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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.


Ohio House Bill 537: Proposed Regulations for Midwives and Birthing Centers

House Bill 537, introduced in the Ohio House of Representatives, proposes a comprehensive regulatory framework for certified nurse-midwives, certified midwives, licensed midwives, and traditional midwives. The legislation would clarify scope of practice, establish licensure standards, and impose new requirements for freestanding birthing centers and home births. Healthcare providers and facilities should be aware of the proposed changes and their potential operational impact.

Proposed Health Information Privacy Reform Act Expands Protections Beyond HIPAA

The Health Information Privacy Reform Act (HIPRA) seeks to extend privacy protections to health data not covered under HIPAA, including data collected by apps and wearables. HIPRA introduces broader definitions of protected health information, strengthens privacy and security requirements, establishes patient notification rights, and sets national de-identification standards. Companies processing health data should monitor developments to ensure compliance.

Medicare Updates on Skin Substitutes: LCDs Withdrawn, Payment Changes Take Effect

Medicare’s planned Final Local Coverage Determinations (LCDs) for skin substitutes were withdrawn in late December 2025, meaning previous coverage rules remain in effect. The 2026 Medicare Physician Fee Schedule introduces a single payment rate of approximately $127.14 for these products. Providers should review implications for diabetic foot and venous leg ulcer treatments.

Understanding the Seven Core Elements of an Effective Healthcare Compliance Program

The Affordable Care Act requires healthcare providers participating in Medicare, Medicaid, and CHIP to maintain an effective compliance program. Guidance from the Department of Health and Human Services and the Office of Inspector General outlines seven core elements that form the foundation of these programs, from written policies and compliance oversight to auditing, training, and corrective action. This alert highlights each element and explains how practices can tailor compliance programs to their size and risk profile while meeting federal expectations.

Preventing a Board Investigation

Healthcare professionals in Ohio are subject to licensing board investigations that can lead to disciplinary action. Staying compliant with regulations, documenting carefully, and operating within your professional scope can help prevent issues. If contacted by a board, working with an attorney is critical to protect your license and rights.