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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

Heath 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

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

Hospice Patients, Part D Coverage and Analgesics

November 5, 2013 04:21 PM

On October 30, 2013, the Centers for Medicare & Medicaid Services (CMS) sent a memo to all Medicare Part D plan sponsors instructing them to recoup payment directly from hospices for prescription analgesics paid for by the Part D plan during dates in 2011 and 2012 when the beneficiary was enrolled in hospice. The memo is from the Medicare Program Integrity Group and Medicare Drug Benefit C & D Data Group and is a follow-up to other guidance to Part D sponsors released earlier this year, as part of a general CMS effort to ensure that prescription drugs for hospice patients are financed through appropriate areas of Medicare. 

The memos provide guidance and instruction to Part D plan sponsors regarding payment for medications for hospice beneficiaries that are paid for by the Part D plans.  The instruction is based on analyses conducted earlier this year by the Center for Program Integrity (CPI) of 2011 and 2012 prescription drug event (PDE) records submitted to report Part D payment for pain control medications where the date filled is within the dates of the beneficiary’s Medicare hospice election.

The most recent memo was released in response to clarification sought by Part D plan sponsors and states “…for the purposes of this recovery effort only, we presume that all the drugs were used for the palliation and management of the terminal illness and/or related conditions. They are, therefore, considered to be related to hospice care and thus a case-by-case analysis to determine relatedness is not required. Since the drugs were the payment responsibility of the Medicare hospice, the PDE reflects an overpayment that should be recovered from the hospice…”  Again, the payments are for analgesics only.

The National Association for Home Care & Hospice (NAHC) and its affiliated Hospice Association of America (HAA) are concerned about CMS’ blanket statement that all analgesics are presumed related to the terminal (or a related) diagnosis and instruction that case-by-case analysis to determine relatedness is not necessary. 

NAHC and HAA are working to share these concerns and dialogue with the appropriate parties on a reasonable approach to addressing payments by Part D plans that should have been paid for by the hospice.  Readers can refer to previous coverage of Hospice/Part D issues in the October 24, 2013, issue of NAHC Report .

If hospices receive any requests from Part D plan sponsors requesting payment, preauthorization of hospice patient medications or information about hospice patient enrollment dates please contact us at Katie@nahc.orgor

In the interim, hospices should take the following steps to ensure compliance with Medicare:

  • Implement or reinforce process for medication review on each regularly scheduled hospice visit to ensure the hospice is aware of all medications the patient is taking.  This is particularly important for patients residing in facilities.
  • Implement or reinforce process for identifying related and non-related medications and communicating this information to the pharmacy and the patient/family.
  • Conduct routine audits to ensure documentation supporting non-related medications is clear and present in the medical record.
  • Conduct routine audits to ensure the pharmacy is billing hospice for ALL related medications.
  • Develop the same processes for supplies and other hospice-related items





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