New York's Medicaid spending is a target for fraudsters, as it is the nation's most costly Medicaid program, costing the state 77% more than the national average and 24% higher than No. 2 spender Kentucky. The state's Consumer Directed Personal Assistance Program, funding home care aides, has grown to nearly $15 billion a year, and the state’s Health Commissioner, Kathy Hochul, is being investigated for bid-rigging of the contract with Public Partnerships LLC, the company Hachul hired to oversee CDPAP. Meanwhile, the state also uses hundreds of millions of Medicaid dollars to subsidize health insurance for SEIU 1199 members, and grants fund lobbying for increased Medicaid spending. The main investigator in the state Attorney General's Office, the Medical Fraud Control Unit, completed an average of just eight probes per billion dollars spent from 2020 to 2024, compared to 63% below the US average.