Evidence record
Electronic Visit Verification Audit Ohio Department of Medicaid
- Jurisdiction
- Ohio
- Publishing agency
- Ohio Auditor of State
- Publication date
- November 1, 2024
- Source record
- Original document linked
Findings
5
Recommendations
3
Overall conclusion
The audit identified significant gaps in EVV utilization and matching, with only 44% of claims supported by EVV data in 2022. The Department has made efforts to implement EVV but faces challenges including low provider compliance, technical issues, and stakeholder engagement. The report recommends enhanced communication, monitoring, and enforcement strategies to improve EVV adoption and effectiveness.
Scope
The audit analyzed EVV data for the period January 1, 2022, through December 31, 2022, focusing on Medicaid personal care services (PCS) and home health care services (HHCS) in Ohio, including claims paid during this period totaling approximately $2 billion, to assess compliance with EVV implementation and identify barriers to its effective use.
Findings (5)
Each finding has a stable link.
- F-123
EVV was utilized for 44 percent of provider paid PCS and HHCS claims in 2022.
- F-124
Approximately 56 percent of all paid services were not processed in the EVV system, indicating they were not matched to a verified EVV entry.
- F-125
37 of 100 providers in the sample did not submit any EVV data at all.
- F-126
Approximately 34 percent of EVV entries were manually adjusted.
- F-127
Low compliance rates attributed to lack of incentives, administrative burdens, and beneficiaries’ privacy concerns or misunderstandings.
Recommendations (3)
- R-145
Communicate with beneficiaries to address misconceptions about EVV and consider reconvening stakeholder groups for input.
Related finding F-127 - R-146
Create a statewide scorecard to report EVV system effectiveness and compliance.
Related finding F-124 - R-147
Evaluate and implement EVV as a condition of payment for all required services, establishing standards for EVV data match percentages, and proactively assist non-compliant providers.
Related finding F-125