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Testimonials

In the various roles he has undertaken through the years, Val J. Halamandaris has been a singular driving force behind the policy and program initiatives resulting in the recognition of home health care as a viable alternative to institutionalization. His dedication to consumer advocacy, which enhances the quality of life and dignity of those receiving home health care, merits VNA HealthCare Group’s highest recognition and deepest respect. 

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VNA HealthCare Group

I have the highest respect for them, especially for the nurses, aides and therapists, who devote their lives to caring for people with disabilities, the infirm and dying Americans.  There are few more noble professions.

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President Barack Obama

Home health care agencies do such a wonderful job in this country helping people to be able to remain at home and allowing them to receive services

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U.S. Senator Debbie Stabenow (D-MI) Chair, Democratic Steering and Outreach Committee

Home care is a combination of compassion and efficiency.  It is less expensive than institutional care...but at the same time it is a more caring, human, intimate experience, and therefore it has a greater human element...it’s a big mistake not to try to maximize it and find ways to give people the home care option over either nursing homes, hospitals or other institutions

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Former Speaker of the U.S. House of Representatives Newt Gingrich (R-GA)

Medicaid covers long-term care, but only for low-income families.  And Medicare only pays for care that is connected to a hospital discharge....our health care system must cover these vital services...[and] we should promote home-based care, which most people prefer, instead of the institutional care that we emphasize now.

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Former U.S. Senator Majority Leader Tom Daschle (D-CD)

We need incentives to...keep people in home health care settings...It’s dramatically less expensive than long term care.

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U.S. Senator John McCain (R-AZ)

 

Home care is clearly the wave of the future. It’s clearly where patients want to be cared for. I come from an ethnic family and when a member of our family is severely ill, we would never consider taking them to get institutional care. That’s true of many families for both cultural and financial reasons. If patients have a choice of where they want to be cared for, where it’s done the right way, they choose home.

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Donna Shalala, former Secretary of Health and Human Services

A couple of years ago, I spent a little bit of time with the National Association for Home Care & Hospice and its president, Val J. Halamandaris, and I was just blown away. What impressed me so much was that they talked about what they do as opposed to just the strategies of how to deal with Washington or Sacramento or Albany or whatever the case may be. Val is a fanatic about care, and it comes through in every way known to mankind. It comes through in the speakers he invites to their events; it comes through in all the stuff he shares.

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Tom Peters, author of In Search of Excellence

Val’s home care organization brings thousands of caregivers together into a dynamic organization that provides them with valuable resources and tools to be even better in their important work. He helps them build self-esteem, which leads to self-motivation.

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Mike Vance, former Dean of Disney and author of Think Out of the Box

Val is one of the greatest advocates for seniors in America. He goes beyond the call of duty every time.

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Arthur S. Flemming, former Secretary of Health, Education, and Welfare

Val has brought the problems, the challenges, and the opportunities out in the open for everyone to look at. He is a visionary pointing the direction for us. 

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Margaret (Peg) Cushman, Professor of Nursing and former President of the Visiting Nurses Association

Although Val has chosen to stay in the background, he deserves much of the credit for what was accomplished both at the U.S. Senate Special Committee on Aging, where he was closely associated with me and at the House Select Committee on Aging, where he was Congressman Claude Pepper’s senior counsel and closest advisor. He put together more hearings on the subject of aging, wrote more reports, drafted more bills, and had more influence on the direction of events than anyone before him or since.

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Frank E. Moss, former U.S. Senator

Val’s most important contribution is pulling together all elements of home health care and being able to organize and energize the people involved in the industry.

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Frank E. Moss, former U.S. Senator

Anyone working on health care issues in Congress knows the name Val J. Halamandaris.

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Kathleen Gardner Cravedi, former Staff Director of the House Select Committee on Aging

Without your untiring support and active participation, the voices of people advocating meaningful and compassionate health care reform may not have been heard by national leaders.

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Michael Sullivan, Former Executive Director, Indiana Association for Home Care

All of us have been members of many organizations and NAHC is simply the best there is. NAHC aspires to excellence in every respect; its staff has been repeatedly honored as the best in Washington; the organization lives by the highest values and has demonstrated a passionate interest in the well-being of patients and providers.

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Elaine Stephens, Director of Home Care of Steward Home Care/Steward Health Systems and former NAHC C

Home care increasingly is one of the basic building blocks in the developing system of long-term care.  On both economic and recuperative bases, home health care will continue to grow as an essential service for individuals, for families and for the community as a whole.

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Former U.S. Senator Olympia Snowe (R-ME)

NCOA is excited to be part of this great event and honored to have such influential award winners in the field of aging.

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National Council of Aging

Health care at home…is something we need more of, not less of.  Let us make a commitment to preventive and long-term care.  Let us encourage home care as an alternative to nursing homes and give folks a little help to have their parents there.

