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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

HHS Holds Forum on Medicare Appeals Backlog

October 30, 2014 10:13 AM

The Office of Medicare Hearings and Appeals (OMHA) at the US Department of Health and Human Services held its second forum to review the status of its efforts to reduce the huge backlog of pending appeals before Administrative Law Judges (ALJ) that has crippled the system. In late December 2013, OMHA revealed that it had suspended the assignment of cases to ALJs because of the mounting backlog. At that time over 600,000 appeals were pending assignments to ALJs and OMHA indicated that the suspension on case assignments would last at least two years. The status report at today’s forum painted an even worse picture despite incredible efforts by OMHA to add resources and reach new heights of efficiency.

Presently, the average processing time following assignment of an appeal to an ALJ is 514 days in contrast to the 90-day requirement under Medicare law. That does not show a full picture, as it does not include the wait time prior to case assignment - a tenure that is expected to exceed two years.

 Additionally, the case backlog now exceeds 900,000. With each ALJ team expected to clear 1,000 cases annually, there is no way that the backlog can be significantly reduced without major new resources, alternative resolution processes, or a dramatic change in the volume of claim denials entering the system every week. OMHA recently added seven new ALJ teams in a new office in Kansas City. That office has a proposed budget of 18 teams in the FY 2015 budget of the President. At best, increasing the ALJs by another 11 puts nothing more than a tiny dent in the ever-increasing backlog.

OMHA is also pursuing a number of initiatives to improve efficiencies such as increasing electronic appeal processing. It is clear that OMHA is do what it can within its limited resources to address the surge in appeals caused by increased claim reviews by MACs, PSC/ZPICs and RACs. However, at nearly 14,000 new ALJ appeals each week, those efforts cannot meet the demand.

One promising development is the recently unveiled administrative settlement process instituted by the Centers for Medicare and Medicaid Services (CMS) that currently is limited to hospital appeals. CMS focused that process on hospitals because that sector’s appeals made up the majority of Part A cases in the system. The settlement design offers the opportunity for a hospital to take 68 cents on the dollar of the amount in controversy if it agrees to drop its appeals. An OMHA official indicated that an estimated 50% of hospital appeals before ALJs may be resolved through this process.

While the impact of hospitals settling their appeals will have a material impact on the ALJ backlog, it will fall far short of what is needed to get the system in line with the required 90 day standard. Earlier this year, NAHC proposed using a settlement system comparable to that now available to hospitals for any pending home health or hospice appeals. With this new information on the backlog, NAHC will heighten its efforts to secure such an option for providers. CMS did not formally reject the NAHC proposal, but instead implemented it just for the hospitals. At that time, HHAs and hospices had less than 30,000 pending ALJ appeals in contrast to the several hundred thousand hospital appeals.

NAHC is also considering filing a lawsuit to challenge the appeals delays. The CMS settlement option for hospitals first surfaced in response to a lawsuit brought by the American Hospital Association seeking enforcement of the 90 day standard.

More information about the OMHA forum ad the initiatives taken to reduce the backlog can be found at    




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