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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

Hospices Receive Notices from Collection Agencies for Analgesics

May 27, 2014 09:05 AM

The Hospice Association of America (HAA), a NAHC affiliate, has learned that many hospices have received letters from PRS, a debt collection company, requesting payment for pain medications that were paid under Medicare Part D that should have been covered under the Medicare Part A hospice benefit.  The claims are for 2011 and 2012 payment.  

All letters we have seen are for claims paid by United Healthcare Insurance Company or an affiliate under the Medicare Part D program. The letter states the hospice has 30 days to dispute the debt.  If the hospice does not dispute it, PSR will consider it a valid debt.  Because this request is not directly from CMS there is not an appeals process, just the dispute option.

HAA has been in touch with PRS and has gotten additional information.  HAA continues to communicate with PRS, and has also reached out to other appropriate parties.  Further information will be shared as it is learned.

Here is what HAA has learned thus far:

1.  Medications are not listed on the request letter, only Rx number.  PRS has told us they cannot put the medication name in a letter due to privacy requirements; however, they are working on developing a speadsheet that contains this information.  That spreadsheet would be specific to each hospice and could be e-mailed to the hospice in a secure format.  If the hospice is willing to receive the information this way PRS will send it.  We do not have an anticipated completion date for these spreadsheets.

2.  The total dollar amount listed in the body of the letter does not match the total computed when adding the dollar amounts listed with the Rx numbers.  PRS is looking into this but could not explain that at this time.

3.  The letter states that the hospice has 30 days from receipt of the letter (not the date of the letter) to file a dispute.  Some hospices have been told that by filing a dispute they will not receive additional information.  As we understand it from PRS -  PRS will notify Optum Hospice Rx, which is PRS' customer, of the dispute and Optum Hospice Rx will decide the future course of action. We would like to have this information confirmed in writing from PRS but we do not have that at this time.

4.  Hospices are reporting that they have been able to cross reference the Rx number and dollar amounts with invoices to figure out the exact medication.. Upon doing so they realize that the hospice paid the pharmacy for the medication or told the pharmacy to bill them and the pharmacy did not, the medication is unrelated or unreasonable/unnecessary, and some have found that the medications are for patients who were not on service for the date listed.  These would all be reasons to file a dispute.

5.  PRS has made it clear to us that they are willing to work with providers on payment plans.  It sounds as if they are willing to work with hospices on the issues identified and resolution.

HAA is suggesting that hospices review their records to determine if the medication(s) should be covered under the Medicare hospice benefit.  If so, the hospice should pay the debt.  If not, the hospice should dispute the debt.

Providers may find the following Q&A from the Part D Q&A document on the hospice center website helpful:

Q.6 – Are all the drugs in the four categories identified in the 2014 Call Letter considered related and, therefore, covered  under the hospice benefit?  Are all maintenance drugs considered unrelated and, therefore, covered under Part D?

A.6 – Any drug whether it is a maintenance drug or in the four categories of [sic] identified in the 2014 Call Letter (including analgesics, antiemetics, laxatives, or antianxiety drugs) may be unrelated to the terminal illness and/or related conditions and, therefore, coverable under Part D.  As a result, coverage determinations must be made on a case-by-case basis for each drug.

The Q & A are available now on the hospice center website here.

As a reminder, HAA continues to collect stories on the impact of the Part D PA process on beneficiaries and hospices for advocacy efforts.  Please see information below on how to submit your stories.

STORIES ARE NEEDED

NAHC and others will continue to fight the Part D PA policy.  In order to do so, hospice providers must submit stories that illustrate the serious issues that are arising for patients, family members, and hospices as the result of CMS’ imposition of the PA process.

In an effort to simplify submission of stories, NAHC has developed a brief online survey tool - comprised of seven questions - is located here.   The survey is intended to be used by hospices to submit descriptions of incidents where the PA policy has created problems.  The survey is open to all hospices, regardless of membership.  Participation is very much appreciated and will help with efforts to educate The White House, CMS, and Congress on the many negative consequences arising from imposition of the Part D prior authorization requirement for hospice patients.

 

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