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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

Senators Seek to Reform Home Health Face-to-Face Physician Documentation Requirement

July 23, 2015 09:36 AM

Senators Robert Menendez (D-NJ) and Pat Roberts (R-KS) are working on legislation to reform the home health face-to-face physician encounter documentation requirement. The Senators demonstrated their commitment to addressing the issue in June by introducing a bill (S. 1650), and they are continuing their efforts to improve the bill in order to ensure it resolves serious concerns with the existing face-to-face requirement and its impact on patient care.

Both Senators have expressed the need for legislation in order to reform the existing requirement. “The existing home health face-to-face requirement is simple in theory, but has proven unworkable in practice,” said Senator Menendez in a statement regarding his efforts to reform the face-to-face requirement.

“I’ve been concerned the face-to-face encounter requirement would be particularly difficult for our most vulnerable beneficiaries, especially those in rural areas, and could limit access to care,” said Senator Roberts.

The current face-to-face encounter requirement to certify eligibility for home health services has resulted in substantial increases in home health claim denials and a backlog of appeals. Under a provision of the Affordable Care Act, a home health provider cannot bill Medicare for services to a home health patient unless the certifying physician has a face‐to‐face encounter with the beneficiary 90 days prior to the start of home health or 30 days after the start of home health. As part of this certification, CMS required physicians to document several detailed clinical findings in a narrative in order to support the need for home health services. CMS has since dropped the narrative requirement (see previous NAHC Report article here) but replaced it with a physician documentation requirement that can be equally problematic.

As a result of the previous narrative requirement, Medicare has denied payment for thousands of home health services. Agencies and certifying physicians are now struggling to comply with the new physician documentation requirement. According to a nationwide home health provider survey, 52% of face‐to‐face claim denials resulted mainly from Medicare determining that the physician documentation was insufficient, even though medically necessary care was provided. The federal Office of the Inspector General (OIG) has recommended a more uniform method for physicians to document face‐to‐face encounters, based on the fact that physicians are experiencing difficulty complying with the cumbersome requirements. Seventy‐five bipartisan members of Congress stated that the “complicated, confusing and overlapping documentation requirements … exceed the intent of the law passed by Congress.”

In June, Senators Menendez and Roberts introduced the Home Health Documentation and Program Improvement Act of 2015 (S. 1650) in an attempt to address the problem by reformingthe documentation requirement. The legislation would require CMS to develop a standardized form for collecting evidence of a beneficiary’s eligibility for home health services. It allows ahome health agency to complete the form that is then reviewed and signed by the referring physician. The bill exempts home health agencies from collecting documentation for beneficiaries who have been discharged from a hospital or skilled nursing facility within 14 days prior to the initiation of home health services. It also seeks relief from past claim denials.

Although the legislation allows the home health agency to fill out the form, it requires that a statement justifying eligibility for home health services must be included in the form. This sounds similar to the previous narrative requirement that CMS abandoned. The home health agency would be allowed to compose the statement for the physician, but NAHC is concerned that claims could still be denied based on a subjective determination that the statement is insufficient even when a review of the whole record would establish eligibility. This could result in technical denials of valid claims.

NAHC is working with the sponsors of the legislation to delete the bill’s requirement of a statement and simply require that the physician document that the face-to-face encounter occurred. Stay tuned to NAHC Report for more developments in the ongoing campaign to obtain relief from the F2F documentation requirements.

In addition to seeking a legislative remedy, NAHC continues its legal challenge to the claim denials resulting from the Medicare home health services physician face-to-face narrative requirement. You can read more about NAHC’s lawsuit here.




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