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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 Florida, Massachusetts, and Illinois

April 7, 2014 03:40 PM

The National Council on Medicaid Home Care – a NAHC affiliate - reports on recent developments in home care Medicaid fraud and abuse, including: 1) alleged caregiver fraud in Florida; 2) alleged and convicted personal care services fraud in Massachusetts; and 3) convicted personal care services fraud in Illinois. 

Florida

As reported by the Florida Attorney General’s office, on April 1, Julia Privis and Alla Privis were arrested for allegedly billing over $18,000 of Medicaid services not rendered.  The services included bathing and skin care, range of motion exercises, and urine tests.  The Privises were employees of Ultimate Home Care, Inc.—one was a home health agency administrator and the other was a home health aide.

Julia Privis has been charged with Medicaid Fraud (one count, second-degree felony), and Grand Theft (two counts, third-degree felonies).  Her maximum sentence if convicted is 25 years in prison.  Alla Privis has been charged with Medicaid fraud (one count, third-degree felony), and Grand Theft (one count, third-degree felony).  She faces a maximum prison sentence of 10 years.

To see the press release, click here.

Also as reported by the Florida Attorney General’s office, on March 27, Melinda Warren surrendered to authorities for billing over $25,000 in unauthorized services to Florida’s Agency for Persons with Disabilities (APD) Consumer Direct Care Plus program.  Warren knowingly hired someone unauthorized to provide these services, and then billed the program as if she had provided the services herself.

Warren is charged with Grand Theft, Medicaid Fraud, and Employing a Provider without a Background Screening.  Warren faces a 30 year prison sentence as well as over $120,000 in fines if convicted.

To see the press release, click here.

Massachusetts

As reported by the Massachusetts Attorney General’s office, on March 31, James Lynch pled guilty to fraudulently billing approximately $63,000 to Medicaid for services not rendered.  As a personal care attendant, Lynch billed Medicaid for services conducted while he was working at another job.  Allegedly, the beneficiary worked with Lynch to inflate his timesheets; in return, the beneficiary allegedly received half of these paid claims.

Holly-Beth Ropel, who was indicted with Lynch on the same charges, is scheduled for a pre-trial conference on April 17.  These two defendants were two of out of 32 indicted personal care attendants and surrogates resulting from investigations from the Massachusetts Attorney General’s office in February 2013.  For details of the indictments and later arraignments, click hereand here.

To see the March 31 press release, click here.

As reported by the Worcester Telegram & Gazette, on March 20, Beverly Cousin and her son Rashad Cousin were indicted for allegedly fraudulent billing over $96,000 in personal care attendant services.  Beverly Cousin was charged with making false Medicaid claims (5 counts) and larceny of more than $250 by false pretenses (5 counts).  Rashad Cousin was charged with three counts of each of the same charges.  Ms. Cousin, a personal care attendant services beneficiary, allegedly falsified time sheets that reflected services provided by Rashad while he was living outside of Massachusetts.  Ms. Cousin also allegedly submitted timesheets for another son, who was in prison at the time, and other timesheets for when she was hospitalized.

To see the news article, click here.

 Illinois

As reported by the United States Attorney’s Office for the Southern District of Illinois, on March 20, Tisa Vaughn, was found guilty of engaging in a scheme to commit health care fraud.  Specifically, she billed Illinois’ Home Services Program for personal assistant services not rendered.  These services were billed as provided to her sister while her sister was at the hospital, or when Ms. Vaughn was otherwise not caring for her sister.

Sentencing is scheduled for July 11.  Ms. Vaughn faces a maximum sentence of 10 years in prison, 3 years supervised release, and a $250,000 fine.

To see the press release, click here.  To see Ms. Vaughn’s July 2013 indictment, click here.

Analysis

Stephen R. Wigginton, United States Attorney for the Southern District of Illinois, stated: “Nationwide, the biggest fraud problem in the Medicaid program has been these personal assistant programs which represent the number one fraud complaint to state Medicaid fraud units.” It appears that the concerns with billing for services never rendered are especially acute in consumer-directed care programs, as is the case in the Illinois and Massachusetts personal care programs, and Florida’s Consumer Direct Care Plus program, above. As Wigginton further stated:

Especially vulnerable to fraud are programs, such as the one implemented in Illinois, that allows the Medicaid recipient to control the selection and payment of personal care attendants. In most cases, the personal care assistant is a relative or family friend, who often is a ghost employee. In a typical fraud scenario, the scam payments made by the State of Illinois are split between the Medicaid recipient and the ghost employee. [Illinois press release].

While consumer-directed care programs 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.

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. 

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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