In This Issue:
In the spirit of Thanksgiving all of us at the Ohio Department of Medicaid are deeply grateful for your dedication to serving Ohioans in need.
Wishing you a holiday filled with joy!
Beginning January 1, 2026, Ohio Home Care and PASSPORT waiver providers must submit claims with complete and matching EVV data. Claims that do not match will be denied.
To help you prepare for this change, Ohio Medicaid and HHA Exchange (formerly Sandata) have developed a series of trainings and resources to help you be successful. They include:
Providers can find the latest tools supporting the claims validation requirement on Ohio Medicaid’s Electronic Visit Verification webpage.
Clarification on DODD Unit Calculations
We’ve received a few questions about how unit calculating works for DODD services. First total the time for the calendar day, then calculate the units based on that total.
When billing for more than one service code in a day, the total number of units you can bill must match the total minutes recorded in the EVV system for that day.
For example, if EVV shows 8 units total, but you round up and get 4 units for one code and 5 for another, that adds up to 9 units—which is too many.
The provider must decide how to split the 8 allowed units between the codes so the total doesn’t go over what EVV recorded.
For more details, review How to Align DODD Claims with EVV Units.
EVV Covered Services for DODD Providers
Need help understanding what services must comply with EVV claims submission requirements? Check out DODD’s billing and claims webpage.
A couple reminders:
- After a service has been given, providers have up to 350 days to submit a claim.
- Shared Living services are not subject to EVV requirements and visits should not be captured in EVV for these services.
The November EVV Stakeholder Workgroup meeting has been rescheduled for Monday, November 17, from 2:30–4 p.m. so members can enjoy the full Thanksgiving week holiday. Register here to attend the meeting. To catch up on last month’s meeting see October EVV Stakeholder Workgroup presentation .
ODM’s proposed EVV rules amendment to OAC 5160-32-02 and 5160-32-03 allowing independent providers to select an ODM-certified alternate EVV vendor has been approved. Make sure the selected Alt EVV system:
- Complies with technical specifications
- Adheres to business rules
- Completes a technical certification process with Sandata
- Successfully completes (or has previously completed) a demonstration with Ohio Medicaid.
Visit the “Information for Providers” section on the Electronic Visit Verification webpage for more guidance.
MyCare Ohio is a managed care program designed for Ohioans who receive both Medicaid and Medicare benefits. On January 1, 2026, the redesigned program launches, rolling out in phases across the state to offer a person-centered integrated approach to managing benefits.
In preparation we want to make you aware of a few key changes coming.
- After December 31, Aetna Better Health of Ohio will not be participating in ANY program requiring EVV and United Healthcare will not be serving as a MyCare Ohio health plan.
- On January 1, Anthem will be added as a Next Generation MyCare Ohio program payer.
Visit MyCare-Ohio for more insight into the 2026 launch.
Independent Providers
As an independent provider with an existing EVV account how do I add a new, active Medicaid ID to replace the inactive one currently linked to my account?
To replace an inactive Medicaid ID, access the Provider Network Management (PNM) module and update the email address under the Primary Service Address. Edit Key Identifiers Quick Reference Guide for more instructions.
Once updated, follow the steps below to add a new Medicaid ID.
- Go to the Sandata EVV Registration Portal.
- Click on “Register as Provider.”
- Enter the new Provider Medicaid ID.
- Enter the provider’s social security number (SSN) in the EIN/TIN field.
- Click “Register.” If a match is found, the provider completes the standard registration steps.
NOTE: Independent providers without access to updating key identifiers in PNM must complete a Provider Admin Transfer in Medicaid’s Provider Network Management module. Review the Provider Administrator Transfer Guide for instructions.
All Providers
How do I complete a Sandata Mobile Connect group visit? When completing a group visit in the Sandata Mobile Connect (SMC) app, it is important to complete each recipient’s visit separately.
If you accidentally select “Complete Group Visit,” the visit will end for all recipients without giving you the ability to select the home or community location. Follow the process outlined here to ensure all required data is captured and sent to Sandata EVV.
Sandata regularly updates its EVV software via releases to ensure it runs smoothly. Below are the changes introduced in the Sandata EVV web portal and Sandata Mobile Connect app.
 Questions about releases or the system in general should be directed to the Sandata EVV Provider Hotline at 855-805-3505 or ODMCustomerCareemail@sandata.com.
Ohio Medicaid and HHA Exchange (formerly Sandata Technologies) are ready to assist providers and agencies in meeting claims validation requirements and more.
Click here to see who to contact regarding specific topics.
To stay updated on ODM EVV program communications, sign up for notifications by clicking Subscribe to Medicaid News on the Ohio Medicaid website.
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