Section 5164.401
(A) The department of medicaid shall develop, procure, certify, or approve a process or system to obtain global positioning system coordinates to verify nonemergency medical transportation services provided under the medicaid program to medicaid recipients. In developing, procuring, certifying, or approving a system under this section, the department may do any of the following:
(1) Establish an internal electronic verification system;
(2) Contract with one or more vendors to establish an electronic verification system;
(3) Integrate with existing electronic verification systems utilized by the department.
(B) A system or systems developed, procured, certified, or approved in accordance with this section shall do all of the following:
(1) Utilize a ride dispatch system that is similar to other private transportation services;
(2) Utilize GPS-based verification to track a provider's arrival at a pickup location, initiation of a transport, arrival at a drop-off location, and completion of a transport;
(3) Record timestamps, route data, and total distance traveled during a transport;
(4) Be capable of transmitting data directly to the department as a condition of payment.
(C)(1) An electronic verification system developed, procured, certified, or approved in accordance with this section shall be used to ensure payment integrity within the medicaid program, compliance with state and federal requirements, and serve as a fraud prevention measure within the medicaid program. No data transmitted or stored by an electronic verification system shall be used to conduct unrelated surveillance of medicaid providers or for enforcement purposes unrelated to the medicaid program.
(2) All data transmitted or stored by an electronic verification system shall be encrypted, be subject to role-based access controls and audit logs, and comply with all requirements under state and federal law regarding the protection of patient information.
(D) The department shall integrate any electronic verification system developed, procured, certified, or approved under this section with the department's existing claims and encounters database and systems. If necessary, the department shall coordinate with medicaid managed care organizations and seek any necessary federal approval to facilitate coordination with electronic verification systems in the medicare program.
(E)(1) Not later than six months after the effective date of this section, the department shall develop technical standards and a plan for implementing the requirement of this section and sections 5164.402 to 5164.406 of the Revised Code. The department shall submit a copy of the plan to the general assembly in accordance with section 101.68 of the Revised Code.
(2) Not later than twelve months after the effective date of this section, the department shall establish a pilot program under which certain medicaid providers must utilize the electronic verification systems established under this section.
(3) Beginning not later than eighteen months after the effective date of this section, the department shall require all nonemergency medical transportation service providers to utilize an electronic verification system established under division (B) of this section.
(F) In establishing and requiring utilization of electronic visit verification systems under this section, the department shall ensure that medicaid recipients are not denied medically necessary services solely on the basis of a provider's failure to utilize a required system. The department shall further ensure that any transition periods that are the result of implementing the requirements of this section do not impact the continuity of care for medicaid recipients. The department shall provide training and technical support to providers to ensure compliance with this section.
Last updated August 12, 2026 at 4:31 PM
Available Versions of this Section
- October 6, 2026 – Enacted by Senate Bill 315 - 136th General Assembly [ View October 6, 2026 Version ]