New York to Replace Health Insurance Provider for CDPAP Home Care Workers

The state of New York will replace Leading Edge Administrators as the health insurance provider for hundreds of thousands of home care workers participating in the Consumer Directed Personal Assistance Program (CDPAP) next year. This decision follows investigative reports revealing issues with Leading Edge, including underpayment to doctors, unauthorized patient billing, insurance cancellations without notice, misappropriation of funds intended for low-wage workers, and questionable financial practices. Leading Edge, also known as Omni Advantage, was contracted by Public Partnerships LLC (PPL), a care management company overseeing the $11 billion CDPAP program, which allows low-income elderly and disabled individuals to hire their own caregivers. PPL itself has faced criticism for delayed paychecks, exposure of sensitive employee data, and poor customer service. Home care workers objected to a health insurance plan administered by Leading Edge that required them to pay for coverage lacking basic benefits like hospital visits and primary care, despite often being low-income earners. The plan included an expensive option with significant out-of-pocket costs, which will end when PPL introduces a new insurance provider in May. PPL has not disclosed the reasons for the change but has indicated that some payroll deductions for benefits will likely continue. An improved health insurance plan will be offered starting January 1, covering more services but at a higher annual cost, available only to full-time workers. Critics view the changes as only marginal improvements amid deeper systemic issues with PPL's handling of health benefits for home care workers. Advocacy groups and workers have highlighted the financial strain imposed by current insurance costs and the company’s delayed communication about changes. The unfolding situation illustrates ongoing challenges in administering affordable and comprehensive health insurance within state-contracted home care programs, emphasizing the need for regulatory oversight and potential policy reform to better support this workforce.