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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 New York, Rhode Island, and Louisiana

August 29, 2014 05:22 PM

Home Care Medicaid Fraud Developments in New York, Rhode Island, and Louisiana

The National Council on Medicaid Home Care – a NAHC affiliate - reports on recent developments in home care Medicaid fraud and abuse, including: 1) alleged independent caregiver fraud in New York; 2) alleged home care agency fraud in Rhode Island; and 3) alleged personal care owner/operator, employee and beneficiary fraud in Louisiana.

New York

On August 20, the New York Attorney General’s Office charged Alicia Santiago for billing Medicaid for services not rendered. The charges allege that Ms. Santiago submitted fraudulent time sheets totaling almost $4,000 to Innovative Care, LLC., who then in turn billed Medicaid. Ms. Santiago was paid approximately $1,800 for these alleged services.

The charges further allege that while Ms. Santiago’s time sheets from November 2012 to April 2013 indicate that she was providing 186 hours of night shifts for home care services for a family member, in fact during these times she was working as a certified nurse aide (CNA) at a nursing home.

Ms. Santiago was arraigned on Grand Larceny in the Third Degree (one count), and Grand Larceny in the Fourth Degree (one count). She faces a maximum prison sentence of 2 1/3 to 7 years in prison. The presiding judge has adjourned the case until September 10, 2014.

For details, see the NY AG press release, here.

Rhode Island

According to news stories published in late July, St. Jude Home Care is no longer providing home care services following an investigation by the Executive Office of Health and Human Services of Rhode Island (EOHHS). EOHHS alleges that St. Jude’s had fraudulently billed a total of $250,000 in both Medicare and Medicaid payments.

EOHHS relayed a suspicion it had of the company regarding overbilling and suspect paperwork to federal authorities, who have since withdrawn the company’s ability to bill Medicare and Medicaid. The Centers for Medicare & Medicaid Services (CMS) had issued a notice to St. Jude’s in early July alleging that the company had “failed to maintain compliance with Medicare requirements,” and ordered a cessation of payments for skilled nursing services after July 19, expanding to all services after August 19. While the notice did not mention specifics, it triggered a similar cessation of Medicaid payments.

Owner Priscilla Pascale maintains her innocence, stating that the government’s removal of her ability to bill Medicare and Medicaid stems from “trumped-up charges” resulting from a “vendetta” that has caused the unemployment of 300 people and the displacement of 1,000 beneficiaries.

St. Jude’s is currently under criminal investigation by the Rhode Island Attorney General’s Medicaid Fraud Control Unit.

To see the full news story, click herehere and here.

Louisiana

In early June, seven owners and employees of Majestic Home Care Services, LLC, and one Medicaid beneficiary, were arrested for Medicaid personal care services fraud. Co-owners Latesha Taylor and her mother, Martha Taylor, billed Medicaid for services not rendered. Latesha also submitted a letter to the Department of Health and Hospitals fraudulently stating that Majestic had a $50,000 line of credit.

Majestic hired supervisors and direct service workers, some of whom were members of the Taylor family, who then conspired with Medicaid beneficiaries to fraudulently bill Medicaid. Under these arrangements, beneficiaries would permit the direct service workers to submit paperwork for services not rendered, and the beneficiaries would sign the timesheets. In exchange, the direct service workers would give the beneficiaries up to half the reimbursement through either bank deposits or cash payments. In one such scheme, Louisiana Medicaid paid over $100,000 in the span of three years.

Martha Taylor’s sons, Ricky Taylor and Byron Collins, Jr., provided fraudulent high school diplomas to work for Majestic. Latesha Taylor is charged with knowingly facilitating this. Ricky Taylor and Byron Collins, Jr. are also charged with fraudulently billing Medicaid while in prison and in custody on separate matters.

To see the full list of all plaintiffs and charges, click here.

Analysis

As Medicaid home care spending increases, anti-fraud efforts have focused more resources in a variety of “risk areas.” Recent prosecutions have highlighted serious program integrity weaknesses in both consumer-directed and agency models of home care. These prosecutions include many cases of billing for services never rendered and include allegations of beneficiary complicity as well. Often family members are involved. These risks may provide home care agencies with an opportunity to supply some program integrity oversight along with caregiver training and supervision.

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. Agencies should guard against Medicaid programs promulgating new regulatory measures that affect agency-model and consumer directed care equally. 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.

NAHC and the Council have always had a zero-tolerance policy for those who would look to divert funds from Medicare or Medicaid for their own personal gain. We have taken a very focused and aggressive approach to fraud concerns in-home health care. “The fraud committed by the very few, hurts all of home care and the patients we serve. The industry must be a leader in health care compliance and program integrity. NAHC has made great progress in that regard and will continue to set the gold standard for all of health care,” stated NAHC president, Val J. Halamandaris.

 

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