What Ohio's “No Match, No Pay” Policy Means for EVV
As of March 1, 2026, the state of Ohio is transitioning to a “no match, no pay” policy. This means any mismatch between EVV data and billing claims will result in an automatic denial.
Before this policy was implemented, Medicaid would pay bills immediately, even if the EVV data didn’t match the claim. It was then up to the administrator to correct the EVV record with an eye towards future audits. Now that this honor system is obsolete, Ohio home care agencies can still resubmit a claim with the corrected data — but they won’t see a dime until the process is complete, changing the entire conversation around Ohio EVV.
Now that 100% data accuracy is a must-have, agencies are up against severe cash-flow volatility. Even minor logging errors or GPS mismatches can freeze payments for weeks, often leaving providers without the liquidity required to make payroll. Here’s everything you need to know about the new policy as it comes into effect.
Overview of Ohio EVV Requirements
EVV state requirements can look different from region to region, but some baseline standards remain the same. The purpose of EVV is to prove each caregiver is providing approved services to the right client at the right time and in the right place.
To do so, the system must log six data points for each home care visit: the type of service performed, the individual receiving the service, the date of service, the location of service delivery, the caregiver’s name, and the appointment’s start and end time. Across the U.S., every home care visit serving a Medicaid waiver participant must meet this requirement.
The following programs must be tracked using EVV per the Ohio Department of Medicaid. A complete list of billing codes per program can be found here.
- State Plan Home Health & Nursing Services
- Ohio Home Care Waiver
- MyCare Waiver
- PASSPORT Waiver
- Level 1 Waiver
- Individual Options Waiver
- SELF Waiver
What “No Match, No Pay” Really Means
“No match, no pay” means exactly what it says: if claim data does not match a verified visit record (or valid EVV exemption), the claim is automatically denied with no upfront payment. This foists all of the revenue risk onto the agency, as mismatched information now presents an immediate cash flow disruption.
Previously, mismatches were typically flagged for post-payment review, giving home care agencies the cash they need upfront and allowing for after-the-fact corrections. Now, it can take 30 to 60 days for those payments to come around after a correction, creating a significant financial bottleneck.
Policy Timeline & Enforcement Milestones
Every Ohio home care agency should know these key rollout deadlines:
- October 1, 2025: DODD Waiver hard edits go live.
- January 1, 2026: PASSPORT & OH Home Care Waiver hard edits take effect. Immediate claim rejections if EVV isn’t 100% accurate.
- January 1, 2026: NextGen MyCare Transition members moved to new payers (like Anthem). Outdated authorizations in EVV now result in denials.
- March 1, 2026: MyCare Ohio hard edits go live. “No match, no pay” takes full effect.
Prior to last October, major changes were already taking effect. March 2025 was Phase 1 of “no match, no pay”: claims for State Plan Home Health Services billed to Fee-for-Service (FFS) Medicaid were the first to face automatic denials if a matching EVV record was not found. Phases 2 and 3 occurred in June 2025, when enforcement expanded to Private Duty Nursing (PDN) and Home Health services billed through Managed Care Entities. On August 1, strict validation began for PDN, Nurse Assessments, and Consult services billed to all Managed Care Entities.
Due to all of these changes combined, agencies’ billing cycles are no longer operating in the same way. In 2026, billing became a daily task rather than a weekly review, as administrators now pore over each submission to double-check for errors. As of April 1, yet another administrative touchpoint will be added to the mix: any manual edit made in an alternate EVV system must include a specific “Code 99.” If your software isn’t updated to send this code, the visit will be rejected.
Operational Risks Under “No Match, No Pay”
EVV has transformed from a routine compliance task into a primary pillar of agency survival, with essentially zero margin for error. A missing clock-out, for example, used to be a simple “warning” on a report. Now, it’s an automatic denial and $0 upfront.
With so much riding on each submission, billing teams are spending far more time on manual verification. They’re no longer just billing experts, but also “error hawks,” chasing down caregivers to fix GPS errors or make manual edits before a single invoice can be sent.
By the time administrators fix the EVV record associated with a rejected claim and resubmit, weeks can go by before the payment comes through. Meanwhile, the caregiver associated with that appointment was likely paid out weeks ago, creating a dangerous cash flow imbalance.
How To Stay Compliant With Ohio EVV Requirements
With so many manual tasks coming into play, agencies must automate as much of the EVV process as possible. AxisCare, for example, is fully compliant with Ohio EVV requirements and integrates with Sandata to help agencies stay compliant and avoid denials.
Switching to mobile check-ins over telephone check-ins is another way to reduce the risk of errors. A caregiver mobile app connects directly to GPS to deliver accurate, real-time data straight to a unified system. On the other hand, telephony leaves room for misunderstandings and is not necessarily conducive to real-time communication.
With “no match, no pay” in place, agencies may want to enforce a new requirement for caregivers to sync their apps before leaving the client’s home. In 2026, a visit that hasn’t synced to the Sandata aggregator by the time it’s billed is a guaranteed denial.
Teams may also appoint a delegated member to clear the Sandata exceptions (red dots) list every day. To avoid denials, a visit must be in “Verified” status before the billing software touches it. It’s also important to verify that billed units do not exceed the total minutes recorded by EVV. If a caregiver works 55 minutes, you can only bill 3 units. If your software rounds up to a 4th unit, it will trigger a mismatch denial.
Technology’s Role in Navigating “No Match, No Pay”
Many EVV software systems have early-warning features that flag errors before caregivers even leave a client’s home. For example, instead of finding out about a missed visit during the Monday morning billing review, admins will receive a text or notification as soon as a missed punch is logged.
GPS fencing prohibits check-ins from occurring anywhere else but the client’s location, and many apps prompt caregivers to finish tasks or capture required signatures before they can clock out. That way, every visit has a clean, complete record of the six essential data points.
When agencies rely on a digital management system that unifies all of their data, they unlock reporting capabilities that can secure their operational health. Key Performance Indicators (KPIs) like auto-verification rate (the number of visits that sync perfectly without any manual edits) track revenue cycle trends, and if agencies fall below a certain metric, it can trigger a mandatory Corrective Action Plan (CAP).
Preparing for Future Changes & Audits
“No match, no pay” marks a major turning point for Ohio’s EVV landscape, but it shouldn’t be mistaken for a grand finale. It establishes a new baseline moving forward, but the associated regulations may very well continue to evolve.
Agencies have a responsibility to proactively monitor OEM communications for crucial updates, while keeping an eye on their internal EVV performance metrics to protect their financial wellness. The more they stay on top of EVV compliance and data hygiene, the more ready they’ll be for any audits or post-payment reviews that come their way in the future.
Remain EVV Compliant With AxisCare
AxisCare is a purpose-built home care software that is fully integrated with EVV. Our teams stay on top of emerging legislation and integrate the necessary guardrails into our platform, keeping you compliant and ahead of the curve. Request a free demo with our team to learn more about how we can help defend your bottom line.
