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Dear Provider,
The Ohio Department of Medicaid (ODM) is introducing an Online Live-In Caregiver Exemption Request Form to streamline the request process.
The new form replaces the previous process of completing and submitting the form manually to ODM via encrypted email or fax. The online form also includes validations to ensure required fields are completed prior to submission.
If you have already submitted the paper form, it is currently being processed, and you do NOT need to submit an online request.
Exemption Requests
Ohio Administrative Code rule 5160-32-01, Electronic Visit Verification (EVV) program, permits an exemption to visit capture requirements when the direct care worker (DCW) is a resident of the same household as the Medicaid waiver recipient receiving services.
Online Exemption Request Form
The online exemption request form is designed to simplify the application and approval process for providers.
- Fields are visually flagged with red asterisks to quickly denote data requirements needed prior to submission.
- Service Procedure Codes are included for all applicable supports subject to this exemption.
- Upon form submission, providers will receive an automated email confirming that an application has been submitted and is in queue for ODM review.
- Following ODM’s review, the provider will receive follow-up email notices, based on the completeness of the application. The responses may:
- Notify the provider of reason ODM is unable to process the request for exemption and to resubmit the request.
- Verify that the request has been approved and remind the provider to validate the live-in caregiver exemption within the EVV system.
Requirements Prior to Approval
Prior to submission of this form, the provider must ensure the DCW, and the Medicaid recipient records are in the EVV system.
For those using an alternate EVV vendor, a Fiscal Management Services entity, or both, the DCW record, and the Medicaid recipient record must both be documented in the state’s Aggregator system.
PLEASE NOTE: Direct care workers seeking live-in caregiver exemptions must continue to log all services subject to EVV until ODM officially approves the exemption request. Additionally, any paper-based request forms already submitted to ODM do not have to be resubmitted electronically.
For More Information
Details on the live-in caregiver process can be found on the Ohio Medicaid EVV webpage under the “Information for Providers” resource card. Scroll down to find “Live-in Caregiver Exemption view.”
Thank you.
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