Ohio DODD EVV, in plain English.

What is EVV, and why does Ohio require it?

Electronic visit verification (EVV) is the electronic capture of six facts about a home- or community-based service visit: the service, the person receiving it, the date, the location, the worker, and the start and end times. The federal 21st Century Cures Act requires every state Medicaid program to use EVV for personal care and home health services; Ohio's program started in 2018.

The point is simple even if the mechanics are not: the visit billed to Medicaid must be the visit that happened. Ohio Medicaid runs the program for its own waivers and for the Department of Developmental Disabilities (DODD) and the Department of Aging, so the same rules, the same aggregator and the same claims checks apply to an IDD agency delivering homemaker/personal care as to a PASSPORT agency delivering personal care aide services. Done well, EVV protects the provider as much as the payer: a clean, time-stamped record is the best answer to any question an auditor can ask.

Which DODD services require EVV?

Under OAC 5160-32-01, EVV applies to services on the Individual Options (IO), Level 1 and SELF waivers that are homemaker/personal care, participant-directed homemaker/personal care, residential respite when billed in fifteen-minute units, waiver nursing delegation, and waiver nursing service. Services provided by telehealth are exempt, and live-in caregiver visits are exempt once ODM has approved the exemption.

The rule sets the test as well as the list: a service is subject to EVV when its definition includes help with activities of daily living or work by a licensed health professional, it is delivered in the person's home or community, and it is paid in hours, partial hours or per assessment. Services that do not meet that test and are not on the list, for example adult day support, non-medical transportation, HPC transportation, shared living, and residential respite billed per diem, are not subject to EVV under the rule as it stands today. Two cautions: the same rule lists state-plan home health, private duty nursing and RN assessment or consultation as EVV services, so a DODD agency that also bills those is covered for them; and the proposed 2026 rule changes described below would bring some per-diem services into EVV.

What are the six data elements?

OAC 5160-32-02 lists them: the type of service performed, the individual receiving the service, the date of the service, the location of service delivery, the direct care worker providing the service, and the time the service begins and ends. Location is recorded at both the start and the end of the visit, as "home" or "community".

Location is not a GPS coordinate in the record. The worker (or the system) records whether the visit happened at the person's home of record or in the community, and the location at the end may differ from the start. GPS may be used to capture that location, but only with the person's signed consent (see below). When a plan allows services somewhere other than the person's home, a parent's house for instance, that counts as community.

How does Ohio's EVV model work?

Ohio Medicaid contracts Sandata (now part of HHAeXchange) as the state's EVV aggregator. Agency providers and independent providers choose either the state-provided Sandata EVV system or an ODM-certified alternate EVV system; either way, every visit ends up in the Sandata aggregator, which stores it, checks it for the six elements, and confirms that claims are supported by visit data.

The rule allows three ways to capture a visit: an application on a device (one issued by ODM at no cost, or the worker's own phone), telephony (a phone call to start or end the visit), and manual entry, which is permitted only when a device or phone is not available or appropriate and is never to be used for routine verification. Every new provider requests an EVV account in the Sandata provider self-registration portal with its Medicaid ID; agencies choose Sandata or an alternate vendor during that registration, and a provider with more than one Medicaid ID subject to EVV needs an account for each. Independent providers who want an alternate system first register for a Sandata account and then re-register to switch.

What is an alternate EVV vendor, and how does one get certified?

An alternate EVV vendor is a software system that captures visits in its own application and sends the required data to Sandata, Ohio's aggregator, instead of the worker using the state-provided Sandata app. OAC 5160-32-03 allows any provider to use one. To be certified, the vendor must meet ODM's technical specifications and business rules, pass a technical certification with Sandata, and complete a demonstration with ODM.

Certification is the vendor's job, but the provider has obligations too. Under 5160-32-03 a provider using an alternate vendor notifies ODM (or its contracted entity) of the intent to do so and completes alternate-system aggregator training; the provider remains responsible for making sure the visit data in the aggregator is correct and reflects the visit as it occurred, and that billing is supported by visit data. Neither ODM nor Sandata pays any cost of developing, certifying or using an alternate system. ODM can request re-approval of any alternate system at any time, and a vendor that stops meeting the specifications can have its certification revoked. Financial management service vendors contracted with ODM, the Department of Aging or DODD must hold and maintain alternate-vendor certification themselves. ODM publishes the list of certified vendors as a PDF (linked in the sources), and alternate-vendor support runs through a dedicated Sandata line, 1-844-289-4246, OHAltEVV@Sandata.com.

Most agencies that pick an alternate vendor do it for one reason: they do not want EVV to be a separate chore. If clock-ins, documentation, scheduling and billing already live in one platform, bolting a stand-alone EVV app onto the side creates another login and another place for data to fall out of sync.

What does the 2026 pause on new alternate vendor applications mean?

In 2026 ODM paused the processing of new alternate EVV vendor applications while it rewrites program requirements to implement Senate Bill 315 and the governor's Medicaid fraud-prevention initiatives; the changes affect the state vendor, the already-certified alternate vendors and every pending application. Agencies already using a certified vendor keep using it; a vendor that is not yet certified cannot become certified until the pause lifts.

