Making the most of a beneficiant New York state program to assist his ailing mom, Ballal Hossain signed up a dozen relations to work as her caregivers.
Over six years, they have been paid $348,000 to take care of the aged lady at a Manhattan condo.
Besides the mother was in Bangladesh all the time.
Extremely, Hossain bought away with the fraud by having his brother pose as their sick mom for at any time when inspectors confirmed up, earlier than lastly being caught. He was later sentenced for grand larceny, in accordance with prosecutors.
It’s only one egregious instance of a welfare program — known as the Client Directed Private Help Program, or CDPAP — that has price New York taxpayers a whole bunch of tens of millions of {dollars} to waste and fraud.
First arrange in 1994, CDPAP was supposed to alleviate the variety of aged folks going to nursing houses.
However with no {qualifications} or medical certifications required to enroll as a carer in CDPAP, this system metastasized with little oversight.
The Publish was in a position to establish at the very least $179 million stolen by CDPAP recipients during the last 10 years, whereas this system wasted at the very least $1 billion of taxpayer money on middlemen.
“Since you are in folks’s houses, it’s laborious to see what’s happening, and weak folks can’t cease somebody from committing fraud on their behalf,” Invoice Hammond, Senior Fellow for Well being Coverage on the Empire Heart for Public Coverage, a non-partisan suppose tank in Albany, instructed The Publish.
Prices for this system itself have greater than quadrupled.
In 2019, CDPAP spending was $2.5 billion, however by 2023 this system accounted for $9.1 billion of Medicaid spending in New York state, with 250,000 folks enrolled to obtain therapy and 400,000 caregivers — “Private Assistants” in CDPAP parlance.
The state Division of Well being admitted to The Publish for this story that this system has led to a “fiscal disaster.”
Even Gov. Kathy Hochul herself known as it out, saying it was “one of the abused applications within the historical past of New York,” in 2024, and including, “one thing has to provide.”
By that point, she had made guarantees of reform and took motion to consolidate CDPAP, however this system solely expanded, now serving greater than 280,000 sufferers — with prices persevering with to climb.
Annual spending by New York State on CDPAP skyrocketed to $12 billion in 2025, in accordance with Well being and Human Providers Secretary Robert F. Kennedy, Jr.
“I used to be all the time fearful concerning the excessive progress, and that individuals can be making the most of a program that was not tightly managed,” stated Hammond, who has intently adopted this system for years.
And that’s precisely what occurred in three circumstances prosecuted within the final six years.
Zakia Khan pleaded responsible to “a sweeping scheme” to bilk Medicaid out of $68 million in 2025. She was the proprietor of two Brooklyn-based grownup daycare facilities, who paid kickbacks and bribes to sufferers for companies they billed for however have been by no means offered between 2017 and 2024, in accordance with the Division of Justice.
Khan and co-conspirators then laundered the money by means of different entities they managed, in accordance with courtroom paperwork.
In 2023 one other Brooklyn-based healthcare CEO, Marianna Levin, was sentenced to 4 and a half years in jail for defrauding Medicaid out of $100 million for residence well being care staff, courtroom paperwork say.
Between 2015 and December 2020, Medicaid reimbursed businesses Levin managed which claimed to offer private care to residents dwelling in New York Metropolis and Nassau County.
A good portion of the billings have been fraudulent, in accordance with the DOJ.
In 2019, Farrah Rubani, the CEO of Hopeton Care in Brooklyn, was indicted by the New York Lawyer Common for allegedly embezzling $11 million.
Authorities claimed she use the corporate to fleece the state well being program by submitting false claims. Rubani and her police officer husband have been additionally accused of utilizing the money to purchase a $250,000 Bentley and a lavish trip residence. Her husband was not charged with wrongdoing.
Because of the investigation, the Lawyer Common froze Medicaid funds to Hopeton and all of Rubani’s property.
Rubani — who on the time of her indictment denied the costs by means of her lawyer — was by no means criminally convicted, however agreed to pay $148,000 damages, in accordance with 2025 courtroom paperwork.
A LinkedIn account beneath Rubani’s identify suggests she nonetheless works within the trade as senior vice chairman of residence well being service Prolonged Residence Care. She couldn’t be reached and a lawyer who represented her didn’t reply to The Publish’s request for remark.
On the in-home stage, carers — who, as of 2026, are paid between $18.65 and $20.65 per hour — have been caught making the most of the system, sources confirmed.
They’ve been identified to ship payments claiming take care of folks whereas they have been hospitalized or after that they had handed away, or for treating two folks on the identical time, although they have been somewhere else.
A healthcare supply instructed The Publish: “We’ve recognized a number of examples of private assistants manipulating the system to work 23-hour days for relations, with projected annual earnings of round $200,000.”
“Facilitators” are additionally an enormous downside.
In 2024, New York State Lawyer Common Letitia James and the US Lawyer for the Japanese District of New York introduced a settlement settlement with two Brooklyn-based residence care businesses that labored as “fiscal intermediaries” — the technical time period for middlemen.
Edison Residence Well being Care and Most well-liked Residence Healthcare settled for greater than $17 million for defrauding Medicaid and underpaying greater than 25,000 residence well being aides.
By the point Hochul began reform in 2023, the state was paying middlemen from greater than 600 firms, with prices reaching between $500 million and $1 billion that 12 months alone, in accordance with sources.
Among the firms have been charging an eye-watering $1,000-a-month per particular person they represented, The Publish can reveal, however doing little greater than operating the payroll.
“There have been no requirements for who might do it, no certification,” stated Hammond, referring to the middlemen. “Anybody might arrange one among these firms.”
Displaying simply how bloated these fees have been, sources who’ve regarded into them instructed The Publish the identical work is now being finished for over 93% much less, at fees of $68.50 per particular person, per thirty days.
In response to the fraud and overspending, New York State changed all firms performing as middlemen with a single firm, Georgia-based Public Partnerships, LLC (PPL).
Nonetheless, transferring to that system has been beset by issues, hit with lawsuits by the businesses who’ve been lower out, and took till April 2025 to lastly put in place.
New York State Division of Well being stated they’ve already made vital financial savings and consider unifying the system beneath PPL will end in decrease prices.
“New York State took vital steps to reverse the CDPAP fiscal disaster by reining in administrative prices and establishing methods to remove alternatives for waste, fraud and abuse,” a spokesperson instructed The Publish.
“Fraudsters fought tooth and nail for over a decade to maintain [the old] damaged system in place – however these days are over as a result of we shut them down.
“The State Division of Well being … [cut] out a whole bunch of middlemen – saving $1 billion for taxpayers over the previous 12 months and defending residence take care of individuals who really want it.”
Sources additionally pointed to what they known as a “$10 million darkish cash marketing campaign” which was allegedly arrange in an try to dam CDPAP reforms.
The Medicaid Inspector Common stated it has recognized greater than $3.5 million {dollars} in CDPAP overpayments between 2019 and 2024, which have since been recovered.
A spokesperson for PPL echoed the Division of Well being assertion, saying their mandate was solely to “defend Medicaid {dollars}.”
“We have now delivered significant accountability and long-term stability for CDPAP . . . making certain this crucial program stays viable for years to come back.”
