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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 a Half Dozen States

March 5, 2014 12:46 PM

The National Council for Medicaid Home Care – a NAHC Affiliate - recently reported on developments in home care Medicaid fraud and abuse, including: 1) recent arrests in Washington, DC; 2) convicted caregiver fraud and record Medicaid recoveries in New York; 3) alleged caregiver fraud in Arkansas; 4) convicted caregiver fraud in Wisconsin; 5) convicted beneficiary fraud in Kansas; and 6) alleged caregiver fraud in Michigan.

Below is a synopsis of these developments:

Washington, District of Columbia

In what the FBI is calling “the largest health care fraud takedown in the history of the District of Columbia,” on February 20, federal authorities arrested and charged 25 people with Medicaid fraud. One defendant, an owner of three home care agencies and who was barred from federal health care programs following revocation of her nursing license, allegedly defrauded the Maryland and DC Medicaid programs out of over $75 million. Charges for this defendant include money laundering.

For details on the case, including recently unsealed charges, see the FBI press release here<​/a>.

New York

As reported by the New York State Office of the Attorney General, on February 6, personal care assistant Stephanie Benodin, 26, pled guilty to attempting to steal over $10,000 from her 88-year old client. Benodin’s plea deal includes a two-month prison sentence, three years probation, and a three year exclusion “from working with incompetent, elderly, infirm or disabled persons.”

Benodin worked for The Tuttle Center, a retirement community in Port Washington, N.Y.  According to the Attorney General’s office, “She admitted that she took the victim’s check out of her checkbook, signed the victim’s name without permission or authority, made the check payable to Benodin’s mother for $10,000 and deposited it into her mother’s bank account. The check was returned for insufficient funds.”

Benodin pled guilty to Fourth Degree Attempted Grand Larceny.  Sentencing is scheduled for April 9 in Nassau County District Court.

To see the press release, click here.

On February 3, Gov. Andrew Cuomo (D-NY) announced that New York’s Office of Medicaid Inspector General (OMIG) recovered the largest amount in Medicaid dollars in the history of the office with $851 million in 2013. One of the “notable actions” listed in the press release was going after home health payments that should have been paid for by Medicare.  The office found $496 million in this type of inappropriate Medicaid billings (both federal and state share) in 2013, of which the office recovered $211 million for New York, accounting for approximately 25% of the state’s total Medicaid recovery for that year.

To see the press release, click here.

Arkansas

As reported by the Arkansas Attorney General’s office, on January 30, attendant-care provider Sondra Torres, 34, was arrested for fraudulently billing Medicaid.  She allegedly billed for services not rendered during the period July 14, 2013 to July 27, 2013.

To see the press release, click here.

As reported by the Arkansas Attorney General’s office, on January 27, attendant-care provider Amanda Fielder, 28, was arrested on one count of class C felony Medicaid fraud.  She allegedly billed for services not rendered totaling $2,216.16 during Aug. 29, 2013 to Oct. 5, 2013.  While billing for Medicaid, she allegedly lived 52 miles away with no transportation to access the beneficiary.

To see the press release, click here.

Wisconsin

As reported by the Wisconsin Office of the Attorney General, on January 28 in Walworth County Circuit Court, Lara Skrzypczynski was sentenced to three years probation with a condition of a 90-day jail sentence, and ordered to pay $45,786.87 in restitution, for Medicaid fraud and falsification of patient health care records.  On December 5, 2013, she had pled guilty to felony Medicaid fraud (one count) and misdemeanor falsification of patient health care records (one count).

As the Attorney General reports:

According to the amended criminal complaint, Skrzypczysnki submitted more than 150 fraudulent claims seeking payment for private duty nursing services that she did not deliver to two adult male patients with Duchenne Muscular Dystrophy in Genoa City, Wisconsin.  When audited by the Wisconsin Medicaid program, Skrzypczysnki falsified her patients’ medical records to make it appear as though she had provided the services that she billed for, and was paid for by the State. [Wisconsin Office of the Attorney General press release] 

To see the press release, click here.

Kansas

As reported by the Kansas Attorney General’s office, on January 16, Teresa McConnell, 53, was sentenced to 60 days of house arrest and ordered to pay $50,758.41 in restitution to Kansas’ Medicaid program, after she pled no contest to 15 felony charges of Medicaid fraud.   McConnell had allegedly submitted false time sheets for home health care services as a beneficiary, while the supposed care providers were in prison and she was in the hospital.

To see the press release, click here.

Michigan

As reported by the Michigan Attorney General’s office, on January 10, felony charges were brought against 11 defendants for alleged fraudulent billing of the Medicaid Independent Living Services Program (Home Help Services Program).  This Program is a cost-saving rebalancing program helping individuals to receive care at home rather than at an institution by assisting them with personal care and general household activities.  This program is a consumer-directed program in which beneficiaries can choose their own caregiver, like a friend or family member, or have one given to them by Medicaid.

The defendants, all between the ages 35-65, allegedly defrauded Medicaid for a total amount exceeding $60,000.  Many of the defendants received checks for services not rendered after their clients - often family members - died.  Every defendant has been charged with one count of felony Medicaid fraud - concealing or failing to disclose a material fact in order to obtain a Medicaid benefit.  If convicted, each defendant faces four years in prison and a $50,000 fine.

As of the press release, eight of the eleven defendants had been arraigned and had pre-exam conference and preliminary exams scheduled later in January, and arraignments were being worked out for the remaining defendants.

To see the press release, click here.

Conclusion

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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