EVV Update for Ohio Medicaid

Dear Provider, At the ODM EVV Stakeholder Group meeting, it was explained that ODM is planning to perform post-review audits on providers for their EVV claims beginning February 13th. So, while ODM “delayed” the billing go-live that was slated to begin February 13th, providers still could be subject to ODM “clawbacks” from that date moving forward. What does this mean? This means any claim that isn’t cleared through EVV could be subject to recoupment by ODM for “overpayment.” While ODM has said that the focus of the reviews will be on the “lowest performing providers”, ALL providers could be subject to these reviews. ODM shared that around 52% of claims would be denied because of non-clearance through EVV. According to ODM, this information was compiled from data sets taken from October and November of last year. While we might be able to assume the numbers have improved since that time, claims being denied is nowhere near the regular average of less than 8%. Overall, we think ODM’s announcement of a delay is not really a delay if they plan to recoup dollars, and it’s caused a false sense of security with providers. Our best advice at this point is to keep moving forward toward compliance. In the meantime, please continue to work towards coming into compliance with EVV, if you are not already.