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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

NAHC Litigation Update

April 21, 2015 08:05 AM

The National Association for Home Care & Hospice (NAHC) is currently prosecuting two lawsuits in federal court on behalf of the home care community.  In one case, NAHC continues to challenge the Medicare rule that required physicians to compose a “narrative” following the physician’s face-to-face encounter with the home health patient.  While Medicare dropped the requirement following the filing of the lawsuit, NAHC continues to litigate the case as a potential remedy for the tens of thousands of claim denials already imposed in home health agencies and the risk of future claim audits.

In the second lawsuit, NAHC is challenging new US Department of Labor (DoL) rules that essentially eliminate any use of the “companionship services” and “live-in domestic services” exemptions from overtime pay under the Fair Labor Standards Act (FLSA).


NAHC v. Burwell:  This case is in the middle of briefing by the parties.  The Department of Justice, on behalf on the Medicare program, recently filed its Motion for Summary Judgment and supporting Memorandum.  NAHC’s cross-motion and brief are due on May 7.

Medicare’s brief argues that it has the authority to require a physician narrative under the law passed by Congress in 2010 as part of the Affordable Care Act (ACA).  Its position is that the ACA provision does not prohibit the Centers for Medicare and Medicaid Services (CMS) from requiring that the physician, who certifies the Medicare patient eligibility for coverage, support that certification with a narrative explaining what specifically in the face-to-face encounter demonstrates that the patient is homebound and in need of skilled care.  The crux of that argument is that the word “document” in the ACA language permits CMS to define the standard of necessary documentation.  With that authority in the law, CMS argues it was within its power to require that a narrative be part of that documentation.

In litigation involving challenges to the validity of a regulation, courts review the case using standards set by the US Supreme Court that apply a two-part test.  First, is the regulation in conflict with the plain language of the law?  If it is not, the second part of the test is whether the interpretation by the federal agency is wholly unreasonable, rising to the level of being an arbitrary and capricious interpretation of the law.  In the second test, the federal agency’s interpretation is given deference by the courts as the federal agency, rather than the court, is considered to be the expert in the laws under its purview.

CMS argues in its brief that the plain language of the law does not prohibit its interpretation on what is required documentation.  Further, CMS argues that its interpretation is reasonable because it helps validate the bona fides of the physician’s certification of the patient.

The NAHC responsive brief is under development.  It will argue that the plain language of the ACA limits CMS to requiring only that the physician document that the encounter occurred, thereby prohibiting a narrative requirement.  NAHC will also argue that the narrative requirement is arbitrary and capricious as the standards for compliance are at best vague and the narrative requirement results in the irrational outcome of patients who are clearly homebound and in need of skilled care being denied coverage without a full record review.

Briefing in NAHC v. Burwell continues through July 24.

HCOA, IFA, and NAHC v. Weil and Perez:  In this challenge to DoL’s new rules on overtime compensation for home care aides, the US District Court ruled in NAHC’s favor and invalidated the DoL rules redefining the application of the “companionship services” and “live-in domestic services” exemptions under the Fair Labor Standards Act.  The case is presently before the US Court of Appeal for the District of Columbia.

All briefs have been filed in this case and oral argument before a three-judge panel is set for May 7.  DoL argues that the case is controlled by an earlier ruling of the Supreme Court in Coke v. Long Island Care at Home.  In Coke, the Court held that DoL had the authority to include third-party employers (home care agencies) under the “companionship services” exemption.  DoL argues that the Coke decision means that DoL has the discretionary authority to apply or not apply the exemption to third-party employed home care aides.

NAHC argues in its brief that the District Court was correct in concluding that the Coke decision is not controlling as the Supreme Court was not addressing the same issues now presented.  NAHC argues that the plain language of the FLSA requires the exemptions to apply to any employee engaged in companionship services or live-in domestic services.  Further, NAHC argues that the redefinition of “companionship services” is beyond DoL’s authority as that redefinition effectively eliminates “care” from the employee’s function in the application of the exemption.

One interesting development in the case is the nature and volume of “friend of the court” briefs filed.  DoL has on its side an assortment of unions, states, Members of Congress, and consumer organizations.  On NAHC’s side, there are Members of Congress, disability rights groups, and state Medicaid programs.  Most notably, the Members of Congress include Senate Majority Leader Mitch McConnell, several Senate Committee chairs including Lamar Alexander who heads up the committee with jurisdiction over the FLSA, and Tim Wahlberg, the Chair of the Workforce Protection Subcommittee of the House Education and the Workforce Committee.

The Medicaid programs argue to the court that they cannot be forced to cover the unfunded costs of overtime compensation.  At the same time, the disability rights groups argue that Medicare will not raise reimbursement rates and instead force restrictions on working hours of home care aides to the detriment of people with disabilities.


Litigation is always a last resort for NAHC.  However, NAHC will always fight every reasonable fight on behalf of the home care community.  These lawsuits are more than reasonable.  Please stay tuned to NAHC Report for future updates on these lawsuits.




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