Colorado Medicaid spending on a single in-home care company jumped $21M in one year

Jennifer Brown – The Colorado Sun

Colorado Medicaid spending on a single in-home care company jumped $21M in one year

The state has moved to terminate its agreement with Freedom Care, a nationwide for-profit company that state officials say targeted Medicaid clients with TV ads

A nationwide company that sends caregivers into people’s homes to help with daily tasks caught the attention of Colorado officials as its Medicaid payments skyrocketed to nearly $22 million so far this year from about $1 million last year.

That scrutiny has led to a courtroom fight after the state Medicaid program terminated its agreement with Freedom Care, accusing the company of caring more about profits than people.

Freedom Care has 732 caregivers and more than 700 Medicaid clients who are older Coloradans and people with disabilities. The for-profit company sought an injunction against the Colorado Department of Health Care Policy and Financing after the state ordered it to cut off services for current clients by Nov. 15 and immediately stop taking new clients.

A two-day hearing before an administrative law judge Oct. 29-30 will determine whether Freedom Care can continue operations in Colorado.

The state initially ordered Freedom Care to notify its current clients within 10 days that they needed to find new care. But the New York-based company won a preliminary injunction in Denver District Court last week so that it could keep serving current clients at least until it can appeal its termination to the administrative law judge.

The state Attorney General’s Office, on behalf of the Medicaid program, argued that Colorado taxpayers should not continue paying $550,000 each week “to a provider that has so seriously failed to comply with state and federal requirements.”

Lawyers for the state said Freedom Care, which operates in 15 states, uses “aggressive marketing practices” that include television ads urging people to “call Freedom Care now so you can receive daily help” from a “family member or friend who gets paid to be your caregiver.” The company’s services include helping people with household tasks like meal preparation, laundry and getting in and out of bed.

In Colorado, the company is targeting and providing care only for clients with Medicaid, the government insurance program for people with low incomes or disabilities, and its “focus on growing its client base and profit margins” was not matched by a regard for health and safety, state lawyers alleged. The company’s administrator and other supervisory employees live out of the state or the country and were “infrequently present” to oversee Colorado operations, state lawyers said.

“Freedom Care demonstrated an extraordinary and flagrant disregard of state regulatory requirements that are meant to protect Medicaid member health and safety and to ensure that limited public funds are properly spent,” they wrote. “Freedom Care’s actions have placed its clients at imminent risk of harm and have likewise placed the State of Colorado at serious risk of having to pay back the federal government millions of dollars.”

Freedom Care received a license to operate in the state in 2022 and has since failed to fully cooperate with state regulators, attorneys alleged.

The state health department attempted to inspect Freedom Care’s operations first in April 2025, but there was no one at the office, court records state. The state agency tried again in October 2025 and had the same problem. State health officials finally were able to conduct their review three months ago, when they found “catastrophic agency-wide failures” in basic home care.

The nine findings of “immediate jeopardy” and “imminent threat of severe harm” included failure to report or investigate allegations of abuse and neglect, according to the Colorado Department of Public Health and Environment. Freedom Care had received two complaints about abuse, two for noncompliance with regulatory requirements and four for fraudulent Medicaid billing, state health officials found.

The findings of the state health department inspection prompted the state Medicaid program to send Freedom Care a termination notice in September, initially ordering the company to notify its clients of the termination within 10 days. That requirement would have put Freedom Care out of business before the administration appeals process hearing, the company argued.

Freedom Care argued that immediately trying to transfer its clients to other providers would “disrupt care for hundreds of vulnerable Colorado Medicaid clients,” would reduce access to care for many other Coloradans and would cause “significant and irreparable harm.” The company’s client base is 4% of the enrollment in the state’s home-based services Medicaid program, wrote Freedom Care’s attorney, Richard Murray.

The company “responded immediately and comprehensively” after the state health department released its findings, he argued.

In a two-week span in July, Freedom Care sent 364 emails to two surveyors from the state health department in response to their requests. Of those, 109 were not opened by the end of the month, according to the company’s attorney.

The state health department accepted the company’s remediation plan in July, and Freedom Care sent a team of 36 people, including 13 registered nurses, to Colorado to help respond to the deficiencies the state found, the company said.

“Freedom Care corrected the issues and remediated those findings almost immediately,” Murray wrote. “Bewilderingly, despite the department’s assertion of an ‘imminent risk,’” it did not return to “verify the successful remediations.”

Both Murray and Medicaid officials declined to comment while the case is pending.

The move to terminate Freedom Care’s operations in Colorado comes as the state is facing a $1.6 billion budget shortfall, mostly due to Medicaid spending.