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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 Sends Letter to CMS Proposing a Phase-in Approach to the Face-to-Face Requirement

Letter offers steps CMS should take to phase-in the Face-to-Face requirement to ease the Jan. 1 start date
December 15, 2014 12:55 PM

Last week, NAHC President Val J. Halamandaris sent a letter to the Centers for Medicare and Medicaid Services (CMS) Administrator Marilyn Tavenner urging a phased-in approach to the new face-to-face documentation requirements. The new requirements are scheduled to take effect on January 1, 2015.

The letter highlights CMS’ past willingness to phase-in new requirements, as well as reiterating the challenges that both home health agencies and physicians will face if the new requirements are not phased-in:

“The new documentation requirement takes effect on January 1, 2015. However, CMS has not yet issued any interpretive guidance on the rule change nor has there been any educational efforts directed towards physicians or home health agencies on it. While an “Open Door” call is scheduled for December 16, it is highly likely that any information conveyed in that call will not be conveyed to all the physicians and home health agencies that care for home health patients sufficiently to bring about full compliance by January 1. It is also likely that there will be many unanswered questions remaining after the call that will require CMS to issue further guidance.

Even if full guidance is issued before the end of the year, it will take time for home health agencies and physicians to conduct internal staff education, develop internal process and checks, and coordinate with each other to address the necessary changes in their work flow processes.

Since the inception of the current face-to- face rule, the home care community has strived to achieve compliance through extensive education of both providers and the physician community. NAHC expects to play a significant role in assisting our member agencies again to do so. However, the effective date of the new requirements is just days away.

Our past experiences with the face-to-face requirements indicate that there is a clear need for comprehensive and detailed guidance along with widespread dissemination of educational materials, both to home health and to physicians. There is also a leaning curve on such new requirements.

In the past, CMS has recognized the value of phasing-in the application and enforcement of rules that require interpretive guidance and extensive education of affected parties. In fact, CMS delayed enforcement of the current face-to-face rule in 2011 because of the significant changes needed by physicians and home health agencies. In the final rule, CMS recognized the ongoing confusion with the standards of compliance. With this new generation of requirements, we should learn from that experience and first issue any necessary guidance, complete the essential education, and test the understanding of the affected home health agencies and physicians before enforcing the new requirements with claims audits and coverage denials.

Given the myriad of challenges that the January 1 effective date will pose, Mr. Halamandaris’ letter then goes on to outline a detailed approach to phasing-in the new requirements:

  1. CMS should conduct the scheduled December 16 call and solicit input from all stakeholders on that call.
  2. CMS should hold a stakeholder meeting involving representatives of the home health community, physicians, Medicare beneficiaries, and Medicare contractors.
  3. Following the call and the stakeholder meeting, CMS should issue draft interpretive guidance for public review and comment.
  4. Comprehensive interpretive guidance should be issued following consideration of the public comments.
  5. CMS and its contractors should conduct education and outreach on the new requirements to the home health and physician communities along with updates to the CMS and contractor web sites to include the guidance on compliance standards. A strong effort should be made to directly engage the physician community, going beyond the issuance of MLN Matters, as the key to success in achieving compliance involves the physician community.
  6. The new documentation requirements would “go live” after the educational efforts are completed. However, compliance with the standards will initially be subject only to test auditing for purposes of studying the outcome of the guidance and education efforts. Based on the results of the test audits, any necessary changes in the guidance and education will be completed.
  7. During the test audit phase, no claims would be subject to payment denial based on a failure to meet the new documentation requirements. This approach would not interfere with CMS’ authority to audit and review claims for all the other criteria for coverage.
  8. Once the test audit phase is completed, CMS would issue a notice indicating the date when full enforcement will begin.

With the January 1, 2015 effective date fast-approaching, NAHC will keep all of its members  updated on any developments on the face-to-face issue through future issues of NAHC Report.

To read the full letter, please click here.




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