Using a New York state assistance program meant to help an elderly parent, Ballal Hossain enrolled more than a dozen relatives as paid caregivers for his sick mother. Over a six-year period, the family collected $348,000 for providing in-home care at a Manhattan apartment.
But prosecutors later determined that the woman was never there at all — she was living in Bangladesh the entire time.
According to authorities, Hossain managed to keep the scheme going by having his brother impersonate their mother whenever inspectors arrived. The ruse eventually unraveled, and Hossain was later sentenced on grand larceny charges, prosecutors said.
The NY Post reports that this case is one of the starkest illustrations of the scale of abuse tied to a state welfare initiative known as the Consumer Directed Personal Assistance Program, or CDPAP, which has drained hundreds of millions of taxpayer dollars through fraud and waste.
Created in 1994, CDPAP was designed to allow elderly and disabled New Yorkers to remain in their homes instead of entering nursing facilities.
But because the program requires no medical licensing or professional credentials for caregivers, oversight remained minimal as enrollment ballooned.
An investigation by the NY Post found that at least $179 million has been stolen by CDPAP recipients over the past decade, while middlemen siphoned off an estimated $1 billion in taxpayer funds.
Richard Harrow, who spent 27 years prosecuting Medicaid fraud in New York and now works in Albany handling similar cases, said the scope of the problem dwarfs other high-profile scandals.
“If you think Minnesota is a big deal, multiply that by 10,” he told The Post, referencing Minnesota’s $1 billion daycare fraud case.
“CDPAP is the biggest fraud there is because it all takes place in people’s homes.”
The price tag for the program itself has surged dramatically.
In 2019, CDPAP cost the state $2.5 billion. By 2023, spending had climbed to $9.1 billion, making up a massive share of New York’s Medicaid budget. At that point, roughly 250,000 patients were enrolled, supported by about 400,000 caregivers, referred to in the program as “Personal Assistants.”
The New York State Department of Health acknowledged to The Post that CDPAP had become a “fiscal crisis.”
Gov. Kathy Hochul herself publicly criticized the program in 2024, calling it “one of the most abused programs in the history of New York,” and warning that “something has to give.”
Although Hochul pledged reforms and initiated consolidation efforts, enrollment continued to climb, surpassing 280,000 patients, with costs still rising.
By 2025, annual state spending on CDPAP had exploded to $12 billion, according to Health and Human Services Secretary Robert F. Kennedy, Jr.
“I was always worried about the high growth, and that people would be taking advantage of a program that was not tightly controlled,” said Bill Hammond, senior fellow for health policy at the Empire Center for Public Policy, a non-partisan Albany think tank, in comments to The Post.
Those concerns were borne out in multiple major prosecutions over the last six years, the NY Post reports.
In 2025, Zakia Khan admitted guilt in what prosecutors described as “a sweeping scheme” that defrauded Medicaid of $68 million. Khan owned two adult daycare centers in Brooklyn and, according to the Department of Justice, paid bribes and kickbacks to patients for services that were never delivered between 2017 and 2024.
Court filings show that Khan and her co-conspirators then laundered the proceeds through other businesses they controlled.
Another major case surfaced in 2023, when Brooklyn healthcare executive Marianna Levin received a four-and-a-half-year prison sentence for stealing $100 million from Medicaid through fraudulent home health care claims.
From 2015 through December 2020, Medicaid reimbursed agencies run by Levin that purported to provide personal care services in New York City and Nassau County. Prosecutors said a substantial portion of those claims were fraudulent.
In 2019, Farrah Rubani, the head of Brooklyn-based Hopeton Care, was indicted by the New York Attorney General for allegedly embezzling $11 million.
Authorities said Rubani submitted false claims to Medicaid and used the proceeds for personal luxury purchases, including a $250,000 Bentley and an upscale vacation property. Her husband, a police officer, was accused of benefiting from the spending but was not charged.
Following the indictment, the Attorney General froze Medicaid payments to Hopeton Care along with all of Rubani’s assets.
Rubani, who denied the allegations at the time through her attorney, was never criminally convicted. Court records from 2025 show she later agreed to pay $148,000 in damages.
A LinkedIn profile under Rubani’s name indicates she remains active in the home health industry as a senior vice president at Extended Home Care. Attempts to reach her were unsuccessful, and her former attorney did not respond to requests for comment.
Abuse has also occurred at the individual caregiver level, according to sources familiar with the program.
As of 2026, personal assistants earn between $18.65 and $20.65 per hour. Investigators have found cases where caregivers billed Medicaid for services while patients were hospitalized, after patients had died, or for caring for two individuals simultaneously in different locations.
One healthcare source told The Post: “We’ve identified several examples of personal assistants manipulating the system to work 23-hour days for family members, with projected annual earnings of around $200,000.”
Another major vulnerability involved the so-called “facilitators” — private companies acting as fiscal intermediaries that processed payroll and billing.
In 2024, New York Attorney General Letitia James and the US Attorney for the Eastern District of New York announced a settlement with two Brooklyn-based agencies serving in that role.
Edison Home Health Care and Preferred Home Healthcare agreed to pay more than $17 million after being accused of defrauding Medicaid and underpaying more than 25,000 home health aides.
By the time Hochul began restructuring CDPAP in 2023, the state was paying over 600 intermediary companies, with annual costs estimated between $500 million and $1 billion, according to sources.
Some intermediaries charged as much as $1,000 per patient each month, despite performing little more than basic payroll processing.
“There were no standards for who could do it, no certification,” Hammond said. “Anyone could set up one of these companies.”
Sources who reviewed the costs told The Post that the same services are now being performed for more than 93% less — at about $68.50 per person, per month.
In response, New York State eliminated all intermediary companies and replaced them with a single provider, Georgia-based Public Partnerships, LLC.
The transition was rocky, triggering lawsuits from displaced companies and taking until April 2025 to fully implement.
The Department of Health said the consolidation has already produced major savings and is expected to significantly reduce future costs.
“New York State took significant steps to reverse the CDPAP fiscal crisis by reining in administrative costs and establishing systems to eliminate opportunities for waste, fraud and abuse,” a department spokesperson told The Post.
“Fraudsters fought tooth and nail for over a decade to keep [the old] broken system in place – but those days are over because we shut them down.
“The State Department of Health … [cut] out hundreds of middlemen – saving $1 billion for taxpayers over the past year and protecting home care for people who actually need it.”
Sources also cited what they described as a “$10 million dark money campaign” allegedly aimed at blocking CDPAP reforms.
The Medicaid Inspector General said investigators identified more than $3.5 million in CDPAP overpayments between 2019 and 2024, all of which have since been recovered.
A spokesperson for Public Partnerships echoed the state’s position, saying the company’s role is focused exclusively on safeguarding public funds.
“We have delivered meaningful accountability and long-term stability for CDPAP . . . ensuring this critical program remains viable for years to come.”
{Matzav.com}
