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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

Action Alert: Urge Congress to Amend SGR Legislation to Remove Surety Bond Requirement and Repeal or Revise Face-to-Face Physician Documentation Rule

April 7, 2015 10:52 AM

Now is an important time for home care and hospice advocates to urge their members of Congress to amend the Sustainable Growth Rate (SGR) replacement legislation. Congress should remove the SGR bill’s current surety bond requirement on home health agencies and add language repealing or revising the face-to-face physician documentation rule.

As NAHC previously reported, Members of Congress adjourned for their two-week April recess without the Senate having passed legislation to permanently replace the SGR. Senate leaders plan to consider the SGR legislation after returning on April 13. The Centers for Medicare & Medicaid Services (CMS) has stated that it can hold off on processing claims until April 15, which provides Congress with two days to pass a final bill before physicians start to experience payments reductions.

While it may be unlikely that Congress will either open the bill for amendments or accept more than a small number of amendments agreed upon in advance, we want to make another effort to stop the surety bond and obtain F2F relief in the SGR legislation. At a minimum, the effort will help set the stage for further advocacy as Congressional leaders have indicated they expect more Medicare legislation later this year.

Here are the issues NAHC encourages advocates to emphasize with their members of Congress.

Remove the Surety Bond Requirement on Home Health Agencies

The current SGR bill contains a modification of the home health surety bond requirements, setting the bond minimum at $50,000 and allowing Medicare to scale the bond value up commensurate with the volume of Medicare revenue in the home health agency.

Currently, Medicare has the authority to impose a surety bond on home health agencies but has chosen against doing so. The provision in the SGR bill would make the surety bond a mandatory condition for all home health agencies to participate in Medicare. It would also require that a bond be no less than $50,000 in value with the authority to scale the bond amount to much higher levels based upon the Medicare revenue in the home health agency. 

According to information NAHC obtained from the Congressional Budget Office, the bond requirement would bring only $10 million in Medicare savings over 10 years, while NAHC estimates the cost of the bonds to be $130 million over that same period of time. The small savings is indicative of the fact that virtually all Medicare overpayments are fully repaid by home health agencies. While achieving minimal savings, the nonsensical surety bond requirement could drastically harm agencies and limit access to care.

Please urge Congress to amend the SGR legislation to remove the surety bond requirement on home health by clicking here.

Repeal or Revise Face-to-Face Physician Documentation Requirement

Currently, the SGR bill does not include relief from the burdensome face-to-face physician encounter requirements.

As NAHC has reported extensively, a provision of the Patient Protection and Affordable Care Act requires a patient to have a face-to-face encounter (F2F) with a physician to certify the need for Medicare home health services. CMS’s flawed rule implementing the ACA provision includes burdensome paperwork requirements that have  caused confusion among physicians, home health agencies, and other parties involved.

As a result, the rule has limited access to care and posed a high risk that Medicare patients who are homebound and in need of skilled care will be denied Medicare coverage. While CMS has tried to resolve these problems, the underlying regulatory requirements remain difficult to understand and apply. Congress should act to repeal or revise the documentation requirement as part of the SGR legislation.

The revisions NAHC is seeking: 1) limit the physician documentation requirement to demonstrating that a timely encounter occurred, consistent with the original intent; 2) narrow the circumstances where a F2F is required by excluding patients transferred from a hospital or SNF where physician encounters are virtually guaranteed; 3) provide an exception in areas where physicians are scarce; 4) permit a waiver in a case-specific situation where a F2F is not feasible; and 5) permit F2F encounters by way of an expanded telehealth definition as the standard in the current law is useless as the patient must leave her home to have a telehealth visit with a physician. 

Urge your member of Congress to repeal or revise the F2F documentation requirement on physicians by clicking here.

Invite Your Member of Congress to Attend a Home Visit

 NAHC encourages you to ask your members of Congress to accompany your agency on a home visit. This is a compelling way to inform Congress about the importance of home care and hospice for the ill, aged, and disabled. A prominent example of how effective these visits can be, Senator Susan Collins (R-ME), chair of the Senate Aging Committee,  has said that accompanying a home care visit was a transformative experience and made her a passionate advocate for home care and hospice.

NAHC will continue to provide updates on the SGR legislation, as well as these key policy priorities. Please stay tuned for future action alerts.




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