Why Your CDPAP Hours Were Reduced and How to Get Them Restored

CDPAP, which refers to the Consumer Directed Personal Assistance Program, is New York's Medicaid benefit that lets eligible adults hire family members or friends as paid caregivers in place of a home care agency.

A reduction in your CDPAP hours can mean one of two things. Your eligibility rules changed. Or an administrative error interrupted what you were already approved to receive. The fix is different depending on which one applies to you.

I work with New York families on this every week. The most common source of confusion right now is the September 2025 regulatory shift, which changed how many daily activities a person must need help with in order to qualify. If your hours were cut after a scheduled reassessment, that rule is likely what triggered it. If they disappeared without a reassessment notice, the PPL transition is the more probable cause.

Why Were My CDPAP Hours Reduced?

In short: Why Were My CDPAP Hours Reduced?: CDPAP hours are reduced for two distinct reasons in New York: a stricter eligibility reassessment rule that took effect September.

CDPAP hours are reduced for two distinct reasons in New York: a stricter eligibility reassessment rule that took effect September 2025, or an administrative error during the PPL transition as the sole statewide fiscal intermediary.

An analysis of current New York State program guidance and community accounts shows that most recipients who saw a sudden drop in authorized hours fall into one of two categories: those whose care needs were re-evaluated against the new Minimum Needs Requirements, and those whose hour authorizations were misapplied or lost during the shift to Public Partnerships LLC. Knowing which category applies to you determines the fastest path to restoration.

Call this the "two-track test." Before you call anyone, ask yourself one question: Did you receive a formal written notice of a benefit reduction, or did your hours simply appear lower without explanation? A formal notice almost always signals an eligibility-based reassessment. Hours that changed quietly, with no letter, often point to an administrative or billing error that PPL or your MLTC plan can correct quickly.

Track 1: The Minimum Needs Requirements. According to the New York State Department of Health, as of September 1, 2025, anyone receiving an initial assessment or scheduled reassessment for CDPAP must now be found to need at least limited assistance with physical maneuvering with more than two Activities of Daily Living (ADLs). For recipients with a Dementia or Alzheimer's diagnosis, the threshold is supervision with more than one ADL. This is a meaningful shift. Under the previous rules, a single documented need could support eligibility. Assessors are now looking for documented need across multiple daily activities, and families who were approved years ago may not meet the new bar at their next reassessment.

Track 2: The PPL transition. Your approved weekly hours are determined by your Managed Long-Term Care (MLTC) insurance plan, not by PPL itself. The transition to PPL as the single statewide fiscal intermediary introduced billing code confusion, including the "CDPA Basic 15 minutes" unit that some families mistook for a daily cap. In reality, your authorized total should have carried over unchanged. If it did not, that is an administrative error, not a policy decision, and it is correctable.

The reality is that a reduction is not the same as a termination. Most families can restore lost hours once they understand which track triggered the cut.

How Did the PPL Transition Affect CDPAP Hour Authorizations?

Public Partnerships LLC (PPL) became the sole fiscal intermediary for CDPAP in New York in 2025, but PPL does not control your authorized hours. Your MLTC insurance plan does.

In my experience, this is one of the most common points of confusion we see families struggling with. When agencies like Freedom Care and Marks Home Care exited CDPAP or converted to supplying regular aides, many families assumed PPL had changed their hours. In practice, PPL handles payroll, timekeeping, and employment records. Your Managed Long-Term Care plan remains the only entity that can increase, decrease, or maintain your authorized weekly total.

What this means is that if your hours dropped when you moved to PPL, one of three things likely happened:

• Your prior agency's hour authorization did not transfer correctly to your MLTC plan's records
• A billing code change, such as the shift to the "CDPA Basic 15 minutes" billing unit, was misread as a cap rather than a payment increment
• Your MLTC plan issued a new authorization reflecting a reassessment that coincided with the transition

The first two are administrative errors. They can often be resolved with a single call to your MLTC plan to confirm what hours they have authorized on file and to request a corrected authorization be sent to PPL. Many families I speak with are relieved to find that their plan's records still show their original hours, and the gap is a documentation lag, not a true reduction.

The third situation is different. A reassessment during the transition may have applied the new Minimum Needs Requirements to your case. That is not a paperwork error. That requires a formal challenge.

