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New York’s home-care fraud scandal exposes Medicaid’s rotten incentives



Medicaid is federally funded and state-run, but the program’s beneficiaries often have the least say in who provides their care and what that care costs.

That’s a built-in flaw. States have every incentive to maximize federal matching funds while federal taxpayers bear much of the cost. The result pits state bureaucrats against Washington’s need to control Medicaid spending — and against taxpayers’ interest in stopping providers, insurers, and contractors from cashing in on weak oversight.

New York’s home-care scandal is not merely a contracting failure. It is a warning about Medicaid’s overall design.

That is why cosmetic Medicaid reforms so often produce more spending, more inefficiency, and more fraud.

Just look at New York.

Democrat Governor Kathy Hochul’s administration botched the reform of its roughly $11 billion Consumer Directed Personal Assistance Program, a Medicaid-financed home-care benefit, so badly that federal prosecutors came knocking.

The U.S. Justice Department recently sued the New York State Department of Health and Public Partnerships LLC, the program’s sole fiscal intermediary since 2025. Prosecutors allege that New York’s CDPAP reform, supposedly designed to reduce waste in a billion-dollar program, instead created conditions for an ongoing Medicaid fraud scheme.

Personal care — nonmedical long-term care provided in the homes of elderly and disabled patients — is especially vulnerable to waste and abuse. The reason? It’s difficult to verify that caregivers worked the hours billed or provided the services claimed.

“The service is delivered by unlicensed caregivers in private residences, usually with no on-site supervision,” Bill Hammond of the Empire Center has explained. “The risk is heightened when the aide is a friend or family member of the patient, which is allowed under the popular and rapidly growing [CDPAP].”

New York’s numbers show the scale of the problem.

In 2021, the state employed 138 home-health and personal care aides per 1,000 residents age 65 or older — more than double the national average. New York City employed 236 aides per 1,000 older residents. By 2024, the statewide rate had climbed to 171 aides per 1,000 older residents.

Home care was supposed to reduce New Yorkers’ reliance on nursing homes. Yet the share of elderly New Yorkers living in nursing homes declined more slowly than in almost every other state, while New York’s per capita Medicaid spending on nursing homes remained the highest in the nation and more than double the U.S. average.

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Over the decade leading up to 2025, hundreds of fiscal intermediaries emerged to process payroll for CDPAP lay caregivers and perform other administrative duties. These intermediaries eagerly tapped loosely supervised Medicaid dollars.

Many aggressively advertised the opportunity to become a CDPAP caregiver and get paid by Medicaid to care for a family member — eventually at the same legally mandated minimum pay as professionally trained home-care aides.

That helped fuel what Hammond described as “seemingly bottomless and unchecked demand for a costly Medicaid benefit, which has been rising almost 10 times faster than the growth of the state’s elderly population.”

In 2024, New York passed legislation consolidating CDPAP management under a single statewide contractor. The state awarded that role to PPL.

By then, CDPAP relied on nearly 600 intermediary firms, and enrollment had exploded from roughly 12,000 to more than 250,000 between 2015 and 2023.

By shrinking the bureaucracy, New York lawmakers claimed they would restrain CDPAP’s soaring costs. Once again, they promised greater accountability and hundreds of millions of dollars in savings.

They did not deliver.

According to the Justice Department, the procurement process for “one of the most lucrative contracts for administering a Medicaid program in the nation” was compromised from the beginning. Prosecutors allege that “PPL was preselected as the winner through a sham bid process.”

The transition from hundreds of intermediaries to PPL was also disorderly. An unrealistic timeline, evident to both PPL and the Department of Health, disrupted patient care.

Most important, prosecutors allege that “PPL and New York, without explanation, have disregarded key limits the contract imposed on the revenues and profits PPL was entitled to.” Those limits were “central to the goal of saving hundreds of millions of dollars through the CDPAP transition.”

PPL allegedly “siphoned millions of dollars of Medicaid funding,” with the state Department of Health complicit in the ongoing scheme.

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Pete Kiehart/Bloomberg/Getty Images

PPL can be replaced. But another company eager to rent-seek will inevitably take its place unless the incentive structure changes.

