Starting May 1, home health aides in New York will receive new insurance coverage through Leading Edge Administrators, a health insurer with a controversial past. Despite its troubled history, including legal issues surrounding its founder, Jerry Weissman, the company has been selected to provide coverage for workers in the state’s home care program.
Leading Edge, which was founded in 2010, will offer two basic insurance plans to low-wage home health aides in New York. These plans, however, have been criticized for lacking coverage for essential health services such as doctor’s visits, maternal care, and hospitalization. The move to replace the existing network of insurance providers with just one—Public Partnerships, LLC (PPL)—is part of the state’s efforts to reduce the cost of its $9 billion home care program. PPL selected Leading Edge as the sole insurer for these workers, a decision that has generated significant backlash.
Since the official launch of PPL’s program on April 1, many home health aides have raised complaints about missed paychecks and unreturned calls, with some even filing a class action lawsuit over alleged wage theft.
Leading Edge has a track record of disputes over insurance claims, including instances where the company has retracted approval for procedures after bills were submitted, or attempted to cancel coverage entirely. One of the most alarming cases occurred in 2015, when Leading Edge—then operating under the name Omni Advantage—tried to cancel the insurance of a coma patient, Victor Lopez, who had been in critical care for months following a stroke. Despite his ongoing medical needs, Lopez was told his coverage had ended months earlier due to “end of employment.”
The insurer's history of questionable practices raises concerns about whether home health aides will be able to access the care they are promised under the new plans. Legal experts warn that Leading Edge’s tactics often go beyond industry norms in efforts to avoid paying claims.
Neither PPL nor Leading Edge responded to requests for comment regarding these concerns. With thousands of vulnerable home health aides relying on the new insurance coverage, the situation is expected to remain under close scrutiny as workers continue to navigate the challenges of the new system.
