•  It was widely known that PPL would get the contract before the budget was enacted. Draft legislation had even proposed awarding them a no-bid contract. Though rejected by the Senate, the outcome was the same: PPL still received the contract. Senator Skoufis concluded bluntly: “the bid was steered.”

•  DOH and PPL kept saying that there were no conversations beforehand, PPL went as far as to say they were "surprised and pleased" that they were selected, acting like they had no idea about the no- bid legislation draft at all.
Enrollment and Coverage Discrepancies

Enrollment & Coverage Discrepencies

•  Before PPL: \~280,000–300,000 consumers were enrolled in CDPAP.

•  Under PPL: \~210,000 remain.

•  \~50,000 to 77,000 shifted to higher-cost options.

•  10,000–40,000 participants remain unaccounted for.

•  DOH and PPL presented inconsistent enrollment and payroll figures, with no clarity on unique staff or regional breakdowns.

Failures in Execution:

•  Much of the contract remains redacted, even to the legislators, but testimony confirmed PPL must be failing key obligations during transition.

•  Before transition: at least 280,000 caregivers supported the disability community. Now: \~236,000 onboarded are onboarded with PPL.

•  Delayed payments: 76,000 paid first cycle; 110,000 second cycle. Tens of thousands went unpaid for weeks, some unresolved a month later.

•  By May, 165,000 were paid, leaving at least 71,000 unpaid two months into rollout.

•  Families: “Getting paid today doesn’t mean you were paid yesterday or will be tomorrow.”

•  Hearing was delayed 6 weeks so DOH could prepare, yet Commissioner McDonald arrived unprepared/unwilling to share basic data and did not bring staff to assist with testimony.

Oversight and Transparency Issues

•  Until mid-March, PPL communicated openly with lawmakers, then claimed DOH told them to stop. DOH denied this. PPL insisted otherwise. Contradictions remain unresolved.

•  Vendor Responsibility Form & Review should have flagged concerns about PPL’s financial stability. Unlike other FIs, PPL leaned heavily on lines of credit.

•  Lawmakers pressed: who at DOH is responsible for oversight? McDonald offered vague answers, listing staff but unable to explain their roles. This contradicted the Governor’s claim that rollout was “closely monitored.”

•  McDonald’s testimony drew sharp criticism. Some said it resembled a “bad SNL skit.”

Administrative Costs and Savings Claims

•  DOH claimed they are still on track to achieve \$400M in “administrative savings.”

•  Testimony showed that other costs "ate up" any promised savings: reimbursement rates under PPL are higher than with our "legacy FIs" and it is sad that 50,000–80,000 consumers have been forced into higher-cost care. Costs increased, not decreased.

•  Many concluded: “New York is paying PPL more to do less.”

Impact on Caregivers and Consumers

The hearing revealed why nearly 40% of caregivers have quit or are considering quitting — a catastrophic risk to an already strained workforce. Reasons include:

•  Wages: In wage parity regions, lost \$2–3/hour compared to legacy FIs

•  MEC “Benny cards”: Skim 84 cents/hour from pay, cover little, and can interfere with other insurance. Instead of stability, they add financial stress.

•  Health coverage: The Anthem Bronze Plan was blasted for its inadequate provider network. When Patty Barnes (PPL) was asked if she would accept it herself, she responded all caddy that she didn’t live in NY, so it was irrelevant. She repeatedly deflected and at times contradicted Commissioner McDonald, their testimonies undermining each other. Lawmakers were left wondering who was lying under oath.

•  High Deductible Plan: Even after paying monthly payments and meeting the really high deductible, caregivers are left without real access to doctors despite paying in. When pressed, PPL and DOH could not name participating physicians.

Families summed it up: unstable pay and unreliable benefits destroyed trust. Caregivers cannot rely on income or coverage, fueling exits and worsening the workforce crisis, which forces people out of their homes and into institutions.

Blame Shifting and Accountability Gaps

•  PPL and DOH often blamed families for “waiting until the last minute” on forms, also framing them as easily manipulated.

•  Families countered: the system was rushed and flawed. Some said the Protect Home Care ads were the only reason they knew about the transition and that this organization helped people with enrollment issues more than DOH or PPL did.

•  DOH tried to make itself look like they were helping by saying they pushed for retroactive pay and explained they had 10 staff do overtime to create a “hotline” for wage theft victims — but failed to mention that these extra efforts were only created after legal action was initiated against them. No systemic fixes were shown.

Senators and Participants

•  Some of the Senators present: Gustavo Rivera, James Skoufis, Nathalia Fernandez, Christopher J. Ryan, Patrick Gallivan, Lea Webb, and Sheila Bynoe.

•  Commissioner McDonald insisted CDPAP costs were “unsustainable,” but ignored that aging demographics and agency shortages drove demand. Families turned to CDPAP because agency care was unavailable — saving the state money. CDPAP should never have been scapegoated. The amount of fraud and abuse has been much lower in CDPAP in comparison to other medicaid funded options.

•  Critics emphasized: PPL has failed its most basic duty — processing wages and benefits. Their nonsecure platform allowed money to be diverted overseas (FBI involved). PPL tried to say it wasn't caregiver money - but then where did it come from- had to be from fraudulent medicaid billing. Did it deplete auth hours and impact consumers? No clarity offered.

Core Takeaways

1. Procurement was flawed and conflicts of interest abound. The contract outcome appeared predetermined. Oversight bodies like the Comptroller must be allowed to intervene to break this down further.

2. Coverage gaps are undeniable. Tens of thousands left behind or forced into costlier care. DOH has not honored its obligations, which is why the USDOJ is investigating.

3.  PPL failed its obligations. Payroll delays, benefit mismanagement, broken promises.

4.  Oversight is weak and contradictory. DOH and PPL undermined each other; trust is gone.

5. Families and caregivers are destabilized. This was a manufactured crisis. The harm was avoidable. Accountability is now essential.

The facts revealed cannot be ignored or undone. Senators stressed that further information promised by DOH and PPL must be shared with the public — not hidden — because families have waited long enough. The next steps will determine whether this crisis worsens or whether leadership can restore any measure of trust.