Key Takeaways
- • A report released Nov. 10 by Americans for Financial Reform Education Fund and the Private Equity Stakeholder Project faults Public Partnerships LLC (PPL), a private equity-owned fiscal intermediary, for payment failures in New Jersey and other states.
- • Disability Rights New Jersey received more than 115 complaints during PPL's first year running two state programs, covering missed or inconsistent payments, enrollment delays and unresponsive service.
- • PPL handles registration, payroll, timekeeping and benefits for programs serving more than 700,000 Medicaid participants and caregivers across 18 states, according to the report.
- • PPL has lost or had contracts terminated in New Jersey, Washington, West Virginia and Tennessee, and a federal court is considering final approval of a $162 million settlement with nearly 200,000 New York home care workers.
- • PPL is owned by DW Healthcare Partners and Linden Capital Partners; the release did not include a response from PPL.
Summary
A private equity-owned company that processes payroll for Medicaid home care programs left caregivers unpaid and patients without services in several states, including New Jersey, according to a report released Nov. 10 by Americans for Financial Reform Education Fund and the Private Equity Stakeholder Project. The report examines Public Partnerships LLC, known as PPL, which the groups describe as the nation's largest provider of fiscal intermediary services for self-directed care programs.
In New Jersey, Disability Rights New Jersey received more than 115 complaints during PPL's first year running two state programs. The complaints involved missing or inconsistent payments, enrollment delays and unresponsive customer service. Some workers quit after going unpaid, leaving Medicaid participants without essential services. The groups said PPL has lost contracts or had them terminated in New Jersey, Washington, West Virginia and Tennessee.
The report also cites problems in Pennsylvania, where 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 the switch produced nearly $7 million in added costs in one year instead of the expected savings. The company also faces wage-theft cases involving workers in five states.
The report comes as a federal court considers final approval of a $162 million settlement PPL agreed to with nearly 200,000 New York home care workers. New York awarded PPL a five-year contract worth about $1 billion in October 2024 to serve as the sole intermediary for the state's Consumer Directed Personal Assistance Program, according to the report. PPL is owned by DW Healthcare Partners and Linden Capital Partners.
Ryan Leitner, senior healthcare research coordinator at the Private Equity Stakeholder Project, said PPL's record "should be a warning as private equity expands into the companies that states rely on to administer Medicaid," adding that private equity ownership "adds pressure to generate returns from public programs." Hibba Meraay, a research analyst at Americans for Financial Reform Education Fund, said "workers and clients both suffer" under such arrangements. The groups urged states to set enforceable quality standards for fiscal intermediaries, require public reporting on finances and performance, preserve participant choice, adopt guardrails against profiteering from Medicaid funds, and expand unionization among home care workers. The release did not include a response from PPL.
In New Jersey, Disability Rights New Jersey received more than 115 complaints during PPL's first year running two state programs. The complaints involved missing or inconsistent payments, enrollment delays and unresponsive customer service. Some workers quit after going unpaid, leaving Medicaid participants without essential services. The groups said PPL has lost contracts or had them terminated in New Jersey, Washington, West Virginia and Tennessee.
The report also cites problems in Pennsylvania, where 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 the switch produced nearly $7 million in added costs in one year instead of the expected savings. The company also faces wage-theft cases involving workers in five states.
The report comes as a federal court considers final approval of a $162 million settlement PPL agreed to with nearly 200,000 New York home care workers. New York awarded PPL a five-year contract worth about $1 billion in October 2024 to serve as the sole intermediary for the state's Consumer Directed Personal Assistance Program, according to the report. PPL is owned by DW Healthcare Partners and Linden Capital Partners.
Ryan Leitner, senior healthcare research coordinator at the Private Equity Stakeholder Project, said PPL's record "should be a warning as private equity expands into the companies that states rely on to administer Medicaid," adding that private equity ownership "adds pressure to generate returns from public programs." Hibba Meraay, a research analyst at Americans for Financial Reform Education Fund, said "workers and clients both suffer" under such arrangements. The groups urged states to set enforceable quality standards for fiscal intermediaries, require public reporting on finances and performance, preserve participant choice, adopt guardrails against profiteering from Medicaid funds, and expand unionization among home care workers. The release did not include a response from PPL.
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