Skip to Main Content
National Association for Home Care & Hospice
Twitter Facebook Pintrest


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

NAHC Receives Clarification on the EHR Exception and Safe Harbor Provisions for Health IT

January 17, 2014 10:23 AM

The National Association for Home Care & Hospice (NAHC) recently received clarification on the EHR Exception and Safe Harbor provisions.  The language in the Office of the Inspector General’s (OIG) final rule for the Anti-Kickback safe harbor is nearly unchanged from the previous version.

Most significantly, CMS decided not to take any action with respect to independent home health agencies. CMS did indicate, however, that they will continue to monitor the use of the exception and may take action to exclude additional stakeholders from the exception prior to the new December 31, 2021 expiration date.

Below is a summary of CMS’ final rule for the anti-kickback safe harbor provisions as they pertain to home health agencies:

Effective Date

  • The final rule waives the 30-day delay in effective date for § 411.357(w)(13), “which relieves a restriction on donations of electronic health records items and services.” The final rule extends the expiration of the existing exception from December 31, 2013 to December 31, 2021. 
  • Other provisions of the final rule are effective 90 days after the date of publication in the Federal Register.


  • The final rule extends the expiration of the existing exception from December 31, 2013 to December 31, 2021.
  • CMS stated in the Preamble: “We believe that this expiration date will support earlier adoption of EHRs technology, provide a timeframe that aligns with the financial incentives for EHRs adoption currently offered by the Federal government, and safeguard against foreseeable future fraud risks, while still providing adequate time for donors and physician recipients tomaximize the financial incentives currently offered by the Federal government.”

Protected Donors

  • The final rule excludes laboratory companies from the types of entities that may donate EHRs items and services. CMS did not take any new action with respect to independent home health agencies or donors perceived to be at “high-risk” for fraud.
    • CMS stated that they generally agreed with comments stating that, “the depth, breadth, and frequency of communications between home health agencies and other direct care providers makes the use of interoperable EHR technology essential to improving clinical outcomes and financial efficiencies.”
  • CMS stated in the Preamble: “We will continue to monitor and may, prior to the end of 2021, reconsider in a future rulemaking the risk of program or patient abuse relating to the use of the exception by other donors or categories of donors.”


  • The final rule updates the provision under which EHR software is deemed interoperable, and removes from the exception the requirements related to electronic prescribing capability.
  • CMS revised § 411.357(w)(2) to state that “software is deemed to be interoperable if, on the date that it is provided to the physician, it has been certified by a certifying body authorized by the National Coordinator for Health Information Technology to an edition of the electronic health record certification criteria identified in the then-applicable 45 CFR part 170.”
    • The final language removes reference to “certified EHR technology” because that definition applies only to the Medicare and Medicaid EHR Incentive Programs. CMS recognized that ONC also has authority to adopt certification criteria for health IT that “may not be referenced in the definition of ‘certified EHR technology’ because it is not related to the EHR Incentive Programs.
    • “Then-applicable” was added to the final language to reflect ONC’s decision to “retire outdated editions of certification criteria by removing them from the regulatory text in 45 CFR part 170.”

Data Lock-in

  • The final rule clarifies the requirement at § 411.357(w)(3) prohibiting any action that limits or restricts the use, compatibility, or interoperability of donated items or services. However, CMS states in the Preamble that it was “not persuaded to adopt significant new requirements or modifications to the exception to address the issue of data or referral lock-in.”
  • In the Preamble, CMS stated: “We have always believed and continue to believe that an action taken by a donor (or on behalf of the donor) that limits the use, compatibility, or interoperability of donated items or services with any other health information technology may impede the free exchange of data and limit the ability of providers and suppliers to coordinate care, which is inconsistent with the goals of the exception.”
    • To further clarify its position, CMS modified 42 CFR 411.357(w)(3) by adding, by way of example and without limitation, a non-exhaustive list of some of the forms of technologies that it believes are included within the meaning of the existing regulatory language.” CMS indicates in the Preamble that this includes “health information technology applications, products, or services.”

For a CMS Fact Sheet on the safe harbor provisions, please click here.




©  National Association for Home Care & Hospice. All Rights Reserved.