Ohio Administrative Code
Title 5160 - Ohio Department of Medicaid
Chapter 5160-32 - Choices Program
Section 5160-32-04 - Electronic visit verification (EVV) program providers
Universal Citation: OH Admin Code 5160-32-04
Current through all regulations passed and filed through September 16, 2024
(A) This rule establishes Ohio medicaid service provider requirements for services subject to EVV as described in rule 5160-32-01 of the Administrative Code.
(B) All providers and financial management service vendors will:
(1)
Complete initial and ongoing training per Ohio department of
medicaid (ODM) instructions published on the ODM website
https://medicaid.ohio.gov/resources-for-providers/special-programs-and-initiatives .
(2)
Create and maintain updated and accurate records of
individuals receiving EVV subject services. Needed data elements in the EVV
system include:
(a)
First and last name.
(b)
A minimum of one
known address at which the individual may routinely receive services. For
individuals participating in the address confidentiality program, in accordance
with section 111.42 of the Revised Code, the
address documented will be according to program policy and may include a post
office box.
(c)
Telephone number.
(d)
Program billing
identifier of the individual receiving the service:
(i)
Medicaid
identification number, otherwise known as medicaid ID: the unique billing
number assigned by ODM. The individual's medicaid ID is necessary for claims
validation;
(ii)
PASSPORT information management system ID assigned by
the Ohio department of aging for individuals temporarily enrolled in the state
funded preadmission screening system providing options and resources today
(PASSPORT) waiver program. When the individual receiving the service has been
assigned a medicaid ID, the provider should update the EVV system with the
individual's medicaid ID. Billed claims will not be validated unless the
individual receiving the service has an active and valid medicaid ID entered
into the system; or
(iii)
An indicator that the individual receiving the service
is a newborn, not yet assigned a medicaid ID. When the newborn receiving the
service has been assigned a medicaid ID, the provider should update the EVV
system with the individual's medicaid ID. Billed claims will not be validated
unless the newborn receiving the service has an active and valid medicaid ID
entered into the system.
(e)
Payer, program,
and service provided. Valid values accepted are found on ODM's website
https://medicaid.ohio.gov/INITIATIVES/Electronic-Visit-Verification/ .
(3)
Utilize EVV for
all services described in rule
5160-32-01 of the Administrative
Code.
(4)
Report known or suspected tampering of devices to ODM
upon discovery.
(5)
Report any known or suspected falsification of EVV data
to ODM upon discovery.
(C) Providers and financial management service vendors will create and maintain updated and accurate records of direct care workers providing services. Needed data elements in the EVV system include:
(1)
First and last name.
(2)
Social security
number.
(3)
Email address.
(D) State provided electronic device.
(1)
A provider electing to request an electronic device
provided by ODM will complete EVV training and submit the device request
using
https://etraconline.net/login.
(2)
When a provider is no longer providing services
requiring EVV or determines use of the state provided electronic device is no
longer desired, the provider will initiate the return process. The return
process can be found on ODM's website,
https://medicaid.ohio.gov/INITIATIVES/Electronic-Visit-Verification/ .
Replaces: 5160-1-40
Disclaimer: These regulations may not be the most recent version. Ohio may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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