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Testimonials

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. 

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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.

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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

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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 element...it’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

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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.

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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.

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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.

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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.

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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.

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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.

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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. 

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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.

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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.

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Frank E. Moss, former U.S. Senator

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

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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.

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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.

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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.

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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.

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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.

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Former President Bill Clinton

Home Care Medicaid Fraud Developments in Illinois, New York, Virginia, and Texas

January 28, 2014 10:17 AM

The National Council on Medicaid Home Care – a NAHC affiliate - reports on recent developments in home care Medicaid fraud and abuse, including: 1) convicted beneficiary fraud in Illinois; 2) a settlement of alleged home care company fraud in New York; and 3) convicted caregiver fraud in Virginia and Texas.

Illinois

As reported by the US Attorney’s Office for the Southern District of Illinois, on January 10, Valerie Johnson was sentenced to five years probation, ordered to pay $7,842.26 in restitution, and a special assessment of $100, for one count of Health Care Fraud.  Specifically, the defendant had submitted false and fraudulent bills for receiving personal assistant services via the Home Services Program.  While the services were supposed to be performed by her son, her son was residing approximately 225 miles away.

To see the press release, click here. To see an article about the case, click here. To see previous Council articles on Medicaid home care fraud in Illinois, and on Illinois’ Home Services program, click here, here, and here

New York

As reported in the Rochester Business Journal, on January 1, HCR Home Care (HCR) entered into a settlement agreement with the State of New York (the State) for Medicaid fraud charges by paying $2.5 million plus interest.  The State alleged in the settlement agreement that, from 2002 to 2006, HCR billed for “unallowable costs” including costs associated with company vehicles, country club dues for executive employees, interest on business loans, and marketing.  Additionally, the State alleged that HCR billed for home health aide services not rendered at one of its adult care facilities.  The State also alleged that HCR employed 23 uncertified home health care aides who billed around 6,500 hours of work. 

HCR was reportedly unaware that it had uncertified aides until the investigation began.  During the investigation, HCR stated it unknowingly submitted false timesheets for aides that had inflated their hours.  As part of the settlement, HCR agreed to not publically deny the facts alleged by the State in the agreement.

To see the full Rochester Business Journal article, click here. To see the full settlement agreement, click here.

Virginia

As reported by the US Attorney’s Office for the Western District of Virginia, on December 20, mother and son Sandra and Travis Bugg were sentenced to 36 months of probation and $5,472 in restitution for billing Medicaid for services not rendered.  Additionally, Travis Bugg will be excluded from billing Medicaid and Medicare for 5 years. They had previously pled guilty to making a materially false statement in writing involving a healthcare benefit program. 

On December 16, Tammy Allen pled guilty to health care fraud and making a materially false statement in writing involving a healthcare benefit program.  She admitted to fraudulently billing Medicaid for services not rendered for three home visits.  She faces a maximum 10-year prison sentence.

According to the US Attorney’s Office,                                  ​                         ​   

Sandra Bugg received eligibility to receive Medicaid services through the Medicaid Consumer Directed Program for the elderly and disabled, which allows the person who receives the care to hire their own personal care assistant, regardless of their qualification. As a result, Sandra Bugg hired her son, Travis Bugg, to serve as her personal care assistant. During this time, Tammy Allen, a registered nurse, was hired to act as a service facilitator to determine the number of hours of care a recipient is entitled to receive and to provide home visits for Sandra and Travis Bugg. Travis Bugg has admitted that between September 2011 and January 2012, he billed Medicaid for 88 days of work as his mother’s personal care assistant for which he did not work. Sandra Bugg has admitted to signing the time sheets showing her son working those 88 days when, in fact, she knew he had not been at her home those 88 days.

To see the press release, click here.

Texas

As reported by the US Attorney’s Office for the Southern District of Texas, on December 18, Debra Jean Velasquez and Sylvia Salinas Ramirez were sentenced to 51 and 41 months in prison, followed by two years each of supervised release, for wire fraud and conspiracy to commit wire fraud. 

Specifically, they conspired to defraud the Texas Medicaid program by falsely billing home health payments.  In September, the defendants had pled guilty to the charges. The total amount of the fraud was $155,127.72, and the defendants have agreed to pay that amount in restitution. 

From August 2009 through June 2010, the defendants, while employed by MRNG, Inc. doing business as Caring Touch Home Health (Caring Touch), falsely billed Texas Medicaid and two Medicaid funded managed care organizations (MCOs), Evercare of Texas LLC and Superior Health Plan, Inc. The defendants admitted to creating false and fraudulent time sheets for services never rendered by Caring Touch employees, and then fraudulently billing Medicaid and the MCOs for these services.The defendants billed approximately 562 of these by wire.

The defendants also admitted to creating false and fraudulent payroll records from the false and fraudulent time sheets, which they in turn submitted to payroll staff.  After the defendants received payroll checks, they fraudulently endorsed them and then cashed the checks for themselves. Neither Caring Touch nor the employees whose names were used on the time sheets and checks were implicated in the case.

To see the press release, click here.

Analysis

As Medicaid home care spending increases, anti-fraud efforts have focused more resources in a variety of “risk areas.” Recent prosecutions have highlighted serious program integrity weaknesses in both consumer-directed and agency models of home care. These prosecutions include many cases of billing for services never rendered and include allegations of beneficiary complicity as well. Often family members are involved.

It appears that the concerns with billing for services never rendered are especially acute in consumer-directed care programs. While these types of home care delivery models provide an important level of control to the client, they also run a higher risk of fraud, particularly where the caregivers are from the client’s family. These risks may provide home care agencies with an opportunity to supply some program integrity oversight along with caregiver training and supervision. At the same time, agencies should guard against Medicaid programs promulgating new regulatory measures that affect agency-model and consumer directed care equally.

It can be anticipated that investigations and prosecutions will continue for some time to come as states share information and strategies. Home care companies doing business with Medicaid would be well served if they redouble their internal program integrity efforts. Home care companies should use service attendance and documentation systems that provide reliable ways to validate any self-submitted information. Further, agencies should engage in at least spot checks with recipients to ensure actual delivery of care and continued eligibility for services. In many circumstances, Medicaid will attempt to recover any fraudulent payments from the agency even if the agency is not implicated in the fraud. In addition, the fraud of an employee can create a risk that the employer is also charged with fraud.  Home care companies should anticipate future regulatory and legislative action to stem the growing instances of home care fraud, as is seemingly on the horizon in Illinois. Individual caregiver fraud has also led to a movement to require background checks for caregivers.

Increasing regulation and legislation is a typical reaction to health care fraud, as regulators believe that they can solve all problems through another layer of rules. To the extent that there is a need for reforms, it is important to craft sound legislation that protects patients while putting the fewest restrictions on honest caregivers.  Stakeholders should actively engage in the process of regulatory and legislative reform through the forums or state advocacy.  Home care companies are encouraged to keep abreast of program integrity initiatives in their states, and to contact the Council with any questions or concerns.

 

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