As long as federal taxpayers contribute anywhere from $1 to $9 for every $1 New York contributes to fund Medicaid for New Yorkers, state administrations and health officials will remain too complacent about the misuse of taxpayer money.

Any money recovered from this alleged scheme would be dwarfed by Medicaid’s broader improper spending crisis, which may have exceeded $1 trillion over the past decade.

New York’s home-care scandal is not merely a contracting failure. It is a warning about Medicaid’s overall design.

The program rewards states for spending more, obscures responsibility for waste, and leaves taxpayers chasing fraud after the money is gone. Overhauling Medicaid to restore accountability is long overdue.

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Comer refers disgraced former NY Gov. Cuomo to DOJ for criminal prosecution: 'Caught red-handed'



Andrew Cuomo resigned as New York governor in August 2021 after a report by the state attorney general corroborated 11 women's sexual harassment claims against him. Investigators said that by groping employees and "making numerous offensive comments of a suggestive and sexual nature," the Democratic leader created a workplace "filled with fear and intimidation."

Cuomo, likely counting on New Yorkers to forgive or forget, now has his sights set on Gracie Mansion, the home of the mayor of New York City.

While currently fighting socialist Assembly Member Zohran Mamdani for dominance in the lead-up to the Democratic primary election in New York City's mayoral race, Cuomo may soon also have to fight federal criminal charges.

House Committee on Oversight and Government Reform Chairman James Comer (R-Ky.) referred Cuomo to the Department of Justice for criminal prosecution on Tuesday, evidently hoping Attorney General Pam Bondi will take the matter more seriously than her predecessor, who ignored the October referral of former Rep. Brad Wenstrup (R-Ohio).

'It was a calculated cover-up.'

In his October criminal referral to former Attorney General Merrick Garland, Wenstrup, chair of the now-disbanded Select Subcommittee on the Coronavirus Pandemic, noted, "Mr. Cuomo provided false statements to the Select Subcommittee in what appears to be a conscious, calculated effort to insulate himself from accountability. The Department of Justice should consider Mr. Cuomo's prior allegedly wrongful conduct when evaluating whether to charge him for the false statements."

Comer again seeks to hold the former governor accountable for allegedly making criminally false statements regarding his manipulation of a supposedly independent report concerning New York's COVID-19 nursing home tragedy.

"Andrew Cuomo is a man with a history of corruption and deceit, now caught red-handed lying to Congress during the Select Subcommittee's investigation into the COVID-19 nursing home tragedy in New York," Comer said in a statement.

"This wasn't a slip-up," continued Comer. "It was a calculated cover-up by a man seeking to shield himself from responsibility for the devastating loss of life in New York’s nursing homes. Let's be clear: Lying to Congress is a federal crime."

In March 2020, the Cuomo administration issued a directive stating, "No resident shall be denied re-admission or admission to [a nursing home] solely based on a confirmed or suspected diagnosis of COVID-19. [Nursing homes] are prohibited from requiring a hospitalized resident who is determined medically stable to be tested for COVID-19 prior to admission or readmission."

The House Select Subcommittee on the Coronavirus Pandemic noted in a September report that as a result of this directive, over 9,000 COVID-19 patients were readmitted or admitted to nursing homes between March 25, 2020, and May 8, 2020, "causing predictable but disastrous consequences."

A February 2021 study undertaken by the Empire Center for Public Policy concluded that Cuomo's March 25 guidance "was associated with a statistically significant increase in resident deaths" — deaths Cuomo and his administration were later found to have undercounted.

"Statewide, the findings imply that COVID-positive new admissions between late March and early May, which numbered 6,327, were associated with several hundred and possibly more than 1,000 additional resident deaths," said the study.

'What difference does it make in any dimension to anyone about anything?'

Adding insult to injury, congressional investigators determined that Cuomo "personally drafted and edited portions" of a Feb. 11, 2021, New York State Department of Health report that blamed the spike in nursing home deaths on nursing home staff rather than on his directive.

