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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 Lawsuit Challenges CMS Rule on Face-to-Face Encounters for Home Health Services

June 6, 2014 02:04 PM

The National Association for Home Care & Hospice (NAHC) filed a lawsuit on June 5, 2014, challenging the administration of the physician face-to-face encounter documentation requirements developed and administered by the Centers for Medicare and Medicaid Services.

The NAHC Board of Directors approved the filing of the lawsuit because the regulations have caused a dramatic upsurge in the retroactive denials of patient claims for payment under Medicare.

These denials are based on the allegations not that physicians had failed to see patients or certify them for payment but rather because physicians did not supply sufficient paperwork, i.e. a narrative and explanation for their judgment that patients are homebound or in need of skilled nursing or physical therapy.

“This new regulation, which had the goal of improving the quality of care, has had the opposite effect. It has created a crisis and is denying the infirm elderly the care that they need which is why we had no choice but to take our case to Federal Court,” said Andrea Devoti, Chairman of the NAHC Board of Directors.

The lawsuit was filed in the U.S. district Court in Washington, D.C. NAHC claims that CMS violated Medicare law in three respects:

  1. CMS violated the law that authorized the physician face-to-face encounter by requiring that the physician provide a narrative that explains why a patient is home bound and in need of skilled care. The authorizing statute requires only that the physician document that the encounter occurred.
  2. To the extent that CMS can require the physician narratives, CMS violated The U.S. Constitution and the Medicare Act by failing to provide adequate, reasonable, and clear guidance on the standards for compliance. In other words, CMS must explain what constitutes "sufficient" narratives.
  3. CMS further violated Medicare law by allowing its contractors to deny payment retroactively based solely on the sufficiency of the physician narratives without reviewing the entire patient record to determine whether the patient is, in fact, home bound and in need of skilled care.

“We filed the suit reluctantly only after we tried to make CMS understand that their regulation was redundant, amounted to bureaucratic overkill, created disincentives for physicians to order home care services, and was leading to the loss of care by thousands of Medicare patients who are so sick that they cannot leave home without assistance,” said Val J. Halamandaris, President of NAHC.

NAHC had sought a suspension of retroactive reviews of the physician narratives as an interim action by CMS until such time as CMS revised its rules. CMS informed NAHC that it plans to issue possible revisions in an upcoming proposed rule scheduled for release in late June or early July. Given that home health agencies are experiencing an endless series of claim denials based on the sufficiency of the physician narratives, NAHC determined that is was not in the best interest of the home health community that it take a chance on the possibility of a proposed rule that might provide some undefined change in the requirements which would take effect no earlier than late October when the final rule changes would be issued.

NAHC expects to pursue a preliminary injunction designed to expedite the court's review of the claims presented. Following that effort, NAHC will ask the court for summary judgment on the claim that CMS does not have authorization to require the physician narratives. A trial on the other claims may be needed since there may be disputed factual issues.

While the lawsuit is pending, NAHC will continue to work with members of Congress in hopes of a legislative remedy. Currently, NAHC and its affiliated Forum of State Associations are engaged in an effort to secure relief through the appropriations process underway in the House of Representatives. NAHC has also extended an offer to CMS to reopen the settlement negotiations in hopes of avoiding protracted litigation. NAHC believes that CMS recognizes the need for corrective action on the face-to-face rule.

The lawsuit is being prosecuted by Bill Dombi, NAHC’s Vice President for Law.

Mr. Dombi has a long history of successful litigation against the U.S. Government and health insurance companies on behalf of the home care industry.

NAHC is asking all Medicare patients and provider organizations to join in supporting this litigation.

To access the Compliant filed in federal court, go to this link. Ongoing reports on the progress of the litigation will be published in NAHC Report.





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