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Published Jun 19, 2026
A new U.S. Department of Justice lawsuit targeting Hochul administration officials offers some behind-the-scenes insights into the state government’s overhaul of a popular home healthcare program and resurfaces criticisms that the reboot has missed its mark.
Healthcare consumers and caregivers who use the Consumer Directed Personal Assistance Program, which serves more than 200,000 disabled New Yorkers statewide, have long maintained the overhaul has threatened the delivery of services.
The lawsuit, citing emails and other documents, blames a “sham” selection process that in 2024 awarded a $1 billion state contract to a Georgia-based company, called PPL, to overhaul the sprawling program. It accuses state officials of misrepresenting the benefits of the overhaul and PPL’s capabilities, and wasting taxpayer dollars in the process.
New York state and a representative of PPL issued statements denying claims in the lawsuit, which asks a court to essentially unwind the overhaul and return to a “status quo.”
Federal officials said they filed the lawsuit earlier this week to protect taxpayers from fraud and to prevent further public misrepresentations about the deal.
Here’s what else to know about the CDPAP, the program overhaul and the lawsuit challenging the changes.
What is the CDPAP?
CDPAP allows New Yorkers with disabilities to hire their own personal assistants, including friends or family, to help them with things like dressing or bathing, rather than going through home health agencies. The aides they hire get paid by Medicaid — partly explaining the federal government’s interest.
In 2024, Gov. Kathy Hochul selected PPL to replace more than 600 smaller companies that previously administered the program in an attempt to cut costs and increase accountability. But the lawsuit, which also names PPL as a defendant, alleges that the company was selected through a rigged bidding process and misrepresented both its capacity to administer the program and how it would make money from the service.
The suit names Dr. James McDonald, in his official capacity as state health commissioner, and Amin Bassiri, individually and in his official capacity as state Medicaid director, as defendants, in addition to PPL.
Pushing back, the Hochul administration says the CDPAP overhaul has saved taxpayers more than $1 billion so far, while reining in fraud and abuse and preserving services for consumers.
How did CDPAP become a target for reform?
The program first launched in 1995 but grew rapidly in recent years — from just over 10,000 consumers in 2012 to nearly 250,000 in 2024. Total Medicaid spending on the program ballooned to more than $11 billion in 2024, split between the state and federal governments, according to the state Department of Health.
The program’s growth has coincided with a long-term shift away from nursing home care and toward in-home services as New York’s population ages. But CDPAP’s expansion raised eyebrows when it began to far outpace that of traditional home care, in which consumers go through staffing agencies to hire aides instead of finding their own.
Consumers who spoke to Gothamist said the flexibility CDPAP offers makes it an attractive option, while family caregivers have said it allows them to get paid for providing care that makes it difficult for them to work full-time outside the home. But as spending on the program strained the state budget, critics raised concerns that it was being abused and Hochul began proposing reforms to rein in costs and improve oversight.
What were New Yorkers’ initial concerns about the transition to PPL?
Some state lawmakers raised concerns about Hochul’s plan to streamline CDPAP from the start, worrying that replacing the hundreds of smaller firms that processed caregiver payments with just one would destabilize the program and make it less responsive to consumer needs.
However, legislators ultimately approved the plan, requiring a competitive bidding process to select the company that would take over the program.
Hochul’s selection of PPL in fall 2024 was met with objections from a coalition of consumers and home care companies, who pointed to legal action and criticisms the firm had faced in other states where it operated home care services.
What is the basis for allegations that PPL was "preselected?"
The DOJ lawsuit alleges that internal and external emails show Hochul administration officials considered PPL to take over the program before opening up an official request for proposals to other companies.
The evidence presented in the lawsuit builds on previous reports from the think tank the Empire Center, which received emails exchanged between PPL and the Hochul administration from a Freedom of Information Law Request.
In a state Senate hearing on the CDPAP overhaul last August, state health officials and PPL leaders denied that they had engaged in discussions ahead of the bidding process.
In October 2025, a state appeals court rejected claims that the bidding process was rigged.
What does PPL have to say about claims it misrepresented its payment scheme?
Part of how PPL is helping the state save money is by charging the Medicaid program just $68.50 per member per month, rather than the more than $150 per member per month most companies charged previously, according to Cadence Acquaviva, a spokesperson for the state health department.
That low monthly rate helped make PPL more attractive in its proposal to take over the home care program, according to the DOJ lawsuit. But the lawsuit alleges that PPL has since found a way to take a bigger cut for its services by negotiating higher rates with the insurance companies that act as middlemen in the Medicaid program.
PPL broadly rejected the characterizations in the complaint.
“We remain committed to strong program oversight, financial accountability, and operational efficiency to ensure taxpayer dollars are managed responsibly while supporting high-quality, consumer-directed care,” said Meg Fitzgerald, a spokesperson for PPL.
What concerns have been raised about PPL’s takeover?
PPL began reaching out last January to CDPAP consumers and caregivers, who all were supposed to be registered with the company by the end of March. For months, consumers, caregivers and advocates raised concerns that the timeline was too short and people would fall through the cracks, leaving vulnerable New Yorkers without critical services.
The Hochul administration repeatedly insisted that everything was going according to plan — until finally agreeing to delay the transition in mid-April. At that point, tens of thousands of consumers still had to register with PPL and tens of thousands of caregivers were still unable to log their hours and get paid, the state health department said at the time.
According to the DOJ lawsuit, communications between the Hochul administration and PPL acknowledged much slower progress during the transition period than the parties admitted to publicly.
The lawsuit also alleges that PPL employed an army of temp workers to respond to calls from consumers and caregivers, rather than the trained professionals the company promised. And the complaint alleges that PPL acknowledged internally that some consumers and caregivers were waiting over an hour for help when they called the company’s hotline during that period, while saying publicly that wait times were much shorter.
What do consumers and caregivers have to say about PPL now?
There are still major issues with how PPL is administering the home care program, including poor communication and a slow onboarding process for new aides, according to caregivers and consumers who spoke with Gothamist and feedback on the program shared by New York Caring Majority.
Harlem resident Marcus Johnson is quadriplegic and relies on five personal assistants throughout the week. He said before PPL took over, the smaller company he worked with would always notify him directly if there was a problem with one of his personal assistants’ paperwork, which allowed him to make sure any issues that could disrupt his care got resolved quickly.
“ We don't have that type of communication with PPL,” said Marcus, who is co-director of the Civics League for Disability Rights.
Jaiza Tejeda, a 46-year-old consumer in the program, echoed that sentiment, saying it can be difficult to reach someone at the company who is able to resolve problems.
“ When you call PPL, it's like you're calling a customer service center,” Tejeda said. “We tell them the situation that's going on, and they tell us that everything is fine.”
Marcus and Tejeda said the poor communication leaves them anxious that they could be left without the services they need.
Asked about these concerns, PPL said it received an average satisfaction score of 4.3 out of 5 in a recent survey of 95,000 consumers and caregivers statewide, an improvement over a similar survey conducted in May 2025.
“PPL is committed to transparency, active communication with participants, and ensuring the best experience for all CDPAP enrollees,” said Fitzgerald, the PPL spokesperson.
Maggie Ornstein, who provides care for her mother through the CDPAP, said the DOJ lawsuit shows that “ we knew what we were talking about all along and should be paid attention to and listened to.”
Ornstein echoed others’ misgivings about the Trump administration’s aims with its lawsuit — and said consumers and caregivers must have a seat at the table for any discussion of further changes to the program.