New York disputes rate hike request in CDPAP

In December 2025, New York’s health insurers formally challenged Public Partnerships LLC (PPL), the current administrator of the state’s Consumer Directed Personal Assistance Program (CDPAP). The contention centers on PPL’s proposal for a standardized reimbursement rate increase of 55 cents per unit across all managed care plans. This adjustment correlates with an impending minimum wage increase for home care workers. However, health plans assert this uniform rate hike lacks proper negotiation and possibly violates both state and federal antitrust regulations, as well as PPL’s contractual obligations with the New York State Department of Health.

The dispute extends beyond financial adjustments to questions about the structural management of CDPAP. Critics argue that the process leading to PPL’s sole contractor status compromised competitive bidding principles. Previously, the program operated through multiple intermediaries, but the consolidation to a single vendor has prompted allegations of favoritism and reduced competition. These factors contribute to ongoing legal scrutiny and political pressure, including vocal opposition from state officials and disability advocacy groups who are urging the state to reconsider its contract with PPL.

This controversy highlights the complex balance between managing Medicaid home care program costs, ensuring appropriate caregiver compensation, maintaining program accountability, and fostering competitive contracting. New York’s CDPAP serves a large population of individuals with disabilities and chronic health needs, making the outcomes of this dispute significant for program integrity and service quality. The negotiations and regulatory reviews underway will likely influence how state Medicaid home care programs address wage mandates, contractor oversight, and market competition moving forward.