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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

Senators Highlight Urgency of Reducing Medicare Appeals Backlog

April 29, 2015 09:00 AM

The US Senate Finance Committee today held a hearing on how to make the Medicare audits and appeals system more efficient. The Medicare appeals system is currently backlogged with at least 500,000 cases pending review.  During the hearing titled, “Creating a More Efficient and Level Playing Field: Audit and Appeals Issues in Medicare,” Senators heard testimony from three witnesses, each representing a different level of appeal. 

In his opening statement, Senate Finance Committee Chairman Orrin Hatch (R-UT) noted that preventing improper Medicare payments is a “serious issue.”  However, he said that the “insurmountable increase in appeals” has resulted in long delays for beneficiaries to find out whether their services are covered.  “When any Medicare contractor – either an auditor or a contractor that processes claims – decides that a claim should not be paid, it has a real effect on beneficiaries and providers, which is why it is so important that the appeals process allow these appeals to be heard in a timely and consistent fashion.”

Hatch also raised concern about the fact that the majority of payment appeals are found in favor of the defendant.  He cited statistics from the Department of Health and Human Services, Office of Inspector General, stating that over 60 percent of appeals were found in favor of the defendant. “Such a high rate of reversals raises questions about how the initial decisions are being made and whether providers and beneficiaries are facing undue burdens on the front end,” he said, noting that Administrative Law Judges have “more flexibility in their decision-making than Medicare contractors do.”

Senate Finance Committee Ranking Member Ron Wyden (D-OR) stated similar concerns about the backlog. “Today, the backlog of cases is so enormous that the door to new appeals is closed; new cases are no longer being heard,” he said in his opening statement.  “The number of cases sent to the Office of Medicare Hearings and Appeals has soared from 60,000 in fiscal year 2011 to 654,000 claims in fiscal year 2013. That’s an astonishing 10-fold jump in only two years.”

Wyden said that while the number of cases has increased, the number of hearing officers has remained the same.  “It’s no wonder that the appeals system is buckling under its own weight and that the average time to process a claim is now 560 days,” he said.

The backlog is having a real impact on the lives of beneficiaries, Wyden said.  “We have a duty to ensure that seniors receive the care they are rightfully entitled to receive under Medicare.  We also have an equal duty as custodians of taxpayer dollars to ensure those dollars are spent in the best possible manner.  To balance both these goals we need some fresh thinking.”

The witnesses included Sandy Coston, CEO and President of Diversified Service Options, Inc., a contractor with the Centers for Medicare & Medicaid Services (CMS) that handles the first level of appeal; Thomas Naughton Senior Vice President, MAXIMUS Federal Services, Inc., a CMS contractor that handles the second level of appeal; and Nancy Griswold, Chief Administrative Law Judge, Office of Medicare Hearings and Appeals (OMHA) under United States Department of Health and Human Services, which handles the third level of appeal.

You can access more information about the witnesses and the hearing testimony here.

In its 2015 Regulatory Blueprint for Action, the National Association for Home Care & Hospice (NAHC) provides recommendations to eliminate delays in Medicare Appeals to ALJs.  NAHC recommends that: 1) CMS take all necessary steps to improve the quality and accuracy of initial claim determinations to limit need for an administrative appeal; 2) CMS monitor its contractors that handle early-stage administrative appeals to ensure a high degree of accuracy and to reduce the number of appeals that end up before an ALJ; 3) CMS provide a settlement option to all appellants with claims pending before an ALJ in order to reduce the backlog. That settlement should be based on historical data on ALJ reversal rates and the cost savings achieved by Medicare coming through the avoidance of an ALJ appeal; 4) OMHA increase its resources to handle the level of demand and establish alternative dispute resolution processes to resolves some appeals.

Please stay tuned to NAHC Report for additional information on this issue.  In a subsequent article, NAHC Report will analyze some of the recommendations put forward by the witnesses and senators during today’s hearing.




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