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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

Congress Must Hear from You on Face to Face Legislation

July 12, 2017 03:11 PM

Rep. Earl Blumenauer (D-OR) and Kenny Marchant (R-TX) introduced the Home Health Documentation and Program Improvement Act – better known to the home health community as the face to face/physician documentation certification legislation – in late May of this year. The long-awaited bill would improve the current burdensome regulation regarding physician documentation for Medicare home health services.

A provision of the Patient Protection and Affordable Care Act requires a patient to have a face-to-face encounter with a physician to certify the need for home health care. The implementation of this provision by CMS involves unnecessary and time-consuming paperwork and other requirements that have caused not only considerable confusion among doctors and home health agencies, but, even worse, limited access to care and posed a high risk for denying overage to Medicare beneficiaries who are homebound and in need of skilled nursing care.

The CMS interpretation of this rule led to an ill-defined physician narrative demonstrating the patients need for home care services. Frustration and confusion ensued ultimately resulting in claims being improperly denied that should have otherwise been approved. These claims were deemed “insufficient” by CMS with no further explanation. There are an estimated 25,000 improperly denied claims that have been appealed and are now residing in an untenable backlog. As a result, CMS removed the physician narrative requirement in 2015.

Unfortunately, the current policy put in place by CMS has not been an improvement. Claim status is now solely dependent on the physician encounter documentation. This leaves out the home health agency’s documented comprehensive patient assessment. Claim reviewers are seeing just a piece of the patient’s full record. This clearly does not paint an accurate picture, and predictably, leads to many improper claim denials.

The legislation will remedy this policy’s shortcomings by directing CMS to consider the entire patient record, including the home health agency’s record, when determining benefit eligibility. The bill would also grant CMS the authority to settle improperly denied claims relating to the face to face requirement that currently reside in an appeals backlog.

We Can Fix This

The face to face requirement has been a persistent headache since its inception eight years ago and its evolution over the years has made pinpointing a permanent solution and building congressional support very challenging. However, NAHC believes we have the right solution in the Home Health Documentation and Program Improvement Act and are putting all efforts behind it.

In the House there are currently only 16 supporters for the bill and while that number seems low, it is to be expected. This is a new piece of legislation – it has not been introduced in any previous Congress -- meaning Members of Congress and their staffs are unfamiliar with it and need to learn more before they can put their support behind it. Furthermore, while the bill is a simple fix, it is still a bit technical and not easily understood by laymen.

This is where your help is needed.

NAHC has communicated with members and staffers about this issue and we will continue to do so. However, it makes a bigger impact when members hear from their own constituents. Please reach out to your Representatives and ask for their support on H.R. 2663, the Home Health Documentation and Program Improvement Act. You can send this message to members of Congress in just moments at the NAHC Legislative Action Center.

NAHC will notify members of a Senate bill as soon as it is introduced and keep readers up to date as the legislation builds support in Congress.

A NAHC fact sheet with additional information and talking points can be found here.




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