entities. in other states,” the lawsuit says.

The agency also declined to disclose how certain parts of each contract proposal would be scored, the company claimed.

“(The Department of Health’s) evasion had the effect of putting (the public partnership’s) competitors at a disadvantage,” the lawsuit states.

The lawsuit also claimed the state illegally coordinated with the public partnerships before they were announced as the winner of the contract. Indeed, when this was announced in a press release, the State and Public Partnerships had already selected companies with which to subcontract.

“This should be enough to vacate the award,” the attorneys wrote in the lawsuit.

Opponents of how the state wants to change the program have spent the last six months advocating for Hochul and the Legislature to cancel it and find other ways to reduce Medicaid costs.

This changed things, but not by much. Some lawmakers sympathize with their cause, but no greater effort has been made in the Legislature to prevent the planned change.

Bryan O’Malley of the Alliance to Protect Home Care said he supports the lawsuit seeking to overturn the contract awarded to Public Partnerships. O’Malley said it was a “backroom deal.”

“There is no other way to explain how a company with a record as bad as (the public partnership) would be allowed to manage home care for our elderly and disabled people,” he said. declared. “The Legislature and governor still have time to fix this before New York becomes another PPL disaster,” he said.

Public Partnerships runs several programs in other states, as well as New York, but has been criticized over its handling of some programs. The company did not respond Tuesday to a request for comment on the lawsuit.

If lawmakers want to work with Hochul to adjust or stop the transition, that will happen during the legislative session. This should start in January.