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EVV Requirements for Ohio Medicaid Postponed to January 2025

Client Alert

Recently, the Ohio Department of Medicaid (ODM) announced that it is pushing back the effective date of changes to the Electronic Visit Verification (EVV) claims adjudication process to January 1, 2025. Previously, the EVV requirements were set to go into effect on October 1, 2024.

The ODM initiated its EVV program in 2018 to comply with the Federal 21st Century Cures Act, which required all state Medicaid programs to implement an EVV system to verify personal care services by January 1, 2020, and home health services, by January 1, 2023. 

EVV is an electronic system for providers to capture patient visit data and to more accurately bill ODM for home visits. In Ohio, EVV is specifically required for providers who participate in the following ODM programs:

  1. Ohio Home Care Waiver
  2. MyCare Ohio Waiver
  3. PASSPORT Waiver
  4. Individual Options Waiver
  5. SELF Waiver

The EVV system requires home health providers to enter five important data elements during eligible visits: 

  1. Who receives the service
  2. Who provides the service
  3. What service is provided
  4. Where the service is provided
  5. The date and time the service begins and ends.

Providers have three ways to capture the visit data: via a mobile app; dedicated phone line (i.e., telephony); or manual entry on a computer into the system. However, ODM only permits manual visit entry when a device app or telephony is not available or appropriate for the member’s needs.

If you have any questions regarding the EVV system and/or requirements, please contact BMD Healthcare Member Daphne Kackloudis at dlkackloudis@bmdllc.com  or Attorney Jordan Burdick at jaburdick@bmdllc.com.


Supreme Court Upholds Coverage under the Affordable Care Act

The U.S. Supreme Court has upheld the authority of the U.S. Preventive Services Task Force under the ACA, ensuring continued no-cost coverage for over 100 preventive health services. The decision impacts millions of Americans and preserves provider reimbursement through insurance.

Health Care Providers Take Note: Federal Budget Brings Medicaid and Staffing Rule Changes

The 2025 federal budget introduces significant changes for health care providers and Medicaid recipients, including new cost-sharing requirements, work eligibility mandates, rural health grants, and a pause on minimum staffing rules.

Key Healthcare Provisions in Ohio’s 2026–2027 Budget

Ohio’s newly enacted biennial budget (HB 96) for FY 2026–2027 brings sweeping changes for healthcare providers across the state. The law includes new Medicaid eligibility requirements, reporting mandates, funding directives, and social policy provisions. Several vetoes by Governor DeWine also affect healthcare-related initiatives.

Providers Beware: Court Sides with Insurers in No Surprises Act Arbitration

On June 12, 2025, the Fifth Circuit ruled in favor of Aetna and Kaiser in two lawsuits brought by air ambulance providers challenging how insurers calculated payments under the No Surprises Act’s Independent Dispute Resolution process. The court held that unless there is clear evidence of fraud or serious misconduct, IDR decisions will stand, reinforcing the finality of the arbitration process.

Introducing HB 281: Enforcement of Federal Immigration Laws in Ohio Hospitals

House Bill 281, introduced on May 20, 2025, would require Ohio hospitals to allow law enforcement, including federal immigration agents, to enter facilities and enforce immigration laws. The bill mandates that hospitals comply with information requests and adopt formal policies, raising significant concerns about patient privacy and access to care for immigrant communities.