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Testimonials

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. 

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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.

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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

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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 element...it’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

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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.

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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.

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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.

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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.

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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.

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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.

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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. 

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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.

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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.

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Frank E. Moss, former U.S. Senator

Anyone working on health care issues in Congress knows the name Val J. Halamandaris.

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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.

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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.

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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.

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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.

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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.

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Former President Bill Clinton

CMS Issues Pre-Claim Review Demonstration Operational Guide

June 27, 2016 07:01 PM

The Centers for Medicare & Medicaid Services (CMS) has issued the Pre-Claim Review Demonstration for Home Health Services Operational Guide. CMS had planned to issue the guide by June 28.

The Operational Guide does not provide much more information regarding the Pre-Claim Review Demonstration than what CMS has already communicated to providers through their fact sheet, a Special Open Door Forum (SODF) call (see NAHC report), and the frequently asked questions (FAQs). During the SODF call, CMS stated that the Operational Guide would be a draft and open to public comment. The document appears to be a final version.  

The document is 24 pages long, covers 11 subject areas and includes 4 appendices that diagram the pre-claim review request submission process and claim submissions with and without a pre-claim review.

The Pre-Claim Review Demonstration is a three year project that applies to all home health agencies in Illinois, Florida, Texas, Michigan, and Massachusetts.

Under the demonstration,the agency will submit a pre-claim review request to receive a determination regarding eligibility and coverage before submitting a claim.The contractor will review the pre-claim review request to determine whether the services meet applicable Medicare eligibility and coverage criteria. For initial reviews, a determination is to be issued within 10 business days, for subsequent reviews within 20 days.

As stated on the June 14, Special Open door Forum, CMS outlines in the Operational Guide specific information to be listed on the Pre-Claim Review request. Documentation to support eligibility and coverage for home health services must also be submitted. However, CMS does not specify what documentation needs to be submitted nor do they provide guidance regarding acceptable documentation to support eligibility and coverage to assure affirmation of payment. 

Once a payment decision has been made, the agency will receive notice of the determination along with a unique tracking number (UTN) that must be placed on the final claim.

CMS states in the Operation Guide, as they did on the SODF, that for submission of a claim on a CMS-UB04 Claim Form, the UTN will be in field locator 63. For submission of electronic claims, the UTN must be submitted following the OASIS assessment data (Positions 1-18) in positions 19 through 32 of loop 2300 REF02 (REF01=G1). This claim location for the UTN originally raised concern since it is the same location for home health Treatment Authorization Code.

If a claim is submitted without a UTN the claim will be subject to a 25 % reduction in payment. CMS is providing a 3-month grace period from the 25% reduction beginning from the time the demonstration is initiated in each state.

CMS has also revised the FA​Qs document for the Home Health Pre–Claim Review Demonstration and added several new questions and answers.

A second Special Open Door Forum call on the home health Pre-Claim Review Demonstration is scheduled for June 28.

 

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