Key Takeaways
- • A report from the Private Equity Stakeholder Project and the Americans for Financial Reform Education Fund faults Public Partnerships LLC (PPL), a private equity-owned fiscal intermediary, for unpaid caregivers and disrupted services in several states, including New Jersey.
- • PPL, owned since 2022 by DW Healthcare Partners and Linden Capital Partners, handles registration, payroll, timekeeping and benefits for Medicaid self-directed care programs serving more than 700,000 participants and caregivers across 18 states.
- • Disability Rights New Jersey logged more than 115 complaints during PPL's first year administering two New Jersey state programs, involving missing payments, enrollment delays and unresponsive customer service.
- • PPL's $162 million settlement with nearly 200,000 New York home care workers awaits final federal court approval, and the company faces a Justice Department Medicaid fraud lawsuit.
- • The report calls for enforceable quality standards, public financial reporting and guardrails against profiteering for fiscal intermediaries; PPL did not respond to the report.
Summary
A private equity-owned company that runs payroll and enrollment for Medicaid home care programs has left caregivers unpaid and disrupted services in several states, including New Jersey, according to a report released Tuesday by the Private Equity Stakeholder Project and the Americans for Financial Reform Education Fund. The report focuses on Public Partnerships LLC, known as PPL, and was released as a federal court considers final approval of PPL's $162 million settlement with nearly 200,000 New York home care workers. PPL agreed in June to pay that amount to settle wage-and-hour claims, according to the groups.
PPL describes itself as the nation's largest provider of fiscal intermediary services for self-directed care programs, which allow Medicaid recipients to hire their own caregivers. According to the report, the company handles registration, payroll, timekeeping and benefits for programs serving more than 700,000 Medicaid participants and caregivers in 18 states. The firm has been owned since 2022 by DW Healthcare Partners and Linden Capital Partners.
In New Jersey, Disability Rights New Jersey received more than 115 complaints during PPL's first year administering two state programs. The complaints involved missing or inconsistent payments, enrollment delays and unresponsive customer service, and some workers resigned after going unpaid. The groups said PPL has lost contracts or had them terminated in New Jersey, Washington, West Virginia and Tennessee, and has faced wage theft cases involving workers in five states. In Pennsylvania, thousands of caregivers were not paid promptly, roughly one-third of participants failed to transition to PPL and lost access to self-directed services, and a state audit found nearly $7 million in added costs in one year instead of expected savings.
New York awarded PPL a five-year contract worth about $1 billion in October 2024. The company also faces a Justice Department lawsuit over alleged Medicaid fraud and a separate wage theft lawsuit from upstate New York workers, the report said. Ryan Leitner, senior health care research coordinator at the Private Equity Stakeholder Project, said PPL's record should be a warning as private equity expands into companies states rely on to administer Medicaid. Hibba Meraay, a research analyst at the Americans for Financial Reform Education Fund, said public dollars meant for care are lining the pockets of corporate profiteers.
The report calls for enforceable quality standards for fiscal intermediaries, regular public reporting on their finances and performance, preservation of participant choice, guardrails against profiteering from Medicaid funds and expanded unionization among home care workers. The release did not include a response from PPL.
PPL describes itself as the nation's largest provider of fiscal intermediary services for self-directed care programs, which allow Medicaid recipients to hire their own caregivers. According to the report, the company handles registration, payroll, timekeeping and benefits for programs serving more than 700,000 Medicaid participants and caregivers in 18 states. The firm has been owned since 2022 by DW Healthcare Partners and Linden Capital Partners.
In New Jersey, Disability Rights New Jersey received more than 115 complaints during PPL's first year administering two state programs. The complaints involved missing or inconsistent payments, enrollment delays and unresponsive customer service, and some workers resigned after going unpaid. The groups said PPL has lost contracts or had them terminated in New Jersey, Washington, West Virginia and Tennessee, and has faced wage theft cases involving workers in five states. In Pennsylvania, thousands of caregivers were not paid promptly, roughly one-third of participants failed to transition to PPL and lost access to self-directed services, and a state audit found nearly $7 million in added costs in one year instead of expected savings.
New York awarded PPL a five-year contract worth about $1 billion in October 2024. The company also faces a Justice Department lawsuit over alleged Medicaid fraud and a separate wage theft lawsuit from upstate New York workers, the report said. Ryan Leitner, senior health care research coordinator at the Private Equity Stakeholder Project, said PPL's record should be a warning as private equity expands into companies states rely on to administer Medicaid. Hibba Meraay, a research analyst at the Americans for Financial Reform Education Fund, said public dollars meant for care are lining the pockets of corporate profiteers.
The report calls for enforceable quality standards for fiscal intermediaries, regular public reporting on their finances and performance, preservation of participant choice, guardrails against profiteering from Medicaid funds and expanded unionization among home care workers. The release did not include a response from PPL.
Go deeper than the headline
Research every firm in this story, track the ones that matter and get the daily briefing — free for 7 days.