Adult day care
New York orders a full review of Medicaid social adult day care after a state and federal investigation
About 45,000 New York Medicaid members use social adult day care, and the state is now reviewing the whole benefit — including phasing it out. Families who rely on a program should watch for notices and ask the program what its plan is.
Key facts
- Governor Hochul announced a state and federal investigation into more than 100 social adult day care providers on October 20.
- About 45,000 Medicaid members use the benefit through MLTC plans, and the state is weighing options including phasing it out.
- No program has been shut down, and recommendations are due by December 31.
What happened
On October 20, Governor Hochul announced a coordinated state and federal investigation into more than 100 social adult day care providers suspected of fraud, with searches reported in Queens, Brooklyn and Staten Island.
The state says about 45,000 Medicaid members use social adult day care through Managed Long Term Care (MLTC) plans. The Governor directed the Department of Health to require prepayment review of claims and to weigh options, including phasing out the benefit and moving participants to other services. Recommendations are due by December 31, and a moratorium on new providers remains in effect until January 2027.
What it means for families
No program has been shut down. Families whose parent attends a social adult day program through an MLTC plan may see extra paperwork or claim reviews, and the benefit could change in 2027.
Quick answers
Why is New York reviewing Medicaid social adult day care?
On October 20, Governor Hochul announced a coordinated state and federal investigation into more than 100 social adult day care providers suspected of fraud, with searches reported in Queens, Brooklyn and Staten Island.
What happens next with social adult day care in New York?
The state says about 45,000 Medicaid members use social adult day care through Managed Long Term Care (MLTC) plans. The Governor directed the Department of Health to require prepayment review of claims and to weigh options, including phasing out the benefit and moving participants to other services. Recommendations are due by December 31, and a moratorium on new providers remains in effect until January 2027.
What to do this week
- Call the parent's MLTC plan and ask what would replace social adult day if the benefit changes.
- Keep attendance records and any letters from the program or plan.
- Think through a backup for daytime supervision so a change doesn't become an emergency.
Sources
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