The takeaway here: contact your MLTC plan first, before assuming the reduction is permanent. Ask them specifically what weekly hour total they have authorized for your case. If that number matches what you expected and PPL is paying less, the problem is on PPL's end and is correctable. If the number itself is lower than before, you are looking at a reassessment issue and you have appeal rights.

How Do I Check My Current Authorized CDPAP Hours?

Before disputing a reduction, verify what your MLTC plan has actually authorized. The number on file may surprise you, in a good or bad way.

According to community guidance shared among CDPAP consumers navigating the PPL transition, you can check your approved hours directly through the PPL portal. Log into pplathome.org as the consumer, navigate to the Expended Menu, select Service Authorizations, then Approved Authorizations, then View. Your authorized total will appear in HHHHMM format, hours and minutes. This number is what your MLTC plan has approved, and it is the only number that matters.

A few things to watch for when you look at that screen:

• The "CDPA Basic 15 minutes" label. This is a billing code, not a daily hour limit. It describes how PPL processes payment increments, not how many hours you are allowed per day.
• Weekly vs. daily totals. Under PPL, your hours are tracked as a flexible weekly total rather than a fixed daily schedule. You and your caregiver set the schedule within whatever total your plan has authorized. If you see a weekly total that matches your expectations, you are in good shape.
• Mismatch between plan and PPL. If what you see on pplathome.org is lower than what your MLTC plan told you is authorized, that is a data transfer issue, not a benefit cut. Call PPL at 1-833-247-5346 and ask them to request an updated authorization file from your plan.

From what I have seen working with families across New York, the confusion between a billing code and an actual hour limit is among the most common and easiest problems to resolve. Many caregivers saw the "15 minutes" label and assumed their loved one was only approved for 15 minutes of care per session. That is not what it means.

If your pplathome.org portal shows the correct total and your caregiver is still being paid for fewer hours, call PPL and ask them to audit your recent pay period submissions against your authorization file. Keep a record of the date, time, and name of whoever you spoke with.

The important thing is to get the facts from the source before you file any formal challenge. Many hour discrepancies resolve at this stage without any appeal needed.

What Documentation Do I Need to Contest a CDPAP Hour Reduction?

In short: What Documentation Do I Need to Contest a CDPAP Hour Reduction?: If your MLTC plan has genuinely reduced your authorized hours after a reassessment, your best.

If your MLTC plan has genuinely reduced your authorized hours after a reassessment, your best tool for restoration is a physician letter that documents each specific daily activity where you need help.

Here is the thing about the new Minimum Needs Requirements. The bar is not just "you need care." The bar is that you need at least limited physical assistance with more than two Activities of Daily Living. Each ADL has to be documented separately and specifically. A general letter from your doctor saying "patient needs home care" is not enough. The letter needs to say which activities you need help with and at what level of assistance.

These are the most relevant Activities of Daily Living for a CDPAP assessment:

• Bathing or showering
• Dressing and undressing
• Eating and meal preparation
• Transferring (moving from bed to chair, chair to standing)
• Toileting and continence care
• Mobility and ambulation within the home

For each one that applies, your physician should describe the level of assistance your loved one requires. The distinction matters: "limited assistance" means hands-on help with part of the task; "extensive assistance" means hands-on help with most of the task. If your loved one has a Dementia or Alzheimer's diagnosis, the threshold is supervision with more than one ADL, which is somewhat easier to document but still requires specifics.

In addition to the physician letter, it helps to gather:

• The written notice of your hour reduction (request this in writing from your MLTC plan if you did not receive one)
• Your most recent care plan
• Any specialist letters relevant to your diagnosis
• A written statement from the family caregiver describing the daily care routine

What this means in practice: many families I have supported did not realize they could simply ask their doctor to be more specific. Reassessments can go wrong not because the need is absent, but because the documentation was vague. A thorough, ADL-specific letter can change the outcome of a reassessment or an appeal.

How Do I Appeal a CDPAP Hour Reduction Through a Fair Hearing?

In short: Every Medicaid beneficiary in New York has the right to request a fair hearing when their benefits are reduced.

Every Medicaid beneficiary in New York has the right to request a fair hearing when their benefits are reduced. Most families do not know this. It is one of the most underused protections in the program.

A fair hearing is a formal administrative proceeding before an Administrative Law Judge. You present your evidence, the MLTC plan or Medicaid agency defends the reduction, and the judge issues a written decision. The process is free. You do not need a lawyer, though you can bring one or bring an advocate.

