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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

NAHC/HAA Submit Comments on FY2015 Proposed Hospice Payment Rule

July 9, 2014 12:52 PM

The National Association for Home Care & Hospice’s (NAHC) Hospice Association of America (HAA) has submitted detailed comments to the Centers for Medicare & Medicaid Services (CMS) in response to the May 2 release of a proposed rule to govern the FY 2015 Hospice Wage Index and Payment Rate Update; Hospice Quality Reporting Requirements and Process and Appeals for Part D Payment for Drugs for Beneficiaries Enrolled in Hospice.  The NAHC/HAA comments, focusing on several areas of particular interest and concern, are summarized below. 

The full text of the NAHC/HAA letter to CMS’ Administrator Marilyn Tavenner is available HERE.

CMS’ request for comments on definitions of “terminal illness” and “related conditions” that could be considered in future rulemaking.  NAHC/HAA expressed concern over CMS’ interest in establishing a new definition for “terminal illness” and for codifying a definition for “related conditions”.  While CMS’ proposed definition of “terminal illness” is a thoughtful one, NAHC/HAA were unclear as to whether a new definition is warranted at this time.  NAHC/HAA cautioned that in hospice care, each patient must be viewed individually, with full consideration given to the individual patient’s medical and social history. NAHC/HAA also raised concerns that movement toward any definition (whether for “terminal illness” or “related conditions”) that does not maintain a hospice patient’s right to care outside of the hospice benefit for conditions unrelated to the terminal condition would be a dereliction of duty on the part of CMS.  NAHC/HAA took explicit issue with inclusion of “[conditions that] interact or potentially interact with terminal illness’ and/or which are contributory to the symptom burden of the terminally ill individual” as it is believed that inclusion of these phrases would imply that “related conditions” would, by definition, result in ALL of a patient’s conditions as being part of a hospice’s responsibility. 

CMS’ proposed requirement that hospices calculate their own caps within five months of the close of the cap year and remit any overpayment directly to the Medicare Administrative Contractor (MAC) serving the hospice’s jurisdiction.  NAHC/HAA suggested that five months is insufficient time to ensure that the cap calculations made by hospice providers will be accurate.  Further, NAHC/HAA expressed concern over many hospices’ level of comfort with accessing the proper information from the Provider Statistical & Reimbursement (PS&R) system, and the great potential for inaccuracies.  NAHC/HAA recommended that CMS extend the time frame to somewhere between eight to 12 months after the close of the cap year and consider having the MACs calculate the caps (since they have ready access to the data).  CMS must ensure that providers have full information from the MACs related to establishing extended repayment schedules, and,(if hospices will be responsible for calculating the caps),  they should be provided explicit instructions for accessing the proper reports in the PS&R system to ensure proper and accurate calculation of their caps.

CMS’ proposed limit of three days following the effective day of election (and three days following termination or revocation) for filing of the Notice of Election (NOE) or Notice of Termination/Revocation (NOTR).  While NAHC/HAA is supportive of CMS’ intent in imposing these time limits, there are overriding concerns that CMS has not included any penalty for failure to file the NOTR, which could lead to difficulties in meeting the NOE filing time frame for any subsequent hospice provider that takes a patient onto care.  NAHC/HAA also believe three days following the election/termination/revocation may be insufficient given other administrative requirements (such as establishment of the principal diagnosis to include on the NOE).  NAHC/HAA have suggested 10 days as the deadline for filing of the NOE, and five days for filing of the NOTR.  NAHC/HAA have also cautioned that if CMS moves forward with this requirement it must ensure that other technical issues related to sequential billing and delays in filing of a final claim (due to new drug reporting requirements) do not create technical difficulties with processing of the NOE/NOTR and future patient benefits.

CMS’ proposed addition of the attending physician to the election form.  NAHC/HAA are very supportive of this change but caution that CMS must provide clear guidance to hospices to ensure that they are meeting CMS’ intent relative to any formal changes made to the attending physician designation.  NAHC/HAA also encourage CMS to provide physician education to ensure that physicians are not improperly billing Medicare as a hospice patient’s attending physician when not so designated with and by the hospice.

CMS’ solicitation of comments on coordination of benefits and appeals for hospice patients on Part D.  NAHC/HAA continue to have serious concerns about imposition of a prior authorization process on terminally ill patients and commented on continuing problems that are arising as the result of CMS’ March 10 guidance to Part D plans.  NAHC/HAA conveyed that any process that does not formally include all relevant parties and that does not guarantee timely access to medications for hospice patients will continue to be fraught with problems.  NAHC/HAA understands, however, that if CMS should continue the PA process, codification of elements of the process is essential to ensure that the requirements on plans can be adequately enforced, and made several recommendations relative to specific elements of the coordination process that were included in the March 10 guidance.

Diagnosis Codes on hospice claims.  As part of the proposed rule CMS reminds hospice providers that beginning Oct. 1, 2014, hospice claims will be returned to provider (RTPd) if they do not include an appropriately selected principal diagnosis.  NAHC/HAA recommended that CMS provide a comprehensive list of codes that will result in a claim being RTPd, and that the list be made available as soon as possible.

As mentioned previously, this is a brief summary of the NAHC/HAA comments; we encourage those interested in greater detail to refer to the link provided at the start of this article.




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