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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

CMS Holds its Latest Home Health, Hospice and DME Open Door Forum

November 18, 2014 02:29 PM

The Centers for Medicare & Medicaid Services (CMS) recently hosted its most recent Home Health, Hospice, and DME Open Door Forum.  A summary of Home Health issues covered is provided below. A summary on the hospice issues that were addressed during the ODF will appear in tomorrow’s NAHC Report.

Home Health Conditions of Participation (HHCoPs)

The proposed rule for the HHCoPs was released October 9, 2014. There is a 60 day open comment period. Comments are due December 8 and can be submitted here.

2015 home health prospective payment system (HHPPS) rate update

On October 30, CMS issued the final rule for the 2015 HHPPS rate update. In the rule, CMS projects that Medicare payments to home health agencies in CY 2015 will be reduced by 0.30 percent, or $60 million. This decrease reflects the effects of the 2.1 percent market basket update and the second year of the four-year phase-in of the rebasing adjustments to the national, standardized 60-day episode payment rate, the national per-visit payment rates, and the non-routine medical supplies (NRS) conversion factor.

The rule implements a 3.5 percent increase to the national per-visit payment rates, a 2.82% reduction to the NRS conversion factor, and a reduction to the national, standardized 60-day episode rate of $80.95 for CY 2015. The national, standardized 60-day episode payment for CY 2015 is $2,961.38.

HH PPS case-mix weights 

CMS is recalibrating the HH PPS case-mix weights using CY 2013 home health claims data to ensure that the case-mix weights reflect the most current utilization and resource data available.

Core Based Statistical Area (CBSA) changes for the HH wage index

CMS is finalizing changes to the wage index based on the revised CBSA delineations for the CY 2015 HH PPS wage index. These changes will be made to the wage index using a blended wage index for a one-year transition. For each county, a blended wage index is calculated as 50 percent of the wage index using the current OMB delineations and 50 percent of the wage index using the revised OMB delineations.


CMS finalized three changes to the face-to-face encounter requirements for episodes beginning on or after January 1, 2015. First, CMS is eliminating the narrative requirement currently in regulation. The certifying physician would still be required to certify that a face-to-face patient encounter occurred and document the date of the encounter as part of the certification of eligibility. For medical review purposes, CMS will require documentation in the certifying physician’s medical records and/or the acute/post-acute care facility’s medical records (if the patient was directly admitted to home health) to be used as the basis for certification of patient eligibility.

Second, CMS is finalizing that if a HHA claim is denied, the corresponding physician claim for certifying/re-certifying patient eligibility for Medicare-covered home health services is considered non-covered as well.

Lastly, CMS is clarifying that a face-to-face encounter is required for certifications, rather than initial episodes; and that a certification - versus a re-certification - is generally considered to be any time a new start of care assessment is completed to initiate care.

Therapy Reassessment

CMS is finalizing the elimination of the 13th and 19th visit reassessment requirements. For episodes beginning on or after January 1, 2015, at least every 30 calendar days a qualified therapist - instead of an assistant - must provide the needed therapy service and functionally reassess the patient.

CMS is hosting a National Provider Call - Certifying Patients for the Medicare Home Health Benefit on December 16, 2014 at 1:30 pm ET. To register click here.

Quality reporting

CMS has established a minimum submission threshold for the number of OASIS assessments that each HHA must submit in order to receive the full annual payment update.  Beginning in CY 2015, the initial compliance threshold will be 70 percent. This means that HHAs will be required to submit both admission and discharge OASIS assessments for a minimum of 70 percent of all patients with episodes of care occurring during the reporting period. CMS will increase the compliance threshold over the next two years to reach a maximum threshold of 90 percent.

Home Health Value-based Purchasing Model

The HHA VBP model being considered would include a five to eight percent adjustment in payment made after each planned performance period in the projected five to eight states selected to participate in the model. A HHA VBP model presents an opportunity to test whether larger incentives would lead to higher quality of care for beneficiaries.

If CMS decides to move forward with the implementation of an HHA VBP model in CY 2016, it intends to invite additional comments on a more detailed model proposal to be included in future rulemaking

Conditions of Participation for speech-language pathologists

CMS has revised the Home Health Conditions of Participation (CoPs) for speech language pathologist (SLP) personnel. Now, a qualified SLP is an individual who meets one of the following requirements: a) has a masters’ or doctoral degree in speech-language pathology, and is licensed as a speech-language pathologist by the state where they furnish services (CMS believes that all states license SLPs; therefore all SLPs would be covered by this option); or b) has successfully completed 350 clock hours of supervised clinical practicum (or be in the process of completing these hours), has at least nine months of supervised full-time speech-language pathology experience, and has successfully completed a national examination approved by the Secretary.

These requirements, which align with the requirements in the Social Security Act, will replace the current stringent requirements.

Outcome and Assessment Information Set (OASIS) and Quality Measures

CMS officials also reported that the OASIS C1/ICD- 9 has received approval from the Office of Management and Budget and is posted on the CMS Home Health Quality Initiative website site. To view the website, please click here.

Public reporting for the claims based re-hospitalization measure is scheduled for the July, 2015 release of home health compare.

CMS announced a new email address for questions related to quality measures,

Conversion to Assessment Submission and Processing (ASAP) System

Officials reminded participants that OASIS submissions to the state system will discontinue starting at 6:00 p.m. ET on December 26, 2014.  The HHA state submission system will no longer be used for OASIS submissions. New, modification, or inactivation records in the current flat file format must be submitted prior to 6:00 p.m. ET on December 26, 2014.

Effective January 1, 2015, OASIS assessment data will be submitted to CMS via the Assessment Submission and Processing (ASAP) system. With the implementation of the OASIS ASAP system, Home Health Agencies will no longer submit OASIS assessment data to CMS via their state databases.

Claims Processing

CMS released Change Request 8950 - Correction to Remittance Information When HIPPS Codes are Re-coded by Medicare Systems here . The CR instructs contractors to include remittance advice code pairs to claims where currently only a remittance advice remark code (RARC) is used. In addition, HIPPS codes that are changed based on validation with QIES data are not currently displayed to providers on Direct Data Entry (DDE) screens. They are also not being sent to the remittance advice. The requirements below also ensure the HIPPS code used for payment is displayed appropriately.




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