"An analysis of the timing of admissions versus fatalities shows that it could not be the driver of nursing home infections or fatalities," said the report.

Last year, Cuomo testified before Congress in a seven-hour closed-door interview. The Democrat claimed he was unaware of his devastating March 25, 2020, nursing home directive and suggested that nursing homes were not actually forced to admit COVID-positive patients.

When asked about the real death count, Cuomo channeled another controversial Democrat's callousness, telling congressional investigators, "Let's say there's a 3,000 differential, 2,500. Who cares? What difference does it make in any dimension to anyone about anything? Do you know what I'm saying?"

While evidently prickled by this and other comments, House Republicans took issue with the former governor's claims that "(1) he was not involved in the review or drafting of this Report, (2) he did not have any discussions about a peer-review of the Report, and (3) he did not have any knowledge of individuals outside the NYSDOH reviewing the Report."

All three claims are, according to the Comer, "demonstrably false."

"Mr. Cuomo must be prosecuted to the fullest extent of the law," Comer said in his Monday statement.

Cuomo spokesman Rich Azzopardi said in a statement obtained by NBC News, "This is nothing more than a meritless press release that was nonsense last year and is even more so now. As the DOJ constantly reminds people, this kind of transparent attempt at election interference and law-fare violates their own policies."

"Referrals like these — which have been also made against Planned Parenthood, Hillary Clinton, and Anthony Fauci — don't have to be resubmitted with a new administration, so the only point to doing this is politics," added Azzopardi.

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Andrew Cuomo faces criminal referral for alleged COVID-related cover-up



Former New York Governor Andrew Cuomo is facing a criminal referral for allegedly making "criminally false statements" about a July 2020 report that downplayed the number of COVID-related nursing home deaths.

On Wednesday, the House Select Subcommittee on the Coronavirus Pandemic referred Cuomo to the Department of Justice, arguing that he lied about his involvement in the New York State Department of Health's report. However, the subcommittee's formal referral does not compel the DOJ to move forward with further investigation.

'The Department of Justice should consider Mr. Cuomo's prior allegedly wrongful conduct.'

According to a draft of the subcommittee's criminal referral, the report undercounted the number of deaths by 46%.

Cuomo repeatedly claimed he did not recall seeing the report before its public release, Blaze News previously reported. However, evidence uncovered by the subcommittee allegedly revealed that Cuomo personally made edits to the document.

The referral, signed by Representative Brad Wenstrup (R-Ohio), accused the former governor of making a "conscious, calculated effort" to skirt responsibility for the nursing home death scandal.

"Mr. Cuomo provided false statements to the select subcommittee in what appears to be a conscious, calculated effort to insulate himself from accountability," Wenstrup wrote in the referral letter. "The Department of Justice should consider Mr. Cuomo's prior allegedly wrongful conduct when evaluating whether to charge him for the false statements described."

A June 2020 email from Cuomo's former assistant allegedly revealed that he had made edits to the report before its release. He requested that it include language emphasizing how "community spread among employees or possibly visitation by family and friends were relevant factors" in the deaths. His edits were included in the final version of the report.

Additionally, congressional documents allegedly uncovered that Cuomo's aides requested "two copies" of the report be sent to his residence before its release.

Cuomo fired back at the criminal referral by filing his own against the subcommittee.

The former governor's criminal referral reads, "This interrogation far exceeded the Subcommittee's jurisdiction and appears to have been an improper effort to advantage the interests of private litigants against Governor Cuomo, warranting investigation by the Department of Justice."

Richard Azzopardi, a spokesperson for Cuomo, stated, "This taxpayer-funded farce is an illegal use of Congress's investigative authority."

"The governor said he didn't recall because he didn't recall. The committee lied in their referral just as they have been lying to the public and the press," Azzopardi stated.

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'Hard to comprehend': Pennsylvania nurse who confessed to killing off men in care facilities now linked to 17 deaths



A Pennsylvania nurse who admitted in May to killing patients with fatal doses of insulin has now been linked to 17 care facility deaths. Heather Pressdee, 41, of Natrona Heights was slapped Thursday with dozens of new charges pertaining to a series of slayings going back to at least 2020. Her alleged victims ranged in age from 43 to 104.

