Public Partnerships LLC
Cost Outlier
Billing over 3× the national median for specific procedure codes.
This provider bills $106.28 per claim for A0090 (Non-emergency transport, per mile), which is 10.2× the national median of $10.45.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 4 procedure codes: A0090 at 10.2× median, S5165 at 5.3× median.
Unusually High Spending
This provider's total payments are significantly above the median for their specialty.
High Cost Per Claim
Average payment per claim is much higher than peers billing the same procedures.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
Cost Outlier
Cost Outlier means this provider charges significantly more per claim than other providers billing the same procedure codes. This could indicate upcoding, inflated charges, or specialized services that justify higher costs.
Rate Outlier
Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.
Unusually High Spending
Unusually High Spending means this provider's total Medicaid payments are significantly above the median for their specialty. This doesn't necessarily indicate fraud — high volume practices and those serving complex populations may legitimately bill more.
High Cost Per Claim
High Cost Per Claim means each individual claim from this provider costs significantly more than what other providers charge for the same services. This could indicate upcoding (billing for more expensive services than provided) or legitimate specialized care.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Advanced Detection Signals
Additional statistical tests from advanced fraud detection methods
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Risk Assessment
Bills $152.94 per claim for T1999 (Miscellaneous therapeutic items and supplies) — 5.3× the national median of $28.63.
Bills $106.28 per claim for A0090 (Non-emergency transport, per mile) — 10.2× the national median of $10.45.
Bills $11,727.09 per claim for S5165 (Home modifications, per service) — 5.3× the national median of $2,196.32.
Billing in the top 1% nationally for 1 procedure code: S5165.
This is a statistical summary, not an accusation. See our methodology.
Compared to Supports Brokerage Peers
Total spending distribution among 14 providers in this specialty
This provider's total spending of $7.18B is at the 99th percentile among 14 Supports Brokerage providers.
Above 99th percentile for this specialty — higher spending than 13 of 14 peers
Total Paid
$7.18B
$7,177,816,544
Total Claims
89.8M
Beneficiaries
5.6M
16.0 claims/patient
Avg Cost/Claim
$80
#1 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Public Partnerships LLC is a Supports Brokerage provider based in Latham, NY. From the 2018–2024 period, this provider received $7.2B in Medicaid payments across 89.8M claims.
Important Context
- ℹ️This provider is a known fiscal management organization for self-directed care programs. They manage billing on behalf of thousands of individual caregivers, so aggregate billing is high by design. However, the self-directed care category has been identified as fraud-prone by regulators.
Why This Matters
This provider received $7.2B in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 897,227 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 25 distinct procedure codes. The top code (T1019 (Personal care services, per 15 min)) accounts for 38% of total spending.
$2.70B
36.5M claims
$73.90
$82.47
Personal care services, per 15 min
$2.70B
36.5M claims · 37.6%
$2.37B
28.5M claims
$83.16
$156.98
Attendant care services, per diem
$2.37B
28.5M claims · 33.0%
$444.7M
6.9M claims
$64.54
$84.46
Unskilled respite care, per 15 min
$444.7M
6.9M claims · 6.2%
$343.1M
2.5M claims
$135.57
$169.11
Community-based wrap-around services, per 15 min
$343.1M
2.5M claims · 4.8%
$315.5M
1.2M claims
$273.86
$321.53
Comprehensive community support services, per 15 min
$315.5M
1.2M claims · 4.4%
$225.8M
3.7M claims
$61.18
$48.76
Homemaker service, NOS; per 15 min
$225.8M
3.7M claims · 3.1%
$205.2M
2.6M claims
$79.08
$82.34
Attendant care services, per 15 min
$205.2M
2.6M claims · 2.9%
$178.7M
3.6M claims
$49.65
$124.39
Waiver services, NOS; per 15 min
$178.7M
3.6M claims · 2.5%
$120.8M
790K claims
$152.94
$28.63
Miscellaneous therapeutic items and supplies
$120.8M
790K claims · 1.7%
Non-emergency transport, per mile
$112.4M
1.1M claims · 1.6%
$59.3M
1.3M claims
$45.41
$52.25
Companion care, adult, per diem
$59.3M
1.3M claims · 0.8%
$46.2M
584K claims
$79.16
$108.97
Financial management, self-directed; per month
$46.2M
584K claims · 0.6%
$18.7M
27K claims
$700.56
$856.03
Health care common procedure coding system HCPCS lvl II
$18.7M
27K claims · 0.3%
$16.6M
145K claims
$114.55
$302.34
Companion care, adult, per 15 minutes
$16.6M
145K claims · 0.2%
Home modifications, per service
$7.4M
628 claims · 0.1%
$7.1M
195K claims
$36.54
$137.32
Habilitation, residential, waiver; 15 min
$7.1M
195K claims · 0.1%
$2.9M
22K claims
$133.47
$21.70
Non-emergency transport; encounter/trip
$2.9M
22K claims · 0.0%
$1.9M
24K claims
$77.65
$71.40
Respite care services, per 15 minutes
$1.9M
24K claims · 0.0%
$1.1M
117K claims
$9.43
$162.29
Supports brokerage, self-directed; per 15 min
$1.1M
117K claims · 0.0%
$965K
22K claims
$43.30
$116.67
Home health aide or certified nurse, per hour
$965K
22K claims · 0.0%
$796K
4K claims
$181.00
$249.18
Unskilled respite care, per diem
$796K
4K claims · 0.0%
Specialized supply, NOS; per unit
$293K
327 claims · 0.0%
$191K
6K claims
$30.38
$29.97
Emergency response system, per month
$191K
6K claims · 0.0%
$122K
7K claims · 0.0%
$12K
858 claims
$14.27
$5.39
Unlisted special service, procedure, or report
$12K
858 claims · 0.0%
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