U.S. Health and Human Services Secretary Robert F. Kennedy Jr. is getting involved in the state’s contentious home care overhaul, which remains in limbo a week after it was supposed to take full effect.
Kennedy said in a Saturday post on X that the federal government is conducting a 90-day review of payment changes within the consumer directed personal assistance program, or CDPAP, a popular Medicaid-funded service used by roughly 280,000 New Yorkers. Gov. Kathy Hochul is in the middle of consolidating the estimated $11 billion home care program in hopes of cutting its costs – which Kennedy said are on a “steep upward trajectory.”
Any payment changes the state wants to implement within the Medicaid program have to go through a standard review process by the federal government. But the statement from Kennedy signals that the administration is keeping an eye on Hochul’s rocky home care consolidation, which has sparked controversy as the state has struggled to enroll home care users and workers in its new payment system and did not meet its April 1 deadline to complete the transition.
A representative from the U.S. Department of Health and Human Services did not respond to an inquiry from Crain’s by publication time.
The state submitted a request to change payment rates within the home care program in late March, prompting federal officials to conduct a standard review of whether those changes are consistent with U.S. law, according to Kennedy. The review will allow the federal government to “evaluate how the changes affect access to care and evaluate the appropriate use of federal dollars,” he said.
Kennedy pointed to continued growth in the program’s costs – echoing statements from state officials that home care spending has become unsustainable.
“It’s true that runaway administrative costs have put CDPAP at risk of a fiscal crisis for home care users who rely on the program,” said Sam Spokony, a spokesman for the governor’s office. “That’s why it’s so critical for the state’s reforms to continue moving forward – so we can protect consumer choice and strengthen CDPAP for those who need it, while also protecting all New York taxpayers by putting an end to years of runaway costs.”
The federal government has 90 days to review the state’s requested rate changes, and the review is not expected to hold up the state’s transition, according to the governor’s office.
Kennedy’s April 5 post is not the first time he has called attention to New York’s home care program. The secretary said in a social media post on March 15 that he was directing the Centers for Medicare and Medicaid Services to review “program integrity, consumer choice, and taxpayer value,” and that he instructed the state to submit necessary documentation.
New York Republicans have also called on the federal government to investigate the program. Lawmakers sent a series of letters to the federal government last year calling on officials to investigate Hochul’s overhaul, requesting that they ensure New Yorkers do not lose access to care. Congressman Mike Lawler, a likely candidate for governor in 2026, met with federal officials from CMS and HHS last week “to urge them to step in and ensure care would not be disrupted by Hochul’s disorderly overhaul of the CDPAP program,” according to spokesman Ciro Riccardi.
