FOR IMMEDIATE RELEASE: November 10, 2026
CONTACT: Jarice Thompson, Americans for Financial Reform, jarice@ourfinancialsecurity.org
Matt Parr, Private Equity Stakeholder Project, matt.parr@pestakeholder.org
Private equity-owned PPL’s failures extend far beyond New York
New findings document unpaid caregivers, disrupted services, and failed transitions across multiple states as private equity expands into Medicaid administration
NEW YORK, NY — As a federal court considers final approval of Public Partnerships, LLC’s (PPL) $162 million settlement with nearly 200,000 New York home care workers, a report released today by the Private Equity Stakeholder Project (PESP) and Americans for Financial Reform Education Fund (AFREF) shows that the problems associated with private equity-backed PPL extend far beyond New York.
The report, Public Partnerships, LLC: Private equity prioritized corporate profits over home healthcare workers and recipients, documents a pattern of payment failures, disrupted care, difficult program transitions and inadequate customer service across several states. In some cases, the problems led caregivers to resign or Medicaid participants to lose essential services.
PPL has been owned by private equity firms DW Healthcare Partners and Linden Capital Partners since 2022. PPL CEO Miki Kapoor is also an operating partner at Linden, which owns at least 18 percent of the company. The company is the country’s largest provider of fiscal intermediary services for self-directed care programs and runs registration, payroll, timekeeping and benefits systems for programs serving more than 700,000 Medicaid participants and caregivers across 18 states.
“PPL’s record should be a warning as private equity expands into the companies that states rely on to administer Medicaid,” said Ryan Leitner, Senior Healthcare Research Coordinator at PESP. “Years before New York handed PPL a $1 billion contract, other states had documented missing paychecks, workers leaving their jobs and people losing access to care. Private equity ownership adds pressure to generate returns from public programs, making strong oversight and guardrails even more important.”
“Our findings show that when private equity targets home care programs as a source of reliable public revenue, workers and clients both suffer,” said Hibba Meraay, Research Analyst at Americans for Financial Reform Education Fund. “Public dollars meant for care are lining the pockets of corporate profiteers. We need accountability over these Medicaid middlemen who are siphoning resources out of our care systems.”
The report finds:
- In Pennsylvania, thousands of caregivers were not paid promptly, some for months. Roughly one-third of participants failed to transition to PPL and lost access to self-directed services. A state audit found that the transition produced nearly $7 million in additional costs in one year rather than the expected savings.
- In New Jersey, Disability Rights New Jersey received more than 115 complaints during PPL’s first year administering two state programs. Complaints included missing or inconsistent payments, enrollment delays and unresponsive customer service. Workers resigned after going unpaid, leaving some Medicaid participants without essential services.
- PPL has lost or had contracts terminated in New Jersey, Washington, West Virginia and Tennessee.
- PPL has faced wage-theft cases involving workers in five states.
- In New York, advocates reported missing paychecks, enrollment problems and interruptions in care after PPL became the sole fiscal intermediary for the state’s Consumer Directed Personal Assistance Program. PPL agreed in June to pay $162 million to settle wage-and-hour claims brought on behalf of nearly 200,000 workers.
PPL is part of a broader expansion of private equity into companies that administer Medicaid programs. Private equity firms have acquired Medicaid contractors that manage payments, claims, eligibility systems and other functions that can determine whether patients receive care and workers are paid, giving the firms access to reliable government-backed revenue. Private equity-owned home care chains have also increasingly dominated the sector in recent years.
The report recommends that states establish enforceable quality standards for fiscal intermediaries, require regular public reporting on finances and performance, preserve participant choice and adopt guardrails against profiteering from public Medicaid funding. It also calls for expanded unionization among home care workers to improve wages, reduce turnover and help ensure that Medicaid dollars support patient care.
Read the full report
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