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National Association for Home Care & Hospice
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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

A Status Update on the Hospice Self-Calculation of the 2014 Aggregate Cap

February 13, 2015 05:20 PM

Beginning with the 2014 cap year - November 1, 2013 – October 31, 2014, all hospices are required to self-calculate their aggregate caps using data accessed no sooner than January 31, and submit the calculation and any overpayment to their assigned Medicare Administrative Contractor (MAC) by March 31.  As part of the final fiscal year 2015 hospice payment rule, the Centers for Medicare & Medicaid Services (CMS) indicated that it would provide a pro-forma spreadsheet to calculate the cap, as well as instructions to providers so that they would have guidance on the appropriate steps to take. 

However, some months back issues arose related to how the cap and the 2 percent sequester, which went into effect in April 2013, interact.  Additionally, there was some concern over whether a hospice’s aggregate cap calculation should include the amount of the sequester. CMS and its parent, the Department of Health and Human Services (HHS), have had this issue under scrutiny for some time. CMS has determined that it was inappropriate to issue the cap calculation spreadsheet and instructions without a final determination of whether the cap calculation should include or exclude the sequester.

Representatives of the National Association for Home Care & Hospice (NAHC) have had several communications with CMS this week and understand that a decision has been made on whether the cap calculation should include or exclude the sequester. CMS cannot reveal the final decision until after a formal notice has been sent out to the MACs. Here’s the most recent plan relative to the how the process is expected to unfold:

Some time during the week of February 16: CMS hopes to send notification to the MACs including instructions and the pro-forma spreadsheet for calculation of the aggregate cap. Please note that February 16 is a federal holiday.

Once the MACs receive information from CMS, they will need to develop their own materials to send to hospice providers and post on their websites. Some of the MACs will be establishing special means for providers to submit the cap calculations – including special post office boxes and instructions for electronic submission. 

To date, Palmetto GBA has put out extensive information for its providers earlier today. They suggest that providers wait for the CMS form to submit their cap calculation but also provide information about reports Palmetto will be supplying to its Hospice providers this month to assist with the cap self-calculation responsibilities.  

The Palmetto information is available here.

As NAHC secures additional information on this issue, it will be transmitted to NAHC members through the NAHC member listservs as well as through future issues of NAHC Report.

In the meantime, the transition of the PS&R application - reports from PS&R are needed for hospices to calculate their aggregate caps - from the IACS system to the EIDM system has hit a snag. CMS hopes that the problems will be resolved this weekend. 

Until those issues are resolved, hospice providers can access their PS&R through the IACS system.  Please note that any hospice provider that was not active in the IACS system prior to the start of the IACS to EIDM transition cannot apply for a new account or access the PS&R. 

NAHC has concerns that delayed notification from the MACs on self-calculation of the cap due to the sequester issue, coupled with systems transition snags due to unanticipated problems during the IACS to EIDM transition, may create serious issues for those hospices that are not active in IACS at this time. 

NAHC will be monitoring this issue closely and reporting as additional information becomes available. 

Following are additional links that may be of interest to you: 

CMS site notice that PS&R transition from IACS to EIDM is delayed until further notice.

NGS notice about self-calculation of aggregate cap.




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