New York’s decision to award an $11 billion Medicaid homecare contract to a single vendor without competitive bidding has triggered investigations and renewed debate over transparency in public contracting.

At a Glance

• A no-bid contract worth $11 billion was awarded to Public Partnerships LLC (PPL)
• The contract covers New York’s Consumer Directed Personal Assistance Program (CDPAP)
• State legislators raised concerns about transparency and conflicts of interest
• PPL has faced service-related complaints in other states, including New Jersey
• Ongoing investigations may lead to reforms in Medicaid contracting

Confrontation Over the Procurement Process

On August 21, 2025, State Senator James Skoufis challenged Health Commissioner Dr. James McDonald during a legislative session, presenting evidence that New York had drafted a bill naming Public Partnerships LLC as the sole contractor for CDPAP. The program, which allows recipients to hire and direct their own aides, has grown rapidly, with costs rising from $3.1 billion in 2018 to over $11 billion in 2024.

Watch now: PPL faces multiple issues with Medicaid homecare program (CDPAP) · YouTube

Despite earlier assurances that no single vendor had been selected, state records show PPL was ultimately awarded the contract beginning in December 2024. The lack of competitive bidding has drawn scrutiny from lawmakers, advocacy groups, and independent analysts, who question whether the procurement process ensured accountability.

Centralization Amid Rising Costs

Officials in the Department of Health have defended the decision to centralize CDPAP under a single fiscal intermediary as a response to rising program costs and concerns about fraud. They argue that tighter oversight and administrative streamlining are necessary to sustain the program financially.

Critics, however, contend that the process undermined transparency by relying on a draft bill naming PPL directly. Disability and elder advocacy groups testified that PPL has experienced service disruptions in other states, including New Jersey, raising doubts about its ability to manage a program of this size. Advocates also warned that eliminating local intermediaries could reduce consumer choice and weaken trust in oversight.

Political and Policy Fallout

The controversy has drawn in multiple branches of state government. Legislative committees have launched inquiries into the contracting process, while advocacy groups have pressed for greater accountability. Governor’s office officials have signaled close monitoring of the situation, leaving open the possibility of policy revisions if investigations uncover irregularities.

Policy analysts note that New York’s approach could influence other states considering centralization of Medicaid services. While some experts believe a single-vendor system could improve efficiency, others emphasize the risks of concentrating billions of dollars in Medicaid funding into one private contractor without competitive safeguards.

Looking Ahead

The outcome of ongoing investigations may determine whether the state adjusts or maintains its current approach. For New Yorkers reliant on Medicaid-funded homecare, the transition raises immediate concerns about continuity and quality of services. For lawmakers and policymakers, the case has become a test of how to balance cost control with transparent and accountable governance.

Whether the contract represents necessary reform or a failure of oversight remains under review, with broader implications for Medicaid policy across the United States.

Sources

NY Focus
City & State New York
New York State Senate
New York State Department of Health