PHI Statement on CMS Letter to New York State Regarding Medicaid Program Integrity
PHI is closely monitoring implications for the direct care workforce following the March 3, 2026, letter from the Centers for Medicare & Medicaid Services (CMS) to Governor Hochul. In the letter, CMS’s Dr. Mehmet Oz requested detailed information about New York’s Medicaid program, including its oversight of personal care and home health services, adult day care, and the Consumer Directed Personal Assistance Program (CDPAP).
We share the goal of ensuring Medicaid funds are used appropriately and that beneficiaries receive the care they need.
The letter emphasized the value of the federal-state partnership that drives Medicaid. PHI believes that such a partnership—when pursued in good faith—is essential for the quality of direct care jobs, and the quality of care for older adults and people with disabilities.
Unfortunately, CMS’s letter names the growth of the home care workforce in New York as an area of concern—instead of recognizing that workforce growth is driven by real demand. As PHI has long recognized, the growing population of older adults, combined with people living longer, often with complex conditions, is increasing demand for direct care workers —not just in New York but across the country—and will continue to drive growth for decades to come.
Focusing on the size of the workforce as a challenge to be addressed through federal investigation misses a real opportunity to invest in direct care workers. Strengthening workforce training, wages, and opportunities for advancement are the most effective ways to strengthen workforce recruitment, reduce turnover, improve care delivery and outcomes, and ultimately reduce costs to the system.
Home care workers are among the most underpaid and under-supported members of the labor force. In New York, the median wage for personal care and home health aides is just $18.26 per hour, a wage so low that 41 percent of these workers live in or near poverty and 61 percent draw on public assistance to make ends meet.
In the spirit of the essential federal-state partnership that sustains Medicaid, our hope is that New York State and the federal Administration will work together to ensure New York’s Medicaid program is supported by strong program integrity tools, provider credentialing, and robust oversight mechanisms. This effort must also recognize that a well-trained, fairly compensated, and properly credentialed direct care workforce is essential for quality care. By contrast, penalizing workers, creating unnecessary barriers to care, and destabilizing programs that support community living will only serve to shift costs—and suffering—elsewhere.
See recent Associated Press coverage of this story here for more information: https://apnews.com/article/oz-medicaid-new-york-fraud-investigation-a00bd997ee5b8d839254144377c3b167.