Practically, this makes the vendor list the first thing to check. Ask any vendor for its entry on ODM's certified list and for the date of its most recent re-approval, and ask how it plans to meet the updated requirements when they are published. ODM's EVV page carries the pause notice and the current list; its monthly newsletter is where the new requirements will be announced.

What does a provider have to do?

Under OAC 5160-32-04 every provider must complete ODM's initial and ongoing EVV training and upload the certificate to the Provider Network Management (PNM) module, keep accurate records for each individual (name, at least one service address, phone, Medicaid ID, and payer, program and service) and each direct care worker (name, Social Security number, email), use EVV for every subject service, and report suspected device tampering or falsified EVV data to ODM on discovery.

A provider that delivers no EVV-subject services uploads the ODM 10376 training-exception attestation instead of a certificate. Claims are validated against the individual's Medicaid ID, so a visit recorded against a person without an active, valid Medicaid ID in the system will not validate. Some EVV services also require the recipient's co-signature on the documentation; ODM publishes a co-signature requirements resource by program and service, and the method depends on the waiver and the service.

Do we need GPS consent?

Yes, whenever GPS is used to capture location. OAC 5160-32-02(E) allows the GPS function of any application or device only with the signed consent of the person receiving the service, renewed annually; GPS cannot be switched on for a year in which consent has not been obtained, the provider keeps a copy, and the person can revoke consent at any time. ODM recommends its form ODM 10375, or your own form if it collects the same elements.

Without GPS, the location element is still required; it is captured by other means such as a home-or-community selection at the start and end of the visit. Keep the signed consents with the individual's record and calendar the renewal; an expired consent is one of the most common reasons a visit stops verifying.

How does claims matching work?

The aggregator collects every visit regardless of how it was captured, checks that the record contains all six elements, and confirms that each claim submitted to the payer is supported by the provider's visit data. Missing or inconsistent data produces an exception that the provider must resolve; a claim cannot be substantiated for payment until every exception is resolved and the visit data supports it.

Under OAC 5160-32-02(H), unsubstantiated claims may result in denial of payment or a post-payment review penalty, and ODM commits to telling affected providers at least three months before it starts denying claims or applying penalties on EVV grounds. For DODD providers the practical check happens at eMBS: a claim whose units exceed what the verified visit supports, a claim billed before the visit was verified, or a submitted claim whose visit later lost verification will come back with an EVV-related reason code. ODM publishes a claims-validation error guide and, for DODD, a claims-validation process flow; both are linked from the ODM EVV page.

What are the common reasons a visit fails to verify or a claim is denied?

Most failures trace to setup rather than to the worker: no active payer row for the individual (payer, program and procedure code), a missing or expired GPS consent, an individual record without a valid Medicaid ID, or a worker record missing a required element. The rest are timing: billed units larger than the verified visit supports, a claim billed before verification, or a manual entry used where the app or phone should have been.

Working these before submission is cheaper than chasing them after the claim bounces. Enmantle's EVV Status dashboard, for example, reconciles verified visits against billing rows and lists "not verified but billed" rows, unit mismatches, and submitted claims whose visits lost verification, so the fix happens before eMBS sees the claim.

What changed in 2025 and 2026?

Two of the four EVV rules, OAC 5160-32-02 (data collection) and 5160-32-03 (alternate vendors), were amended effective October 30, 2025. In May 2026 the governor announced Medicaid fraud-prevention initiatives that propose mandatory GPS for all EVV systems, EVV for live-in caregivers, and EVV for certain per-diem services, plus a six-month pause on enrolling new home-health and hospice providers. Senate Bill 315, the Ohio Medicaid Program Integrity and Fraud Prevention Act, was signed on July 7, 2026 and takes effect October 6, 2026.

The proposed rule changes were posted for public comment and, as of this review, had not yet been adopted; the newsletter in the sources describes them and the enrollment moratorium (effective May 14, 2026, for six months unless extended by CMS, covering provider types that include waiver organizations and waiver individual providers). Senate Bill 315 writes electronic visit verification for Medicaid home-care workers into statute, with EVV as a condition of payment, and expands ODM's program-integrity and enforcement authority. Together they mean three things for an IDD agency: assume GPS will be required, assume live-in and per-diem exemptions will narrow, and expect more data-driven audits of providers with incomplete visit data or a high share of manual entries. When the final rules are published, this page will be updated and the review date at the bottom will move.

Where does Enmantle fit?

Enmantle is a DODD-approved alternate EVV vendor and submits directly to Sandata. EVV is not a feature off to the side; it is part of the same platform a direct support professional already uses for the shift, so the visit verified in the field becomes the billable line without re-keying.

What that looks like in practice:

• GPS-stamped clock-ins from the mobile app, captured at the moment the visit starts and ends and nowhere in between, with the ODM 10375 consent tracked on the client's record.
• Service-code mapping handled for you, with every Ohio county board's rates already loaded.
• Submission errors surfaced and handled in an EVV status dashboard that reconciles verified visits against billing rows before the claim goes to eMBS.
• Offline-tolerant capture: clock in, document and log services without signal; it syncs when the device reconnects.
• A straight line to billing: the visit a DSP verifies in the morning is the line your billing director closes on Friday. Same record, no reconciliation.

Switching EVV systems mid-stream is normal: onboarding runs two to four weeks with a parallel-run period, so you keep submitting cleanly while you move, and migration support is included.