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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 Advocacy Leads CMS to Rethink Electronic Submission of NOE/NOTR

June 6, 2016 01:23 PM

In response to advocacy by the National Association for Home Care & Hospice (NAHC), the Centers for Medicare & Medicaid Services (CMS) is now actively pursuing efforts to allow for use of the institutional claim (837I) to submit hospice Notices of Election (NOEs) and related transactions via Electronic Data Interchange (EDI). This action, in CMS’ words, “would reduce, and potentially eliminate, problems with NOEs that result from errors during the Direct Data Entry (DDE) process.”  CMS’ Provider Billing Group is currently in discussions with its National Standards Group (NSG) in the Office of Enterprise Information to explore the potential for allowing hospices to submit NOEs via EDI using a non-standard implementation of the 837I transaction. Once the Provider Billing Group receives an opinion from NSG and has planned its next steps, it will provide a status report to NAHC.

Since October 2014, one of the most administratively burdensome and costly issues that hospices have dealt with has been meeting the timely filing requirements for NOE and Notices of Termination/Revocation (NOTR). Since that time the National Association for Home Care & Hospice (NAHC) and other stakeholders have worked diligently to address the growing number of problems associated with the timely filing policy. Last year NAHC and NHPCO jointly sponsored a hospice survey to help quantify NOE/NOTR-associated costs and financial losses, and the findings of the survey indicated that the financial impact of the requirement has been considerable. Over the last year NAHC has also sought a number of clarifications from CMS and its Medicare Administrative Contractors (MACs) with the goal of easing some of the negative consequences of using direct data entry (DDE) to meet these time-sensitive requirements. While some of these efforts have met with success, each -- on its own -- has made only a relatively modest impact overall, and additional problems continue to emerge in this area.

In implementing the timely filing requirement as part of rulemaking during 2014, CMS stated that NOEs and NOTRs were required to be submitted via DDE as “limitations in electronic submission standards prevent the use of the 837I claim format for this purpose,” but CMS requested input from the hospice industry regarding how electronic submission of NOEs and other transactions might be feasible. Beginning in mid-2015, NAHC began researching the potential for submission of these notices via EDI by exploring the means by which it could initiate development of the electronic submission standards for the NOE/NOTR. However, based on analysis, NAHC soon came to the conclusion that new submission standards may not be necessary since NOE/NOTR are not claims under the Health Insurance Portability and Accountability Act (HIPAA) and therefore should not be subject to the HIPAA transaction submission standards. In a subsequent discussion with CMS Provider Billing Group staff, NAHC discovered that if development of special transaction submission standards for the NOE/NOTR were not necessary, the process for allowing EDI submission of NOE/NOTR would be significantly less complex than had previously been thought by CMS.

Most recently NAHC wrote to Sean Cavanaugh,Director of the Center for Medicare, urging that CMS take action to allow for submission of NOE/NOTR via EDI and providing its analysis of why HIPAA transaction standards are not needed to allow for submission via EDI.  In a response from the Center for Medicare’s Provider Billing Group, Director Diane Kovach states,

“Your research into this question and the findings you share in your letter are gratefully received. My claims processing staff reviewed the material [you sent] and believes that our previous understanding on this subject may have been based on incomplete or inaccurate information. You note that the NOE is not a Health Insurance Portability and Accountability Act-covered transaction. It may be feasible for CMS and hospices to develop trading partner agreements to exchange data using a non-standard implementation of the 837I transaction. This would require CMS to develop a companion guide for NOE transition and for hospices to agree to the voluntary adoption of that companion guide.

“In order to assure that any step we take meets all the necessary requirements, I have instructed my staff to review this possible course of action with the National Standards Group (NSG) in CMS’ Office of Enterprise Information. When we receive an opinion from NSG and have considered our next steps, we will communicate the result to you.”

NAHC will provide future updates on this important issue through the NAHC member listserv and in NAHC Report.




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