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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

OIG Report Finds Persistent Medicaid Abuse in Personal Care Services

October 5, 2016 10:53 AM

Federal investigators in the Department of Health and Human Services’ Office of Inspector General (OIG) are calling for reform after finding more than $600 million of questionable Medicaid billing from November 2012 to August 2016.

A new OIG report revealing the alleged abuse is sharply critical of Medicaid for not sufficiently cracking down on what investigators characterize as persistent fraud and abuse in Medicaid-funded personal care services. Better regulation and oversight is needed to prevent fraud and patient neglect, according to the OIG. The report is a compilation of findings and insights gained through several Medicaid audits and studies performed by the OIG in past years. Essentially, it is a trend report that was triggered by what the OIG perceives as a pattern of fraud and abuse in Medicaid personal care services.

Personal care services (PCS) are nonmedical assistance to the elderly, disabled and people with chronic or temporary conditions, so they can remain in their homes. PCS has expanded considerably since Olmstead v. L.C., a 1999 United States Supreme Court case holding that unjustified institutionalization of people with disabilities violates the Americans with Disabilities Act.

PCS fraud takes many forms, the OIG found. The PCS fraud that has been uncovered predominately involves “consumer-directed care” model services where the personal care aide is directly employed by the Medicaid recipient. However, the OIG notes that the fraud schemes also include agency-model programs where the aide is employed by a home care company.

The most common schemes involve payment for services that were unnecessary or not actually provided. However, fraud is usually difficult to find simply by reviewing documents. Most fraud cases involving PCS are discovered only through referrals from people who know that others are committing the fraud. However, an improvement in the quality and availability of PCS data would allow states, CMS, OIG and others to identify questionable billing practices – such as improbably large volumes of services, services that actually conflict with each other and services that could not have been rendered because the attendant was literally not in the same place as the Medicaid beneficiary.

The OIG report cited the example of a PCS attendant in Illinois who submitted claims for $34,000 for services never rendered to the beneficiary. The caregiver, who was barred from all federal health programs after she lost her nursing license for diverting controlled substances from her employer, claimed to have provided PCS to the beneficiary while the nurse was actually on vacation in the Caribbean.

Other, more serious examples of fraud, include considerable harm to the patient, such as a Pennsylvania beneficiary who died of exposure to cold because of a PCS attendant who lost the patient while shopping in Philadelphia and waited an hour before alerting authorities.

A big part of the problem, according to OIG, is a lack of consistent national standards for personal care workers. To remedy that, the OIG recommends “minimum federal qualifications and screening standards” for personal care workers, including background checks. Furthermore, the OIG recommends that CMS:

  • require states to enroll or register all PCS attendants and assign them unique numbers;
  • require that PCS claims identify the dates of service and the PCS attendant who provided the service;
  • consider whether additional controls are required to ensure that PCS are allowed under program rules and are provided.

The OIG report urges CMS to take regulatory action to establish safeguard that will prevent fraudulent or abusive providers from enrolling or remaining as PCS attendants.

Disturbingly, the OIG points out it issued a major report detailing many of the same abuses in 2012, and no major changes have happened as of yet.

NAHC has taken an aggressive role in combatting the risks of fraud in Medicaid PCS programs. For example, NAHC has supported appropriately targeted use of electronic visit verification systems that provide real-time tracking on the actual delivery of care to Medicaid clients. In addition, NAHC has strongly supported the development of competency standards for personal care aides providing Medicaid services along with credentialing of Medicaid home care agencies. Medicaid spending on home care has grown to over $70 billion annually, surpassing Medicaid nursing home spending for the first time in 2015. Still, the “rebalancing” of long term care spending in favor of home care has triggered concerns such as those highlighted in the OIG Investigative Advisory. NAHC will continue to work to reshape Medicaid into a community-based care program while strengthening program integrity to ensure that limited Medicaid dollars are not misspent.  




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