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Former President Bill Clinton

NAHC Participates in Call with CMS on Phase II of PECOS Edits

April 4, 2013 04:30 PM

The National Association for Home Care & Hospice (NAHC) participated in a conference call with the Centers for Medicare & Medicaid Services (CMS) on April 3, 2013 to discuss Phase II of the PECOS edit activation. During the call, NAHC reported on the information collected from home health agencies about ongoing physician enrollment problems, the findings of one CMS contractor that as many as 4 percent of claims could be subject to denial, and the large number of Veteran’s Administration and military hospitals that have failed to enroll physicians who order and refer for Medicare home health services.

CMS asked NAHC to remind providers that they must submit the physician’s name with his/her individual NPI, rather than a group NPI.

According to CMS, about 1 percent or the errors found during Phase I were the result of home health claims submitted with the physician’s group NPIs.

Below are responses provided by CMS to several outstanding PECOS questions. NAHC will continue to provide additional answers and updates about the May 1PECOS edit activation as soon as they are received.

1.    Will the edits be against PECOS only or will they be applied to other files of Medicare enrolled physician (i.e. legacy files)?

Answer: CMS will edit home health claims against PECOS. However, since there are still “a couple of thousand” physicians who have not been transitioned to PECOS, the PECOS edits will be supplemented by a check of legacy files.

Note: PECOS edits refer to edits against both PECOS files and legacy files from this point forward

 

2.    Where are opt-out physicians listed?

Answer: In enforcing the statutory requirement that physicians be enrolled in Medicare to order or refer services, physicians who have validly opted out of Medicare are treated as if they were enrolled - for purposes of the ordering and referring edits.  If the physician has validly opted out of Medicare, his/her certifications for home health care will not be denied for lack of an approved enrollment record in Medicare.

CMS has made the Ordering Referring Report, containing the NPIs and legal names of physicians and other eligible professionals who have approved enrollment or valid opt-out records in PECOS available, and are encouraging providers and suppliers to view this report here.

 

3.    Can you explain the reason physicians are dropping off the Ordering and Referring File? Could these physicians still be receiving payment from Medicare using a group NPI?

Answer: Physicians who fail to respond to revalidation notices or provide requested information (e.g. license number, IRS information, etc.) will be considered to have “voluntarily withdrawn” from Medicare. Their names will be removed from the Ordering and Referring File. Also, opt-out physicians who fail to renew their opt-out status every two years will be removed. Medicare payments will not be made for any physician that that has withdrawn or been terminated regardless of whether their claims are submitted using an individual or group number.

 

4.    Will home health agencies be paid for services ordered by a physician who has had a gap in their enrollment?

Answer: Medicare payments will be made only for those dates of home health services provided while the ordering physician is actively enrolled in Medicare. Physicians who failed to respond to revalidation notices within the 60-day timeline will have their provider number deactivated. If deactivated, but respond by day 120, they will be retroactively reactivated without a gap (i.e. ordering and referring authority retroactively restored). However, if they fail to respond by day 120, they must reenroll and will be assigned a new date of enrollment (ordering and referring authority terminated as of day 60). 

 

5.    The PECOS Ordering and Referring files do not include the date of physician enrollment. Since home health payments will be based on whether the ordering physician was enrolled in PECOS at the time services were provided, rather than at the time claims were submitted, how will home health agencies identify and track the effective dates of physicians’ PECOS enrollment?

Answer: CMS will not provide this information to providers. Physicians’ date of enrollment is in both physicians’ effective date for billing Medicare notification letters and in the physicians’ PECOS files. Home health agencies must contact the physicians for this information in cases where they have concerns about an initial effective date or a gap in enrollment.

 

6.    Will home health episodes that begin prior to but end subsequent to May 1 be paid in full?

Answer: CMS will get back to NAHC with the answer to this question.

 

7.    Must physicians that order additional visits be enrolled?

Answer: The PECOS edits will look at whether the primary ordering physician is enrolled only. Determination of coverage of services by secondary physicians who are not enrolled in PECOS is the responsibility of other groups at CMS. 

 

8.    If an HHA receives a $0.00 payment on a RAP because the ordering physician is not enrolled in PECOS, should the agency cancel and resubmit the RAP with new information - i.e. corrected physician name and/or NPI, or the name of a different (enrolled) physician?

Answer: Yes, if a RAP is paid at $0.00 because the physician is not enrolled or validly opted out of Medicare, home health agencies may cancel these RAPs and resubmit them once correct information is available.

 

9.    The HHABN issue remains puzzling since this is not a notice of non-coverage. Should agencies use Option Box 2-business reasons? May home health agencies hold beneficiaries financially liable?

Answer: Internal discussions are underway about beneficiary liability and beneficiary notices with the appropriate parties at CMS. CMS will get back to NAHC with the answers.

 

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