Ohio finalizes EVV Phase 5 rollout

Ohio has officially completed the rollout of Electronic Visit Verification (EVV) Phase 5, marking a major milestone in the state’s modernization of HCBS oversight. The update strengthens how visit data is captured, validated, and matched against Medicaid claims, and it signals tighter expectations for IDD, home care, and waiver providers heading into 2026.

What Phase 5 Includes

Phase 5 refines Ohio’s existing EVV program by expanding requirements around data accuracy, unit calculation, and visit matching. Key changes include:

More precise unit calculations
Providers must now ensure that billed units align directly with EVV recorded minutes. The state clarified that total minutes for a given day must convert consistently, preventing overbilling when multiple service codes or segments are involved.

Tighter claim matching rules
Claims that do not properly match EVV data will increasingly face delays, pends, or denials. In preparation for broader enforcement in Phase 6, Ohio is directing providers to clean up visit data in real time and address discrepancies quickly.

Improved oversight across IDD and waiver programs
The updates apply across DODD funded services, Ohio Home Care, and PASSPORT programs with the goal of making EVV a uniform verification tool across all HCBS delivery.

Why this matters for IDD providers

The Phase 5 update is part of Ohio’s larger move toward stronger Medicaid oversight. For IDD agencies, this means:

• More disciplined scheduling and documentation

• A reduced margin for manual corrections or retroactive fixes

• Greater reliance on technology platforms that track minutes, shifts, and notes consistently

• The need to routinely audit EVV data before submitting claims

Providers who operate multiple service types, such as HPC, homemaker and personal care, and community based supports, will feel the impact most as these codes often involve split units and complex shifts.

Looking ahead: Phase 6 and 2026 enforcement

Ohio Medicaid has already announced that Phase 6 enforcement will begin January 1, 2026, when unmatched claims will deny outright. Phase 5 is the state’s final ramp up period.

Agencies are encouraged to review:

• Visit verification processes

• Clock-in/clock-out completeness

• Staff EVV training

• Alignment between scheduling, documentation, and billing systems

EVV accuracy is no longer optional. It is becoming a core compliance requirement.