Ohio’s IDD system is distinctive in that it operates through a network of County Boards of Developmental Disabilities alongside the state-level Ohio Department of Developmental Disabilities (DODD). For IDD agencies, this means billing and authorization relationships often run through county boards in addition to the state Medicaid program — a structure that requires agencies to manage multiple compliance relationships simultaneously.
Ohio’s Dual-Layer IDD System
Ohio has 88 counties, each with its own County Board of Developmental Disabilities. County Boards play a significant role in service coordination, authorization, and oversight for individuals with IDD. Many IDD agencies in Ohio have contractual relationships with their county boards in addition to their Medicaid provider enrollment, and billing compliance requires meeting the requirements of both.
DODD publishes provider guidance and billing requirements through its provider resources portal. Agencies should also maintain close communication with their county board contacts for local requirements and authorization processes.
Ohio Medicaid Claims and the MITS System
Ohio processes Medicaid claims through the Medicaid Information Technology System (MITS). IDD agencies must maintain active provider enrollment and ensure their billing staff can navigate MITS for claim submission, prior authorization, and remittance review.
Ohio EVV Requirements
Ohio has implemented EVV for personal care and home health services in compliance with the federal mandate. Ohio uses a state-designated EVV aggregator, and agencies delivering covered services must ensure their EVV systems transmit visit data in the required format.
Vertex EVV Manager supports Ohio EVV requirements and integrates with the billing workflow to eliminate manual reconciliation. Explore Vertex’s Ohio-specific billing support.
DODD Rule Compliance and Documentation
DODD maintains a comprehensive set of rules governing the delivery and documentation of IDD services in Ohio. Service documentation must demonstrate that services were delivered as authorized, that person-centered planning requirements were met, and that agency staff met applicable qualification standards. Vertex Case Manager maintains the documentation needed to support DODD compliance reviews and Medicaid audits.
Waiver Programs in Ohio
Ohio operates several Medicaid waiver programs for individuals with IDD, including the Individual Options (IO) waiver, the Level One waiver, the SELF waiver, and the Transitions Developmental Disabilities (TDD) waiver. Each has distinct service definitions and rate structures. Agencies serving individuals across multiple waivers must manage billing distinctions between programs carefully.
