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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 Storms Capitol Hill to Stop Pre-Claim Chaos

September 16, 2016 04:03 PM

As NAHC and home health agencies (HHA) warned, the Pre-Claim Review Demonstration (PCR) begun in Illinois on August 3, 2016 by the Centers for Medicare & Medicaid (CMS) is creating chaos for almost 200,000 seniors across the state and the providers who serve them.

NAHC and its members have not been taking this laying down. NAHC staffers accompanied Sheila Guither, Sarah Ratcliffe and Micah Roderick – president, executive director and director of public affairs, respectively, for the Illinois HomeCare and Hospice Council on a series of visits to lawmakers on Capitol Hill to build support for opposition to PCR. They met with members of Congress from the Illinois delegation, including Mike Quigley (D-5), Peter Roskam (R-6), Tammy Duckworth (D-8), Jan Schakowsky (D-9), Bob Dold (R-10), Randy Hultgren (R-14), Adam Kinzinger (R-16), Cheri Bustos (D-17), Darin LaHood (R-18), and Senator Mark Kirk (R). In addition, NAHC staffers met with the office of Rep. Chris Murphy (D-18) of Florida.

Members of Congress are being urged to weigh in with CMS and urge it to cancel PCR or, at the very least, delay it for some time until its many problems can be worked out. Those problems are almost too numerous to list here, but they include a 60-80 percent non-affirmed rate, with reasons for denials often contradictory, nonsensical or downright non-existent. In one case, an agency submitted documentation for PCR and it was non-affirmed. Thinking the information provided was complete, the agency re-submitted the documents. This time the documents were confirmed, but with no explanation for the prior denial or why the very same documents were affirmed the second time they were submitted.

What’s worse, many Illinois agencies have received non-affirmations for physical therapy for whole knee replacements, with the Medicare Administrative Contractors [MAC] deeming therapy medically unnecessary. This is leading to HHAs withholding the start of care to patients until a favorable decision is received, resulting in longer hospital stays. This, of course, defeats the purpose of PCR, which is to eliminate unnecessary cost. An average day in an Illinois hospital costs $2025, but a home health visit costs a mere $168, so every single day a patient spends in a hospital when he or she should and could be receiving treatment at home, is a significant unnecessary cost. The Pre-Claim Review Demonstration is defeating its own purpose!

Other problems include the time-consuming new paperwork burden, an inefficient electronic system that cannot process the documentation, physician unfamiliarity with what is needed for PCR due to poor education from CMS and the MACs, and considerable cash flow problems at agencies. At least one Illinois HHA has closed due to PCR and others may soon follow. A rural hospital is on the verge of closing its HHA program. These closures will cause patients to go without the care they need and provider jobs will be lost.

None of this is what patients want. A recent national poll of voters over age 65 found that 83 percent of U.S. seniors believe doctors should be able to prescribe medications and treatments for their patients without government interference, yet MACs and the CMS are now contradicting doctors and stepping between physicians and their patients.

If PCR was created to root out fraud and abuse, it was poorly designed. The Office of Inspector General (OIG) has identified characteristics commonly found in fraud cases, so CMS should concentrate its resources on pursuing those outliers, instead of punishing hard-working and law-abiding home health agencies and their patients.

As if all this were not bad enough, what’s happening in Illinois will soon be spreading to Florida, Texas, Massachusetts and Michigan. There are 3.5 million homebound Medicare beneficiaries who depend on the Medicare home health benefit and they – and their providers – all stand to be negatively affected if PCR becomes our new national standard.

Due in part to NAHC’s efforts, 116 bipartisan members of Congress signed a May 25, 2016 letterto CMS calling for the withdrawal of the original prior-authorization proposal. In addition, Rep. Tom Price (R-GA), whom NAHC has worked closely with on this issue, asked at a September 7 House Ways and Means subcommittee hearing on Medicare if the country  would be “aided by a delay in this demonstration so CMS can get their act together?”  NAHC also worked with Senators Nelson (D-FL) and Rubio (R-FL) to send a letter to CMS requesting the PCR demonstration not expand beyond Illinois.

NAHC and its members are determined to find a superior alternative to PCR. It is possible to root out the fraud we all deplore without punishing patients and home health agencies. NAHC is committed to staying on this issue and will continue to make our case to members of Congress and CMS.

Stay tuned to NAHC Report on Monday when we will feature videos from home care patients and providers in Illinois discussing how they are dealing with the pre-claim review chaos. It will open your eyes and, we hope, prompt you to take action. Look out for it on Monday!

For even more on this issue, NAHC Report recommends this superb opinion piece written by Illinois HomeCare & Hospice Council President Sheila Guither and published in the State Journal-Register.




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