Another day, another government program that started with good intentions and ended as a taxpayer-funded buffet for scammers.

A New York State health program meant to help the elderly avoid nursing homes instead became a magnet for fraud, losing an estimated $1.2 billion to scammers and middlemen. One veteran Medicaid fraud prosecutor summed it up bluntly: if people were shocked by Minnesota’s daycare fraud scandal, New York’s situation is “Minnesota multiplied by 10.”

The Consumer Directed Personal Assistance Program (CDPAP) was created in 1994 to let elderly or disabled individuals receive care at home. The idea was simple. The execution? Not so much. With no medical qualifications or certifications required to become a caregiver, oversight was minimal and abuse became rampant.

One of the most jaw-dropping examples involved Ballal Hossain, who signed up a dozen family members to “care” for his ailing mother in Manhattan. Over six years, the family collected $348,000. The catch? His mother was living in Bangladesh the entire time. To keep inspectors fooled, Hossain allegedly had his brother pose as their sick mother during visits. He was eventually caught and sentenced for grand larceny — proving that sometimes even the most absurd scams do get noticed.

According to reporting, at least $179 million was stolen outright by CDPAP recipients over the last decade. Meanwhile, the program burned through at least $1 billion on so-called “fiscal intermediaries,” or middlemen — because nothing says efficiency like hundreds of companies skimming off the top.

Richard Harrow, who prosecuted Medicaid fraud in New York for 27 years, didn’t sugarcoat it. CDPAP, he said, is the biggest fraud operation around precisely because it happens inside private homes, far from public scrutiny.

The numbers back him up.

• In 2019, CDPAP cost taxpayers $2.5 billion.

• By 2023, that number ballooned to $9.1 billion.

• By 2025, annual spending had skyrocketed to $12 billion, according to Health and Human Services Secretary Robert F. Kennedy Jr.

Even New York’s own Department of Health admitted the program triggered a “fiscal crisis.” Gov. Kathy Hochul herself called CDPAP “one of the most abused programs in the history of New York” and acknowledged that “something has to give.” That statement alone might be the least controversial thing said in Albany all year.

High-profile prosecutions followed. In 2025, Zakia Khan pleaded guilty to stealing $68 million through kickbacks and fake services at Brooklyn adult daycare centers. In 2023, healthcare executive Marianna Levin was sentenced to four and a half years in prison for a $100 million Medicaid fraud scheme. Another Brooklyn operator, Farrah Rubani, was accused of embezzling $11 million, allegedly funding luxury purchases before agreeing to repay damages.

At the ground level, abuse was just as blatant. Caregivers billed for people who were hospitalized, deceased, or — impressively — receiving care in two places at once. Some personal assistants were reportedly clocking 23-hour days, raking in projected earnings of around $200,000 a year. Truly remarkable stamina.

Middlemen also cashed in big. In 2024, two Brooklyn-based agencies settled for more than $17 million after defrauding Medicaid and underpaying tens of thousands of aides. At one point, the state was paying over 600 middleman companies, costing up to $1 billion a year.

Reforms have since begun. New York officials say consolidating the system has already saved $1 billion for taxpayers and cut out hundreds of intermediaries. The state insists the worst abuses are being shut down and that future oversight will protect both taxpayers and those who genuinely need care.

For once, there’s a silver lining: fraud is being exposed, reforms are underway, and accountability — however late — is finally entering the conversation. With tighter controls and real enforcement, programs like CDPAP can still serve the people they were meant to help, instead of those who saw them as an easy payday.