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National Association for Home Care & Hospice
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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

Agencies Encouraged to Access the HHA PEPPER

September 22, 2015 02:33 PM

PEPPER, which is sponsored by the Centers for Medicare & Medicaid Services (CMS), is a provider-specific Medicare data report that summarizes a provider’s Medicare claims data for services identified as vulnerable to improper payments. The new PEPPER for HHAs released in July summarizes statistics for these six target areas:

  • Average case mix
  • Average number of episodes
  • Episodes with five or six visits
  • Non-LUPA payments
  • High therapy utilization episodes
  • Outlier payments

PEPPER can support an agency’s compliance efforts by identifying where it is an outlier for these target areas. It is an opportunity for all HHAs to self-monitor their billing practices, compare their activities with other HHAs across the nation and determine whether they are an outlier in their practices and possible subjects of special review by the OIG.

How Can I Obtain My PEPPER?

The Chief Executive Officer, President, Administrator or Compliance Officer of the agency should:

  • Review the Secure PEPPER Access Guide
  • Review the instructions and obtain the information required to authenticate access. A medical record number or patient control number from a claim for services with a “from” or “through” date between December 1 - 31, 2014 will be required for access.
  • Visit the PEPPER Resources Portal 
  • Complete all the fields
  • Download your PEPPER

Note: Some  HHAs have stated that the patient control number (PCN) that they obtained from the UB04 claim form for a traditional, Medicare fee-for-service beneficiary with a “from” or “through” date between December 1-31, 2014 was very different from the claim number TMF obtained from the paid claims database. TMF has researched this issue in coordination with CMS and Medicare Administrative Contractor (MAC) staff and has reached out to HHAs that did not have trouble accessing their PEPPER. TMF learned that:

  • The MAC does not change the PCN; they process the claim as it was received from the HHA or from the vendor authorized to transmit claims on behalf of the provider.
  • Some billing software/vendors use the beneficiary health insurance claim number (HICN or Medicare number) as the patient control number. TMF has determined that only 0.25% of the patient control numbers TMF obtained from the paid claims database are formatted as an HICN.

Therefore, TMF suggests that HHAs *not* use a PCN that is the same as the beneficiary HICN to access their PEPPER. Instead, we recommend using the remittance advice received from the MAC to obtain a patient control number; select a PCN for a claim with a “from” or “through” date between December 1 - 31, 2014. This *may* be a nine-digit number that starts with 16, 17, 18 or 19.

If you still have difficulty, please contact us via the Help Desk for assistance.

How can I learn more?

Recorded PEPPER training sessions are available on the Home Health Agency Training and Resources Page at, along with the HHA PEPPER User’s Guide. Join the email list at to receive notifications of upcoming training opportunities and report distribution.

PEPPER is distributed by TMF® Health Quality Institute under contract with the Centers for Medicare & Medicaid Services. Visit to access more information on PEPPER. If you have questions or comments about PEPPER or need help obtaining your report, visit our Help Desk to request assistance. 




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