was first to point out<\/a> that CMS’ number was likely incorrect. While Kinnucan, who studies and writes about Medicaid in New York, didn\u2019t have the data CMS was using, he used a sample of available data to question their estimate. CMS still hasn\u2019t explained how they came to their estimate.<\/p>\n\u201cIf you’re wrong by a factor of 10 in the headline claim in your anti-fraud letter, like, why should the public rely on any number that you give?\u201d Kinnucan told BTPM NPR on Friday.<\/p>\n
Kinnucan believes CMS added up the number of \u201ctotal unique beneficiaries\u201d reported each month over the time period they analyzed. However, \u201ctotal unique beneficiaries\u201d aren\u2019t new beneficiaries each month. They can include people who stay in the home care or personal care service month to month.<\/p>\n
As an example, he looked at Western New York Independent Living, or WNYIL, an independent living center out of Buffalo. WNYIL served as a fiscal intermediary for the previous iteration of New York\u2019s Consumer Directed Personal Assistance Program in 2024. They would manage and pay the workers of beneficiaries of self-directed home care.<\/p>\n
Each month, they had a little over 1,000 \u201ctotal unique beneficiaries\u201d receiving home care. If you add them up over six months, it would look like 6,000 people received care, when in reality, many of the people in a home care program stay with the same provider over a long period of time.<\/p>\n
\u201cIf you had a spreadsheet showing the number of unique people who had used your toothbrush in each month of the year, it would say, you know, January, one person, February, one person, and so forth,\u201d Kinnucan shared, as an analogy. \u201cAnd you couldn’t then add that column up and say, well, 12 unique people used your toothbrush. It was the same person.\u201d<\/p>\n
Todd Vaarwerk, Western New York Independent Living\u2019s Chief Policy Officer, explains Kinnucan\u2019s math makes sense.<\/p>\n
\u201cNot only am I chief policy officer at WNYIL, but I was a consumer of WNYIL\u2019s fiscal intermediary, and I can tell you, I didn’t leave the [fiscal intermediary] every month and come back in so that I could be counted again,” Vaarwerk, who has a disability and uses home care, said.<\/p>\n
WNYIL was a fiscal intermediary until New York State moved from over 600 companies administering the Consumer Directed Personal Assistance Program, or CDPAP, to only one in 2025. <\/p>\n
CDPAP is the state\u2019s largest personal care program, which allows disabled people to hire, train and self-direct aides paid through a fiscal intermediary. Those aides are often friends, neighbors or other people the disabled client is familiar with.<\/p>\n
The alternative option is agency-based personal care services, where agencies assign aides to clients.<\/p>\n
Vaarwerk points out, New York has made moves to reduce costs and utilization of home care. New York has stated that the move to a single fiscal intermediary in CDPAP is a cost-saving measure.<\/p>\n
Additionally, in the fall of 2025, the state implemented a new \u201cthree ADL rule,\u201d as advocates call it. Essentially, the state raised how many activities of daily living a person cannot do alone before they are eligible for home care. These activities include things like getting dressed, bathing and eating.<\/p>\n
\u201cWe can\u2019t turn around and say the parameters currently are not stringent,\u201d Vaarwerk said.<\/p>\n
Vaarwerk adds that while the previous guidelines allowed more people to access care, disabled people see that as a cost-saving measure, because it may allow them to not end up in a facility long-term.<\/p>\n
\u201cAdvocates for people with disabilities have been very clear about the fact that services in the community are cheaper and more effective than services provided in an institution,\u201d said Vaarwerk.<\/p>\n
Kinnucan said he is concerned the focus on Medicaid fraud is rooted in different intentions.<\/p>\n
\u201cIf I’m being honest, I think there are folks in the administration who just think home care for people with disabilities and elderly people is too expensive, and they would like to stop funding it,\u201d Kinnucan said.<\/p>\n
Kinnucan points out Dr. Oz has mentioned<\/a> home care is something \u201cour families would normally do for us, like carrying groceries,\u201d which makes him question if Dr. Oz sees home care as something that shouldn\u2019t be handled by Medicaid.<\/p>\n\u201cReally in the background of this is not really the question of, \u2018how can we root out fraud?\u2019 It’s the question of \u2018does the administration just want to get rid of Medicaid home care?\u2019\u201d Kinnucan said.<\/p>\n","protected":false},"excerpt":{"rendered":"The Trump administration is acknowledging an error made in a recent social media video and letter to New…\n","protected":false},"author":2,"featured_media":192866,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8],"tags":[9,24,55,54,56],"class_list":{"0":"post-192865","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-new-york-city","8":"tag-new-york","9":"tag-new-york-city","10":"tag-new-york-city-headlines","11":"tag-new-york-city-news","12":"tag-ny"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/posts\/192865","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/comments?post=192865"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/posts\/192865\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/media\/192866"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/media?parent=192865"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/categories?post=192865"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/tags?post=192865"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}