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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

Providing Vaccines to Hospice Beneficiaries

October 22, 2013 03:29 PM

In a Change Request (CR 8098) issued May 3, 2013, the Centers for Medicare & Medicaid Services (CMS) indicated that, effective October 1, 2013 - for implementation on October 7, 2013 - Medicare systems will prevent non-hospice providers from providing vaccines to hospice patients. While a hospice may provide influenza, pneumococcal, and hepatitis B vaccines to hospice-enrolled beneficiaries who request them, and may bill the Part B Carrier for both the vaccine and an administration fee, any other provider will be denied reimbursement.

Medicare systems previously did not have the ability to differentiate between claims for the vaccines submitted by hospices and other providers/suppliers. CMS has now established an edit to the Common Working File (CWF) that allows the Medicare Administrative Contractors (MACs) to reject claims submitted by non-hospice providers for vaccines provided to hospice beneficiaries. Issuance of CR 8098 has raised a number of questions; they include questions on how a hospice provider may become a Part B supplier in order to bill for vaccines. Following is information that has been gathered to help address outstanding questions.

How Does a Hospice Bill for Vaccines?

In order to bill Medicare for preventive vaccines, a hospice must be a participating provider with Part B, which requires enrollment using CMS Form 855B with the local carrier/AB MACserving the state within which the provider operates. Submission of the 855B allows the hospice to secure a Provider Transaction Access Number (PTAN) for Part B billing privileges. In many cases the local carrier/AB MAC will NOT be the MAC that processes hospice payment under Part A.

The hospice would also be required to complete a CMS-588 Electronic Funds Transfer (EFT) Agreement, CMS-460 Medicare Participating Physician and Supplier Agreement and submit a $532.00 (2013) application fee. CMS provider enrollment staff have instructed that a hospice should apply as a “mass immunizer” on the 855B; securing a supplier number as a “mass immunizer” will allow the hospice to bill for three types of immunizations -- Influenza, Pneumococcal and Hepatitis.

The vaccine and administration fee should be billed to the local carrier/AB MAC on the Form CMS-1500. Payment is made using the same methodology as if a hospice is a Part B supplier. Additional information may be sought from the local carrier/AB MAC serving the hospice’s state. Given that most hospices may not have a high volume of patients for which they can bill Medicare Part B, hospices may want to conduct a thorough analysis of the potential benefits and costs of becoming a Part B supplier for vaccine purposes. Because use of preventive benefits under Part B is encouraged, there is a waiver of deductible and co-insurance amounts for hospice patients receiving the flu and/or pneumococcal vaccine(s). Hospices wishing to bill for any of the three vaccines should review instructions in Chapter 18 of the Medicare Claims Processing Manual, Publication 100-04.

NAHC’s HAA staff has fielded calls from a number of hospice providers seeking clarification on CR 8098. Hospices have requested additional information regarding:

  • Why a hospice patient’s attending physician may not provide and bill for preventive vaccines and is that policy specified anywhere other than in CR8098?
  • Whether hospices are required to provide preventive vaccines if a hospice patient requests one; if such is the case, why could vaccines not be reimbursed under Part A?
  • If vaccine administration is discretionary on the part of the hospice, why are no other options available to a patient who is interested in receiving the vaccine(s)?
  • Is a hospice eligible for Medicare payment for preventive vaccines if the hospice patient to whom vaccines have been administered does not have Part B coverage?

It is NAHC and HAA’s understanding that the MACs and CMS are receiving numerous questions about vaccine administration and billing by hospices. HAA staff will continue to seek additional details about vaccine policies related to hospice patients and provide updates as they arise through NAHC Report, Hospice Notes, and on the NAHC Member Listserv.




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