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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

PECOS Tips as Edits Draw Near

December 27, 2013 09:01 AM

January 6, 2014 is the date for activation of the Internet-based Provider Enrollment, Chain and Ownership System (PECOS) edits that will result in denial of home health claims if the ordering physician is not enrolled in PECOS or officially opted-out of Medicare. In order to protect against non-payment by Medicare, home health agencies must verify enrollment of all ordering physicians.

Beneficiary Notification

The Centers for Medicare & Medicaid Services (CMS) clarified in their most  recent communication (MLN Matters Article SE 1305)  that claims  denied because they failed the ordering/referring edit will not expose a Medicare beneficiary to liability. Therefore, an Advance Beneficiary Notice is not appropriate in this situation. CMS also informed the National Association for Home Care & Hospice (NAHC) that since thebeneficiary can not be held liable for services ordered by a provider who is not registered in PECOS,  no notice is to be given because the beneficiary can  not be charged.

CMS’ position would prohibit the beneficiary from choosing to privately pay for services even if informed of Medicare non-payment in advance of the initiation of care. NAHC has expressed its disagreement with this policy and requested that CMS reconsider their position. NAHC advices that home health agencies should not initiate services for beneficiaries who are unable to identify a PECOS-enrolled physician to assume ordering responsibilities for episodes of care beginning on and after January 6. 

PECOS Verification Tips

Below are several important tips about PECOS operational consideration:

  1. Physicians approved to order home health services are limited to doctors of medicine, osteopathy, and podiatry.
  2. The NPI must be that of the individual physician, not a group or organization.
  3. Home health agencies must report the name of the physician who ordered services on the RAPs and claims - i.e. the physician who signs the plan of care.
  4. The edit will compare the physicians NPI and the first four letters of the last nameas they appear in PECOS.
  5.  Information such as middle initial, nicknames, credentials, or titles may be included on electronic claims as long as they do not appear in first or last name fields on the claims, and must never appear on paper claims.
  6. If the PECOS information differs from that in NPES or licensure files, agencies should verify and document that identity was confirmed but only use PECOS information on claims.
  7. Enrollment status should be verified upon referral - at the start of care - and on the date of all subsequent episodes.
  8. Retain documentation of verified PECOS enrollment. If you have a claim denied due to the Ordering/Referring provider edits, you must file an appeal. An adjustment cannot be submitted
  9. Check a physician’s enrollment status either:
  • Individually in the CMS Medicare Ordering Referring File download available here:


  • For multiple physician names, by importing the agency’s ordering physician list into the NAHC PECOS toolkit, which contains the latest CMS PECOS enrolled, and pending datasets.Note: a new file must be downloaded twice a week when CMS updates the Ordering Referring File.

NAHC has developed the NAHC PECOS Toolkit, which contains the latest PECOS dataset along with the latest PECOS Pending dataset available to NAHC as supplied by CMS. The toolkit allows NAHC members to check a physician’s existence in the PECOS database.

Please Note: A new file must be downloaded every time CMS updates the dataset.

Impact of Edits on Payment

In response to home health agencies’ questions about the dates of service and application of PECOS edits to claims, NAHC has learned from CMS that:

  • Edits are based on the “from” date on the claims
  • If the “from” date of a claim is prior to January 6, then it will not hit the denial edits and the episode will be paid in full.
  • Claims will always be paid in full if the ordering physician is enrolled in PECOS as if the “from” date of claims – i.e. the start of episode - even if the physician dis-enrolls prior to the end of the episode.  
  • RAPs are not subject to the edits and will continue to process as they do now. 

The effective date of enrollment in PECOS for physicians is determined by CMS by the later of the two following criteria:

  • The date the physician filed an enrollment application that was subsequently approved. For PECOS applications, this is the date that the contractor received an electronic version of the enrollment application and a signed certification statement submitted via paper or electronically.


  • The date the physician first began furnishing services at a new practice location.

Please click hereto view MLN Matters Article SE 1305 which provides more details on the PECOS edits.




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