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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

CMS Holds Its July Home Health and Hospice Open Door Forum

July 13, 2015 09:48 AM

The Centers for Medicare & Medicaid Services (CMS) hosted its Home Health, Hospice, and DME Open Door Forum on July 8. A summary of home health and hospice issues are provided below. 

2016 Home Health Payment Rate Update

The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule (CMS-1625-P) that would update the Medicare Home Health Prospective Payment System (HH PPS) rates and wage index for calendar year (CY) 2016. In the CY 2016 proposed rule, CMS is implementing the third year of the four-year phase-in of the rebasing adjustments to the HH PPS payment. A 2.3 % basket market update is proposed along with a decrease in the national, standardized 60-day episode payment amount by 1.72 percent in each year for CY 2016 and CY 2017 to account for nominal case-mix growth between CY 2012 and CY 2014.

In addition, CMS recalibrated the case mix weights, again, for 2016 and plans to implement annual case mix weight adjustment as part of the payment rate updates. CMS officials announced that the recalibrated case mix weights (Table 9) issued in the propose rule contains errors. CMS has re-issued Table 9 and is posted on the web site. Finally, CMS is proposing to implement a Home Health Value-Based Purchasing (HHVBP) model effective for CY 2016. CMS estimates that the net impact of this proposed rule would result in a decrease in Medicare payments to HHAs of 1.8 percent ($350 million decrease) for CY 2016.

Home Health Value-Based Purchasing (HHVBP) 

CMS proposes to launch a HHVBP program the will be implemented in all agencies in nine randomly selected states, which represents the national population of all HH agencies. The program will run for five years with payment adjustments up to 5 % in the first and second years; 6% in the third year; and  8% in the four and fifth years. CMS is proposing to use 25 quality measures derived from the OASIS, HHCAHP and claims, along with four new quality measures.

Home Health Quality Reporting Program (HHQRP) 

CMS is proposing to require one standardized cross setting new measure for CY 2016 to meet the requirements of the Improving Medicare Post-Acute Care Transformation Act (IMPACT Act): Percent of Residents or Patients with Pressure Ulcers That Are New or Worsened (Short Stay) (NQF #0678).  

HHQRP for OASIS  requires that agencies submit 70 % of quality assessments for the first reporting or year, which begins July 1, 2015 –June 30, 2016 in order to receive  the full annual payment update (APU)  for CY 2017. Agencies have been provided informational reports via CASPER that show historical data for the previous years, but have no impact on the current year’s performance. These reports will remain in agency’s CASPER folder for 120 days, until Oct 25, 2015. 

The first round of the Star Rating for home health agencies on HHC is scheduled for July 13.  In April, agencies were provided preview reports of their rating through the CASPER folder that were removed in early June. At the industry’s request, these reports have been returned to the CASPER folder for another 120 days. These reports are refreshed every quarter. CMS recommends that for long-term retention, agencies should download their reports.

The next round for Star Rating reporting on HHC is scheduled for Oct 8, 2015. The new set of preview reports that were distributed June 30 have been removed due to errors. CMS will be distributing new reports to agencies on July 10. 

For questions or concerns related to accessing reports from the CASPER system, contact the QTSO help desk at 800-339-9313 or email them at

Questions regarding quality reporting and reports should be addressed through a new CMS email address:

A star rating for the HHCAHPS is scheduled to begin on January 1, 2016. CMS will be providing agencies with a “dry run” report on the HHCAHPS Star Rating in September. This information will not be publicly reported.

Outcome and Assessment Information Set (OASIS)

OASIS C1/ICD-10 has been approved by the Office of Management & Budget and is now available on the CMS web site.

Claims Processing

Two claims processing transmittals have been released.  Change Request (CR) 9192is the quarterly update of HCPCS codes used for HH consolidated billing. CR 9198corrects errors in the 2015 HH Pricer program. The revised Pricer is scheduled to be installed in Oct 2015 and will include regrouping logic and instructions. Agencies will not need to take any action; claims will be adjusted at the contractor level.

Officials reminded participants of Medlearn Matters article SE 1410which provides special instructions for home health agencies related to the ICD-10 transition.

During the Question and Answer session of the call, a caller inquired about what would be acceptable practice for compliance with the requirement that the physician provide an estimate of how much longer the skilled services will be required for recertifications. The caller asked if an agency received a verbal order for the duration of services, could the agency add the duration to the recertification statement for physician signature in order to meet the requirement. The CMS official indicated that they would be open to such a process but will review the issue and provide further guidance.  

Hospice Issues

CMS is currently reviewing comments submitted on the proposed FY2016 payment update/HQRP update and expecting the final version of the rule to be publishedaround August 1, 2015. A question was asked regarding how soon after publication of the final rule there would be instructions available for the billing/payment changes. CMS responded that an update to the Medicare Claims Processing Manual is expected to be issued as soon as possible after the final rule - perhaps within a couple of days.

Related to the hospice CAHPS survey, hospices with fewer than 50 survey-eligible decedents during the period January 1-December 31, 2014 may file for a 1-year size exemption from the hospice CAHPS survey and must do so by August 12, 2015. Any exemptions granted are good for one year only.  Hospices will find the exemption request form at:

The deadline for survey vendors and hospices to submit the 2015 access to CAHPS Hospice Survey Data Warehouse Form was July 1, 2015. This form is required to obtain user account information and be granted access to the CAHPS Hospice Survey Data Warehouse. CMS states that those providers who have not yet completed and submitted this request may still do so. The link for the form is:

Hospices must ensure their respective CAHPS Hospice Survey vendors have set up procedures necessary for data submission as no late submissions can be accepted and submissions are how CMS tracks compliance for hospices to determine if the hospice will receive its full annual payment update.




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