Here is the part I want you to pay close attention to: you can request "aid continuing" when you file your appeal. This means your hours stay at their previous level while your hearing is pending. You are not required to accept fewer hours while waiting for a decision that might restore them. Aid continuing is available when you request the fair hearing within a specific window, usually within ten days of when the reduction was scheduled to take effect, so timing matters.

To request a fair hearing in New York, contact the Office of Temporary and Disability Assistance (OTDA) by phone or mail. The number for requesting a fair hearing is 1-800-342-3334. You can also submit your request online through the NY State website. Your written reduction notice should include information about your right to appeal and the deadline.

Common misconception: many families believe a fair hearing is only for extreme situations, like a full termination of benefits. The reality is that any reduction in authorized hours is an action you can challenge. You do not need to accept a cut from 40 hours to 28 hours just because your MLTC plan says so.

The tension is real: the process requires paperwork, follow-through, and knowing your rights. Families who are already exhausted from caregiving often do not have the bandwidth to navigate a formal hearing on their own. That is where having someone in your corner makes a concrete difference. An advocate can prepare your documentation, write the argument, and attend the hearing on your behalf.

Who Should I Call First When My CDPAP Hours Were Reduced?

Start with your MLTC plan, not PPL. Your plan controls the authorization. PPL processes the paperwork.

Many families call PPL first because PPL is the most visible part of the process. They see the PPL app, the PPL timesheets, the PPL support line. But PPL cannot restore hours it did not cut. If you call PPL about a reduction and they say they cannot help you, that is not them being unhelpful. That is because your MLTC plan is the one you need to reach.

Here is the order I recommend:

1. Call your MLTC plan first. Ask them what your current authorized weekly hours are. Write it down, with the date and the name of the person you spoke with. If the number is lower than what you expected, ask them why and request a written explanation.
2. Contact PPL at 1-833-247-5346 if the MLTC plan's number is correct but what PPL is paying does not match. Ask them to reconcile their records with the plan's authorization.
3. Request a fair hearing if the reduction was based on a reassessment and you believe it was wrong. Do this promptly, and ask for aid continuing so your hours are maintained while your case is reviewed.
4. Reach out to the NY Department of Health if you need additional support. Managed care enrollees can call 1-866-712-7197. Non-managed care recipients can call 518-474-5888.

If you are going into any of those conversations without confidence, an advocate can help you prepare. Many families I have worked with did not know what questions to ask or what documentation to request. They accepted reductions they had every right to challenge.

You are not alone in feeling overwhelmed by this. Navigating Medicaid systems, even for families who have been doing it for years, can feel like something is always changing. The rules did change. The administrator changed. But your fundamental right to care, and your right to challenge decisions that affect it, has not changed.

The families who do best in these situations are the ones who act early, document carefully, and ask for help before they accept a reduction as final.

Are You Grandfathered Under the Old CDPAP Eligibility Rules?

If you were already authorized or receiving CDPAS as of September 1, 2025, the new Minimum Needs Requirements do not apply to you yet.

Your situation	Grandfathered?	What to expect
Authorized and receiving CDPAS before Sept 1, 2025	Yes	Current rules apply until your next scheduled reassessment
Enrolled in MLTC plan continuously as of Sept 1, 2025	Yes	Protected from new ADL threshold until reassessment
New application submitted after Sept 1, 2025	No	Must meet 2+ ADL threshold at initial assessment
Scheduled reassessment after Sept 1, 2025	No	New Minimum Needs Requirements apply to that reassessment
PACE program enrollee	Exempt	Minimum Needs Requirements do not apply to PACE

A CDPAP hour reduction is frustrating, but it is rarely the final word. The families I see restore their hours have one thing in common: they moved quickly and called the right entity first.

From what I have seen, the most common mistake is calling PPL to dispute hours that only your MLTC plan can change. Confirm your authorized level in the PPL portal first. Then call your plan with that number in hand.

The new ADL threshold will continue shaping reassessments through 2026. If yours is coming up, start gathering documentation now. Do not wait for a notice. A physician letter that names your specific daily activities is your strongest asset in any appeal.

If you are trying to figure out whether your reduction came from an eligibility change or an administrative error, the team at Understood Care can help. Call us at 646-904-4027. Our services are covered by Medicare.