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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

Heath 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

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

MedPAC Urges Suspension of Part D Prior Authorization for Hospice Patients

Makes Additional Recommendations in Comments on FY2015 Hospice Payment Rule
June 27, 2014 01:20 PM

The Medicare Payment Advisory Commission (MedPAC) recently issued its comments on the Centers for Medicare & Medicaid Services’ (CMS) hospice proposed payment rule for fiscal year (FY) 2015.  Among its recommendations is the suspension of the current requirement that Part D plans impose a beneficiary-level prior authorization (PA) process on coverage of drugs for patients enrolled in the Medicare hospice benefit. 

While MedPAC supports the notion of mechanisms such as PA to ensure proper payment, the letter points to concerns about the added burdens on beneficiaries and their family members as justification for their recommendation, and suggests that CMS issue a regulatory proposal to establish an improved PA process as soon as possible.  MedPAC believes that such a process should require coordination between hospices and Part D plans at the outset of care and that exceptions (or unrelated drugs) should be entered into the system at the outset.  MedPAC indicates the goal should be to make the process as seamless as possible for the beneficiary and family. The National Association for Home Care & Hospice (NAHC) and its affiliated Hospice Association of America (HAA) will express similar concerns in its comments to CMS.

MedPAC also addressed several other issues in its comments, including:

  • Payment Reform
  • Program Integrity
  • Filing timeframes for notices of election and termination/revocation
  • Hospice aggregate cap

Relative to payment reform, MedPAC expressed its dissatisfaction that CMS has not proposed at least an initial step related to payment reform for the coming payment year.  MedPAC continues to have concerns that the existing payment policy encourages some hospice providers to take patients onto service who they believe will have extended stays in order that the hospice reaps financial benefit. MedPAC’s comment letter also applauds CMS’ intent, as expressed in the proposed payment regulation, to address patterns of care gleaned from data gathered in pursuit of payment reform that raise program integrity concerns.  MedPAC also makes specific recommendations as to how CMS might more effectively pursue these program integrity concerns given resource limitations.

MedPAC expresses support for CMS’ proposed timeframes for filing of notices of election (NOE) and notices of termination or revocation (NOTR), and has indicated that it believes the planned three days to be sufficient for hospices to comply. 

MedPAC does express concern relative to CMS’ proposed requirement that hospices calculate their own caps within five months of the close of the cap year.  MedPAC believes early calculation of caps could be subject to gaming and would not likely represent the full liability for many hospices that exceed the cap.  As an alternative, MedPAC is recommending that CMS have the Medicare Administrative Contractors (MACs) perform an initial cap calculation and establish processes for reviewing cap calculations at a later date to ensure that full liability is addressed. 

NAHC/HAA will also, as part of their comments, express concerns about CMS’ proposal relative to calculation of the cap.

MedPAC’s full comment letter is available here.




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