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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. 

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.

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

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’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

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.

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.

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.

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.

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.

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.

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. 

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.

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.

Frank E. Moss, former U.S. Senator

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

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.

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.

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.

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.

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.

Former President Bill Clinton

CMS Releases Change Request 8358 – Additional Data Reporting Requirements for Hospice Claims

July 31, 2013 08:29 AM

The Centers for Medicare and Medicaid Services (CMS) released Change Request (CR) 8358, Additional Data Reporting Requirements for Hospice Claims.  The implementation date on the CR is January 6, 2014. There is, however, additional voluntary reporting and mandatory reporting dates which are outlined below. CMS states that the additional claims data supports hospice payment reform as authorized by the ACA.  Last month, NAHC and its affiliate, the Hospice Association of America (HAA), sent comments to CMS on the Proposed Rule:  Medicare Program; FY2014 Hospice Wage Index and Payment Rate Update; Hospice Quality Reporting Requirements; and Updates on Payment Reform (CMS-1449-P). 

In those comments, NAHC and HAA urged CMS to obtain needed data that accurately depicts costs while making informed decisions regarding hospice payment reform.  Both NAHC and HAA are pleased that CMS has taken this step of obtaining additional data prior to implementing reforms to the hospice payment system.

The additional data that will go on hospice claims includes:

  • General inpatient (GIP) visit reporting for certain hospice-paid staff
  • Facility National Provider Identifier (NPI) number when care provided is not at the hospice facility that is billing the care
  • Post mortem (PM) visit reporting
  • Reporting of infusion pumps and prescription drugs

Mandatory reporting of these additional items on claims begins with claims with dates of service on or after April 1, 2014 with voluntary reporting beginning January 1, 2014.  The CR provides instructions to the MAC and also revises Section 30.3 of Chapter 11 of the Medicare Claims Processing Manual.

Hospices will begin reporting line-item visit data for hospice-paid nurses, aides, social workers, certain calls made by social workers, physical therapists, occupational therapists, and speech-language pathologists providing care to hospice patients receiving GIP in skilled nursing facilities (Q5004) or in hospitals (Q5005, Q5007, Q5008).  The visit data includes the number of visits and length of visit in 15-minute increments and number of calls and length of calls in 15-minute increments for certain social worker calls.  Again, this is for hospice-paid staff only.  Visit data for non-hospice paid staff are not included.  There are no changes to the existing GIP reporting requirements for GIP services provided in a hospice inpatient unit (Q5006). 

Hospices will also report the name, address, and NPI of any nursing facility, hospital (including long term care hospitals and inpatient psychiatric facilities), or hospice inpatient facility when services are provided at any of these locations that is not the same location as the billing hospice’s location. This applies to all levels of care.  In situations where the patient received care in more than one facility during the billing month, the name, address and NPI of the facility where the patient last received services shall be reported on the claim. The CR requires that claims without the required facility NPI information be returned to provider (RTP’d) by the Medicare administrative contractor (MAC) for claims with dates of service on or after April 1, 2013. 

Hospices will use a PM modifier on the claim for visits that occur on the patient’s date of death after the patient has passed away.  Visits occurring after the date of death will not be reported.  These visits will be reported for all levels of care in all sites of service and shall include the number of visits and length of visit in 15-minute increments for hospice-employed nurses, aides, social workers, and therapists. 

In addition, hospices will begin reporting injectable and non-injectable prescription drugs on their claims on a line-item basis per fill.  Over the counter (OTC) drugs are not reported on the claim.  Hospices also need to report infusion pumps on a line-item basis for each pump order and for each medication refill.  DME other than infusion pumps are not reported on the claim.  Hospices will have to use pharmacy, National Drug Code (NDC) and DME revenue codes (e.g. 0250, 029X and 0636) on the claim in order to include this data.  The NDC data includes the quantity of the drug filled. 

All the additional data added to the claim per this CR will appear on the Medicare Summary Notice (MSN) to consumers in the same manner as hospice visit reporting currently appears.

There is one area of this CR on which we are seeking clarification and that is the terminology “hospice-paid” and “hospice-employed”.  CMS uses hospice paid staff when referring to all visit data to be put on the claim except for the post mortem visits. CMS specifies that the PM visit data be for the specified disciplines employed by the hospice.  The discipline visits that occur post mortem would not typically be from hospice-contracted staff but there are exceptional circumstances where a hospice may have a contracted staff member providing such a visit.  We believe CMS intends for these visits to also be reported, but, as mentioned above, we are seeking clarification on this point.  We will provide you with the answer when it is received.

Hospices should begin working on these changes now by reviewing their data collection systems to be sure they can obtain the necessary level of detail.  Hospice billing personnel and contractors will need to familiarize themselves with the NDC as well as the applicable pharmacy and DME revenue codes.  These revenue codes appear to be limited in number based on the changes made to the Claims Processing Manual instructions but billing personnel and contractors will want to verify this.

At the time this article went to print, the full CR was not posted on the CMS website.  NAHC and HAA expect it to be posted momentarily to the Transmittals page of the website.

Providers should check that page here for the full CR.




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