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National Association for Home Care & Hospice
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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

Hospice NOE/NOTR Update

October 18, 2016 03:52 PM

Based on hospice provider feedback, the National Association for Home Care & Hospice (NAHC) understands that problems associated with timely submission/acceptance of hospice Notices of Election (NOE), as well as Notices of Termination and Revocation (NOTR), continue to have a substantial negative impact on hospice revenues and operations.  The Centers for Medicare & Medicaid Services (CMS) is engaged in ongoing efforts to address these concerns (see previous NAHC Report coverage:,,, 

NAHC is providing the following update on progress in this area, based on recent discussion with CMS staff.  CMS’ current plan to mitigate existing problems with NOE submission and acceptance by the Medicare Administrative Contractors (MACs) involves three separate efforts:

(1) Redesign of the Common Working File (CWF) in order to have benefit period information separate from election information independent of claims processing to allow for greater functionality,

(2) Modification of the 837i (institutional electronic claim) transaction to allow for electronic submission of the NOE, and

(3) Significant revamping of information included in the Medicare Claims Processing Manual related to NOE, NOTR, and CHOW.

Following is more detail related to these efforts, as well as the anticipated time frames for completion, where applicable:

Redesign of the Hospice Benefit Period Information in the CWF:  The current structure of the CWF does not allow for separate access to sufficient detail on hospice elections and benefit period information that is independent of claims processing.  CMS plans to separate election information from benefit period information in the CWF, which will allow for greater functionality and flexibility in the processing of election information and thereby reduce administrative burdens on providers and the MACs. It is anticipated that this change will permit changes to alleviate a number of the issues associated with direct data entry and processing of NOEs.  CMS and the MACs conducted an analysis earlier this year and plans are now in place to make the necessary changes.  However, the changes are so significant that they must be approached carefully, and require four separate updates via the routine quarterly releases of updates to the CMS software systems.  At this time CMS plans to issue the first of the four releases in April 2017, which means that if there are no unanticipated issues that arise while the changes are implemented and none of the releases is delayed, the work could be completed by January 2018.

Electronic Submission of NOE:  While CMS initially believed it could not permit hospices to submit NOEs electronically, analysis conducted by NAHC and submitted earlier this year ( convinced CMS that its previous understanding was incorrect.  CMS sought and received internal clearance to pursue electronic processing and solicited further input from an external electronic standards-setting body - The Accredited Standards Committee’s X12. CMS is in the process of addressing the recommendations laid out by X12.  CMS may not require hospices to submit the NOE/NOTR electronically – this must be a voluntary action because of current federal rule.  Electronic submission of the NOE/NOTR means that hospices would be notified during the NOE/NOTR submission process of errors such as incorrect beneficiary information.  Hospices would still have problems if the election date is entered incorrectly, but most other issues would be identified upfront, which would eliminate the days of processing currently needed to identify these types of errors.  CMS will need to develop a companion guide for 837i that hospice providers planning to submit NOE/NOTR electronically must agree to follow.  If this process continues to move forward as anticipated, hospices may be permitted to submit NOE/NOTR using the 837i by late 2017.   Again, issues could arise at any point in the process, but a great deal of progress has been made to date.

Revamping of Claims Processing Manual:  Through the process of addressing problems associated with timely filing of NOE/NOTR, CMS has concluded that there appears to be no single resource that providers can turn to for comprehensive information on submission of NOE/NOTR.  For this reason, it plans to revamp the Claims Processing Manual to provide more comprehensive information related to NOE, NOTR, and CHOWs.  Given CMS’ ongoing and intensive work related to the two issues above (CWF redesign and electronic submission of NOE) and other important matters, claims processing staff have not yet been able to invest significant effort in this project so an estimated time frame for completion of this task is not yet available. 

NAHC will continue to monitor progress in these areas – please watch for updates on the NAHC member listserv and in future issues of NAHC Report.




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