Pressdee has worked at over 11 rehabilitation facilities since 2018. It appears she changed locations at least once in response to disciplinary measures over her alleged abuse of staff and patients.

Pressdee told investigators on May 24 that she gave victims lethal doses of insulin, hoping that "they would slip into a coma and just pass away," reported CBS News.

She was initially charged in connection with the murder of two men, ages 55 and 83, at Quality Life Services in Chicora, and the attempted murder of a third man, age 73.

Pressdee is now suspected to have abused 22 victims and has admitted to trying to kill 19 patients.

Pennsylvania Attorney General Michelle Henry announced Thursday that she filed charges against Pressdee regarding the mistreatment of an additional 19 patients across five care facilities.

The victims had been at Concordia at Rebecca Residence; Belair Healthcare and Rehabilitation; Quality Life Services Chicora; Premier Armstrong Rehabilitation and Nursing Center; and Sunnyview Rehabilitation and Nursing Center — all locations where Pressdee served as a registered nurse.

Investigators indicated Pressdee would administer fatal doses of insulin during overnight shifts when there were few staff on hand and "often took steps to ensure her victims would expire prior to shift change so that they wouldn't be sent to the hospital where her scheme could be discovered through medical testing." If it looked as though her victims might pull through, Pressdee would allegedly take additional measures to ensure they died.

For instance, the criminal complaint noted that when insulin failed to kill one victim whom Pressdee later told investigators "needed to die," she administered a syringe full of air into the victim's catheter to create a lethal air embolism.

The complaint also details various messages the suspect sent to her mother, complaining about patients and her desire to kill various people.

Pressdee reportedly wrote regarding one patient on June 26, 2022, "If you get like this you will get pillow therapy."

Concerning another male patient, she allegedly wrote on Sept. 6, 2022, "I drugged him already and I don't know how he is awake."

On Dec. 7, 2022, Pressdee messaged her mother regarding a female resident who was sleeping, stating, "She could be dead, she hasn't made a noise since 9 and I'm not checking on her," adding later, "Well she's alive and she may die now," according to the complaint.

The Pittsburgh Tribune-Review reported that while a 104-year-old victim had reportedly been mobile and doing well, Pressdee allegedly expressed disgust, telling co-workers, "When is she going to die already?"

Extra to her previous charges, Pressdee now faces two counts of first-degree murder, 17 counts of attempted murder, and 19 counts of neglect of a care-dependent person. Despite her various admissions, prosecutors appear to have stuck with attempted murder charges in various cases where the victims died, as causes of death could not be determined.

Still, Pressdee could face the death penalty, which one of her defense attorneys, James DePasquale, told the Associated Press that he is working to avoid. Capital punishment is legal in the state, although Gov. Josh Shapiro (D) has so far maintained former Gov. Tom Wolf's moratorium on executions.

"We have been in communication with our client and the substantial amount of charges that were brought were not a surprise to anyone involved," said Pressdee's other attorney, Phil DiLucente.

Pressdee is being held at the Butler County Prison without bail.

"The allegations against Ms. Pressdee are disturbing. It is hard to comprehend how a nurse, trusted to care for her patients, could choose to deliberately and systematically harm them," said Henry. "The damage done to the victims and their loved ones cannot be overstated. Every person in a medical or care facility should feel safe and cared for, and my office will work tirelessly to hold the defendant accountable for her crimes and protect care-dependent Pennsylvanians from future harm."

The New York Times reported that the family of 68-year-old Marianne Bower, one of the victims, initially believed that she died of respiratory failure in September 2021. However, they recently learned from investigators that Pressdee admitted to killing Bower with insulin. Bower, like many of Pressdee's victims, was not a diabetic and had no need for insulin.

Rob Peirce, a lawyer representing Bower's estate in a wrongful death suit against the Belair Healthcare and Rehabilitation Center, said, "This is one of the worst cases we have seen with someone in the health care system going from facility to facility and, unfortunately, admitting to killing multiple people."

The Times indicated the facility did not return its requests for comment.

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