Recent reporting from the state suggesting that the discovery of approximately 35 instances of fraud in a program serving over 200,000 consumers and over 220,000 personal assistants justifies the deeply flawed transition to a single statewide fiscal intermediary (FI) demonstrates a troubling lack of context and a dangerous willingness to sacrifice the rights of disabled and aging New Yorkers for the illusion of administrative efficiency.

Firstly, the Managed Care Organizations (MCOs), which are paid billions of dollars to provide care coordination and ensure appropriate service delivery, have consistently failed to fulfill this responsibility. The article notes payments continuing for deceased and hospitalized clients, an oversight that falls squarely on MCOs and the State’s own systems. To be clear, the MCOs who issue the authorizations for these clients were paying the FI. How could MCOs who are charged with oversight and consumer monitoring allow such egregious lapses to occur? And more importantly, where is the accountability of those failures?

Secondly, while Electronic Visit Verification (EVV) itself is not the problem, weak and poorly implemented systems contribute to new opportunities for fraud. Anyone with access to a consumer’s EVV platform can potentially log and verify time, whether it was worked or not. Previously, local, community-based FIs had safeguards in place to prevent this, including personalized oversight of cases. Now, with a single, centralized FI managing the system, those protections are gone, making fraud more difficult to detect and potentially systemic rather than isolated.

Thirty-five instances of fraud in a program involving over 225,000 people is hardly a “big win,” especially when it’s unclear whether 35 individuals committed fraud once each, or if a single person committed 35 acts. Rather than proving success, this statistic underscores the integrity of the program under local stewardship and highlights the greater risks posed by centralized control. It’s a reminder of how much worse things could become when oversight is consolidated and transparency diminished.

Let us be clear: protecting public funds is important. But dismantling consumer control, gutting local oversight, and handing a public program to a private monopoly is not the path to reform; it’s a recipe for disaster.

Article link: https://www.cityandstateny.com/policy/2025/07/doh-and-ppl-identify-fraud-previous-home-care-program/407081/?oref=csny_firstread_nl