New York’s transition to a single company to manage the hundreds of thousands of Medicaid patients and their caregivers in the Consumer Directed Personal Assistance Program is still hitting major roadblocks, now a month after the new company was supposed to have fully onboarded the assistants and clients.
In his North Country district, Assemblyman Scott A. Gray, R-Watertown, has been helping local CDPAP clients interface with PPL, the new company, bridging gaps that have left nearly a dozen local residents without pay or the care they’ve been promised.
According to details shared by the Assemblyman and his office, a handful of local residents who were on the CDPAP program before the April 1 transition deadline have now gone at least a month without their caregivers being paid, and continue to struggle to reach PPL for a resolution.
Constituent casework documents indicate that many patients are complaining that PPL does not honor call back requests, and have been instructed to instead wait on hold when they call for assistance — a wait that could take hours.
Details from casework conversations detail a number of complex situations — one individual, a personal assistant, explained that they had worked for a previous intermediary company up until April 1, and given no information on the transition from that previous company, FreedomCare. When they called on April 1 for more information, the company had already dissolved its CDPAP office. They began applying and eventually did register with PPL, both themselves and their client.
That same individual explained that the client’s insurance company, which handles their Medicaid benefits including CDPAP, has strict restrictions on hours per week worked for the client, but PPL has not honored those restrictions, leaving the client for days without care.
Another case details a PA who thought they were fully transitioned and has in fact been paid by PPL, but has received split payments over multiple checks repeatedly. That worker noted that they’ve submitted for direct deposit, but PPL continues to issue paper checks through the mail.
Yet another case involves one of five personal assistants who care for a north country individual with a traumatic brain injury — the PA said they’ve registered with PPL but it’s unclear if the patient is properly registered as well. They’ve reached out to PPL, they say, but have failed to reach a real human agent to actually discuss the issue — in the meantime, the five caregivers for this one patient have gone unpaid for weeks.
In an interview, Gray said he and his team have been working on this issue for weeks, taking constituent complaints and ferrying information back and forth between the constituents and Gray’s contacts at PPL, including their government affairs team.
“I don’t want to go back and forth with them,” he said. “I said ‘tell me what you need, we’ll get the information, we’ll put it on a spreadsheet and we’ll send it to you’.”
Gray said one key issue that PPL informed him of was that there were a number of cases where the company had multiple clients or PA’s applying for registration with the same names — the company told him they needed telephone numbers and emails to cross-reference their list of repeated names to fix specific payroll issues.
There are other hangups still preventing people from getting paid, but issues are being closed progressively – he said he’s handled 17 cases, and 10 have been resolved as of Friday. There are still concerns over unregistered PA’s, who don’t have accounts with PPL and still need to complete the registration process. From the cases Gray’s office has shared, a significant number of issues seem connected to a lack of information provided to the PA’s and the clients by DOH or PPL – leaving huge gaps in understanding of what is the clients or PA’s responsibility and how to progress through the application and registration process.
The original registration deadline was April 1 – but the state DOH had to offer a “grace period,” which they took great effort to not classify as a delay in the implementation, of up to May 1 to complete registration. That timeline was thrown out the window by a federal court decision last month that ruled the DOH and PPL had to give clients until mid-May, and PA’s until mid-June to complete registration with the new company. In the interim, the previous intermediary companies are meant to still pay the PA’s for their hours worked, with state Medicaid dollars mandated to still flow to them for the time-being.
When reached for comment, a spokesperson for PPL said that the company’s call centers and online resources are freely available and have been ramped up to handle the transition of hundreds of thousands of clients and assistants.
“We have more than 2,000 people supporting the customer service center, which is open six days per week, and have another 500 people supporting other operational functions including payroll,” the company said in a statement through the spokesperson. “We offer daily appointments at our offices across the state and have 45 facilitator partners who also offer in-person or phone assistance.”
And on Friday, the company issued a press release noting that just over 165,000 PAs had submitted timesheets for the last pay period, accounting for about 80% of all PAs registered with the company. Almost all who submitted timesheets were paid, and the company has paid at least 172,000 PAs for time worked since April 1, even if those PA’s haven’t submitted a timesheet for every pay period, and the company has paid $395 million in gross payroll.
“While there remain temporary options to be paid by other fiscal intermediaries, each week we are seeing an increasing number of PAs submit timesheets to PPL,” said company president Maria Perrin. “We continue to focus on helping PAs get registered and providing education and support on timekeeping and other service needs.”
Those 172,000 PAs are a long way from the more than 400,000 PAs who cared for about 280,000 CDPAP clients before April 1 – and its far lower than the number of PAs who have tried to register with PPL. Earlier in March, the state Health Department said 245,000 PAs have started or completed registration, and 215,000 had access to the payroll app. Payroll app access doesn’t mean a PA is eligible to work, however.
Meanwhile, the transition has also kicked tens of thousands of clients out of the CDPAP program – the state DOH has said 60,000 of the original 280,000 clients have moved to other care options, and about 4,000 CDPAP clients had made no determination on their care. Thousands of clients are still working through the transition process, now over a month after their PAs temporarily stopped receiving payments and lost their benefits like health insurance.
According to the PPL statement from Friday, the company is working to fulfill state and federal requirements for all PAs – ensuring they have the right to work in the U.S. and are eligible to be a PA in CDPAP. The company said if a PA submits a timesheet without completing all documentation, the company reaches out to help fix the issue.