New York Legislation Aims to Address CDPAP Transition Fallout

A $50 million stabilization pool proposed to smooth disparities in Medicaid reimbursement rates for high-need home care services.

Published on Feb. 23, 2026

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A little-known issue stemming from New York's transition of the Consumer Directed Personal Assistance Program (CDPAP) to a single fiscal intermediary in 2024 has led to a widening gap in Medicaid reimbursement rates between plans serving lower-acuity and higher-acuity patients. Legislation has been introduced that would create a $50 million stabilization pool to address this disparity and ensure continuity of care for those with complex medical needs.

Why it matters

The CDPAP transition, while intended to streamline the program, has had unintended consequences that have made it less financially viable for home care agencies to serve high-need patients. This has raised concerns about potential disruptions to critical services and the stability of the home care workforce at a time when the state is focused on strengthening this sector.

The details

In 2024, the state consolidated the CDPAP program from hundreds of fiscal intermediaries to a single provider, Public Partnerships LLC (PPL). While this helped curb rapid growth in the state's Managed Long-Term Care (MLTC) program, it also exacerbated disparities in reimbursement rates between plans serving lower-acuity and higher-acuity patients. The proposed $50 million stabilization pool would provide targeted funding to address this gap until a long-term solution to the state's rate-setting formula can be reached.

  • In 2024, the state transitioned the CDPAP program to a single fiscal intermediary, Public Partnerships LLC.
  • In 2026, legislation has been introduced to create a $50 million stabilization pool to address disparities in Medicaid reimbursement rates.

The players

Kathy Hochul

The Governor of New York who spearheaded the CDPAP transition in 2024.

Dan Lowenstein

The senior vice president of government affairs at VNS Health, who says the CDPAP transition has exacerbated disparities in reimbursement rates.

Amy Paulin

The chair of the New York State Assembly Health Committee, who has sponsored legislation to address the CDPAP transition issues.

Cordell Cleare

The chair of the New York State Senate Committee on Aging, who has also sponsored legislation to address the CDPAP transition issues.

Josh Jensen

The ranking member of the New York State Assembly Health Committee, who has expressed concerns about the need to address the fallout from the CDPAP transition.

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What they’re saying

“The way the state set MLTC payment rates made enrolling people who need fewer services financially lucrative. The growth followed those incentives, and it made caring for high-need patients less and less sustainable.”

— Dan Lowenstein, Senior Vice President of Government Affairs, VNS Health (nystateofpolitics.com)

“It's not a blanket rate increase. It concentrates resources where the funding gap is most acute, and it ensures continuity of care.”

— Dan Lowenstein, Senior Vice President of Government Affairs, VNS Health (nystateofpolitics.com)

“We have to make sure that people are getting paid, that people are on those rolls and that the people who were getting services are getting adequate services.”

— Cordell Cleare, Chair, New York State Senate Committee on Aging (nystateofpolitics.com)

“We may have to look at spending $50 million for a screwup. Unfortunately, now the state's taxpayers will have to pay the costs for a plan that wasn't fully fleshed out with stakeholder buy-in.”

— Josh Jensen, Ranking Member, New York State Assembly Health Committee (nystateofpolitics.com)

What’s next

The proposed $50 million stabilization pool legislation will need to be negotiated between legislative leaders and Governor Hochul as part of the state budget process in the coming weeks.

The takeaway

The unintended consequences of New York's CDPAP transition have highlighted the need for a more comprehensive approach to Medicaid reimbursement rates that ensures high-quality, sustainable home care services for the state's most vulnerable residents.