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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

NAHC Submits Comments on Prior Authorization Proposal to CMS

April 9, 2016 09:38 AM

The National Association for Home Care & Hospice (NAHC) recently submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the Medicare Prior Authorization of Home Health Services Demonstration. In its comments, NAHC urged CMS to withdraw the proposal, which would institute a system of “prior authorization” on all home health services in five states (see previous NAHC Report articles here and here). 

“NAHC has long partnered with Medicare and other payers in rooting out the fraud, waste, and abuse through creative policy changes,” NAHC stated in its comments. “However, the proposed prior authorization project falls short of what it takes to be an effective program integrity tool sufficient to offset the down-side risks to Medicare beneficiaries and upstanding home health agencies. For the reasons stated above, NAHC respectfully recommends that CMS withdraw its proposal for prior authorization in home health services.”

NAHC detailed several concerns with the proposal including that it would be costly, burdensome, and ineffective. In addition, NAHC stated that CMS lacks the legal authority and justification for imposing it on home health agencies.

There is no legal authority for the proposed PA demo. The proposal does not comply with the congressionally expressed authority for a demonstration program of this nature. Congress has limited the use of prior authorization to certain items of Durable Medical Equipment (DME). Any proposal to implement a prior authorization system must be promulgated through formal rulemaking.

The proposed prior authorization project is overbroad, untargeted, administratively costly, and would be ineffective in curbing any fraud. “Prior authorization is partly in use in Medicare Advantage plans and a few state Medicaid programs. NAHC members report one common consequence---delayed admission of the patients into home health services,” NAHC stated in the letter. Overall, the agencies report high administrative costs accompanied by continual detours from providing care to undertaking efforts to convince a remote person with the payer to authorize care.”

There are better tools to address Medicare home health risk areas. “CMS has the data capabilities to laser target program integrity measures to identified high risk situations rather than rely on broad-based, random, shotgun-like measures such as prior authorization,” NAHC stated. “Accordingly, CMS should take advantage of this capability to the fullest extent.”

Medicare beneficiaries and providers must be given full due process. “In the event that CMS decides to move forward with consideration of prior authorization, it is essential that CMS provide an accelerated and robust appeal process for providers and beneficiaries. The absence of an authorization is a certain roadblock to care access,” NAHC stated.

The Proposed Prior Authorization Project Does Not Meet Program Integrity Standards Of Value. NAHC outlined standards of value for program integrity measures and concluded that the proposed project:

  • is not sufficiently targeted to the fraud or abuse of concern;
  • is not evidence-based with demonstrated return on investment;
  • does not prevent fraud;
  • is absent adequate legal authority;
  • erects barriers to appropriate care access;
  • would be excessively burdensome;
  • fails to distinguish between fraud and unintentional noncompliance;
  • would be highly likely to lead to a significant number of “innocent victims” through care delays, extended stays in high risk settings and wrongful rejections of authorization.

To view NAHC’s comments, click here.




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