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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

Senate Finance Committee Discusses Issues Related to Improper Payments in Federal Programs, Including Medicare and Medicaid

Some Raise Concerns about Erroneous Medicare Denials and the Backlog of Appeals
October 6, 2015 10:18 AM

The United States Senate Finance Committee held a hearing on Thursday, October 1, to discuss issues related to improper payments in federal programs, including but not limited to Medicare and Medicaid. The hearing followed the issuance of a report earlier this year by the Government Accountability Office (GAO) that estimated for fiscal year 2014 a total of $124.7 billion in improper payments spanning 124 programs and 22 agencies, up from $105.8 billion in fiscal year 2013. In his testimony at the hearing, GAO Comptroller General Gene L. Dodaro  stated that the “almost $19 billion increase was primarily due to the Medicare, Medicaid, and Earned Income Tax Credit programs, which account for over 75 percent of the government-wide improper payment estimate.” GAO found that in FY 2014 the Medicare program paid out nearly $60 billion in improper payments, and Medicaid paid out approximately $17.5 billion in improper payments. An improper payment, according to GAO, is defined by statute “as any payment that should not have been made or that was made in an incorrect amount (including overpayments and underpayments) under statutory, contractual, administrative, or other legally applicable requirements.” GAO’s full testimony and recommendations are available here.

Chairman Orrin Hatch (R-UT) expressed concerns about the amount of improper payments, and emphasized the need to address them. “While these numbers – by their sheer size – are staggering, none of them should be surprising,” Chairman Hatch stated. “This is a problem that has been many years in the making. And, if you ask me, the time for addressing them is long past due.”

Other lawmakers discussed the importance of preventing improper payments, while also stating the importance of preventing more burdensome regulations on health providers. Ranking Member Ron Wyden (D-OR) said “there is action that can be taken” to prevent improper payments, but he emphasized the need to “strike a balance so as not to create a lot of new regulatory burdens and hassles for the overwhelming number of providers who are honest and scrupulous.” Dodaro responded that the goal is to have an “integrated strategy” that “prevents improper payments in the first place.” He said that CMS is not doing enough on the front end.

Senator Pat Roberts (R-KS) referred to the current system as a “byzantine regulatory process” and expressed concerns about the backlog of appeals. “Obviously, our auditing needs improvement,” he said, but “part of that is also causing a tremendous burden on providers who are trying to be responsive. Not all providers are guilty of whatever some auditor says that they are.” Senator Debbie Stabenow (D-MI) similarly raised that fact that underpayments are also an issue, and she said it is import to support those providers that act in good faith.

Earlier this year, the National Association for Home Care & Hospice (NAHC) submitted testimony for a previous hearing that included the following recommendations as a means to reduce erroneous claim denials and resulting appeals:

  • CMS should take all necessary steps to improve the quality and accuracy of initial claim determinations to limit the need for an administrative appeal;
  • CMS should 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;
  • CMS should 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; and
  • OMHA should increase its resources to handle the level of demand and establish alternative dispute resolution processes to resolve some appeals.

The Senate Finance Committee subsequently approved draft legislation to address the backlog, the Audit & Appeal Fairness, Integrity, and Reforms in Medicare (AFIRM) Act of 2015 (see previous NAHC Report article here).

For more information about last week’s hearing, please click here.




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