Key Takeaways
- • The Private Equity Stakeholder Project (PESP) and Americans for Financial Reform Education Fund (AFREF) released a report on November 10, 2026, documenting payment failures, disrupted care and failed program transitions tied to private equity-owned Public Partnerships, LLC (PPL) across multiple states.
- • PPL is owned by DW Healthcare Partners and Linden Capital Partners, which have held the company since 2022, and it runs registration, payroll, timekeeping and benefits systems for programs serving more than 700,000 Medicaid participants and caregivers across 18 states.
- • A federal court is considering final approval of PPL's $162 million settlement with nearly 200,000 New York home care workers, which PPL agreed to pay in June to settle wage-and-hour claims.
- • In Pennsylvania, a state audit found a transition to PPL produced nearly $7 million in additional costs in one year rather than the expected savings, and roughly one-third of participants failed to transition and lost self-directed services.
- • The report recommends enforceable quality standards for fiscal intermediaries, public financial and performance reporting, participant choice protections, anti-profiteering guardrails and expanded unionization among home care workers.
Summary
A report released November 10, 2026 by the Private Equity Stakeholder Project (PESP) and the Americans for Financial Reform Education Fund (AFREF) argues that problems at Public Partnerships, LLC (PPL) extend well beyond New York. The release came as a federal court considers final approval of PPL's $162 million settlement with nearly 200,000 New York home care workers. The report, titled *Public Partnerships, LLC: Private equity prioritized corporate profits over home healthcare workers and recipients*, documents payment failures, disrupted care, difficult program transitions and inadequate customer service across several states.
PPL has been owned by private equity firms DW Healthcare Partners and Linden Capital Partners since 2022. According to the release, PPL CEO Miki Kapoor is also an operating partner at Linden, which owns at least 18 percent of the company. PPL describes itself as the country's largest provider of fiscal intermediary services for self-directed care programs.
The report cites specific state cases. In Pennsylvania, thousands of caregivers were not paid promptly, some for months, and roughly one-third of participants failed to transition to PPL and lost access to self-directed services. A state audit found the transition produced nearly $7 million in additional costs in one year rather than the expected savings. In New Jersey, Disability Rights New Jersey received more than 115 complaints during PPL's first year administering two state programs, including missing or inconsistent payments, enrollment delays and unresponsive customer service. The report also states that PPL has lost or had contracts terminated in New Jersey, Washington, West Virginia and Tennessee, and has faced wage-theft cases involving workers in five states.
In New York, advocates reported missing paychecks, enrollment problems and care interruptions after PPL became the sole fiscal intermediary for the state's Consumer Directed Personal Assistance Program. PESP researcher Ryan Leitner said other states had documented such problems years before New York awarded PPL a $1 billion contract. Hibba Meraay, research analyst at AFREF, said public dollars meant for care were being diverted to corporate profiteers.
The groups place PPL within a broader trend of private equity acquiring Medicaid contractors that handle payments, claims and eligibility systems, which the release says gives firms access to reliable government-backed revenue. The report recommends that states establish enforceable quality standards for fiscal intermediaries, require regular public reporting on finances and performance, preserve participant choice, adopt guardrails against profiteering from Medicaid funding, and expand unionization among home care workers. These are advocacy group findings; the release does not include a response from PPL or its owners.
PPL has been owned by private equity firms DW Healthcare Partners and Linden Capital Partners since 2022. According to the release, PPL CEO Miki Kapoor is also an operating partner at Linden, which owns at least 18 percent of the company. PPL describes itself as the country's largest provider of fiscal intermediary services for self-directed care programs.
The report cites specific state cases. In Pennsylvania, thousands of caregivers were not paid promptly, some for months, and roughly one-third of participants failed to transition to PPL and lost access to self-directed services. A state audit found the transition produced nearly $7 million in additional costs in one year rather than the expected savings. In New Jersey, Disability Rights New Jersey received more than 115 complaints during PPL's first year administering two state programs, including missing or inconsistent payments, enrollment delays and unresponsive customer service. The report also states that PPL has lost or had contracts terminated in New Jersey, Washington, West Virginia and Tennessee, and has faced wage-theft cases involving workers in five states.
In New York, advocates reported missing paychecks, enrollment problems and care interruptions after PPL became the sole fiscal intermediary for the state's Consumer Directed Personal Assistance Program. PESP researcher Ryan Leitner said other states had documented such problems years before New York awarded PPL a $1 billion contract. Hibba Meraay, research analyst at AFREF, said public dollars meant for care were being diverted to corporate profiteers.
The groups place PPL within a broader trend of private equity acquiring Medicaid contractors that handle payments, claims and eligibility systems, which the release says gives firms access to reliable government-backed revenue. The report recommends that states establish enforceable quality standards for fiscal intermediaries, require regular public reporting on finances and performance, preserve participant choice, adopt guardrails against profiteering from Medicaid funding, and expand unionization among home care workers. These are advocacy group findings; the release does not include a response from PPL or its owners.
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