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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

IN FOCUS: Hospice/Medicaid Issues

October 9, 2015 03:34 PM

Hospice Payment Reform/Medicaid: In response to the Centers for Medicare & Medicaid Services (CMS) proposed hospice payment reforms that, by law, are applicable to fee-for-service Medicaid hospice benefits, there was widespread concern that hospices, vendors, Medicare Administrative Contractors (MACs), and state Medicaid programs would not be ready for the anticipated Oct. 1, 2015, implementation. As part of the final hospice payment rule and out of particular concern for state Medicaid programs, CMS delayed implementation of the two-tiered payment system for Routine Home Care (RHC)/Service-intensity Add-on (SIA) until Jan. 1, 2016.

In recent months the National Association for Home Care & Hospice (NAHC) examined billing requirements for some state Medicaid programs to ascertain whether Medicaid programs required sufficient information on hospice claims to allow for the payment reform changes and discovered that a number of states do not currently require hospices to report sufficient detail (including skilled visits, which are essential for implementation of the SIA) on claims to facilitate implementation of the payment changes. NAHC contacted officials at CMS to convey these concerns, and CMS conducted outreach to select states to ascertain their states of readiness. Our understanding is that as part of the calls CMS was able to ascertain that all states are not currently securing information on hospice claims that would facilitate implementation of the payment reforms. As a result, CMS is planning on sending information to state Medicaid offices to assist them in implementing the changes that are needed to be able to move forward with payment reform on the Medicaid side.

At this stage it is unclear whether state programs will be able to change billing processes in time for the scheduled January 1, 2016, implementation or whether CMS will need to allow more time; it is also unclear whether states will use a uniform process or choose their own method (including some type of work-around) for securing the information required for payment reform implementation. NAHC will provide additional details as they are available.

Medicaid Hospice/Managed Care:States are at different points in their development of Medicaid managed care contracts that include the hospice benefit. On the fee-for-service side, Medicaid programs are required, under Section 1902(a)(13)(B), to pay for hospice care based on existing Medicare rates. NAHC has had inquiries relative as to whether this same requirement applies when hospice care is provided by a managed care organization. NAHC has posed specific questions to CMS, to which we received the following response:

Under Medicaid fee-for-service (FFS), the State plan payment must meet the requirements specified in Section §1902(a)(13)(B). However, under Medicaid managed care, as specified in 42 CFR §438.6(c)(2), CMS only requires that payment rates between the State and health plans be actuarially sound. Managed Care Organizations (MCOs), Prepaid Inpatient Health Plans (PIHPs), and Prepaid Ambulatory Health Plans (PAHPs) may negotiate different payment amounts with providers, unless the State requires the MCO, PIHP, or PAHP (specified in the contract) to pay at the same rate as the Medicaid State plan.

Legal research conducted by NAHC staff concluded that, because of the way Medicaid MCO authorizing language is crafted, payments for hospice services provided through a MCO likely are not required to follow Medicare reimbursement requirements. NAHC has submitted follow up questions to CMS and will report on additional findings as they become available.




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