Ohio waiver provider enrollment freeze set to end Nov. 14

Ohio's pause on new Medicaid provider enrollments has kept new developmental disability waiver agencies and independent providers from signing up since May 14. It reaches its scheduled end on Nov. 14, 2026. The Ohio Department of Medicaid (ODM) provider bulletin says the moratorium stays in effect until that date "unless an extension is authorized by the Centers for Medicare and Medicaid Services."

As of Nov. 2, ODM's program integrity page and the bulletin still listed Nov. 14 as the end date and did not announce an extension. Medical Daily reported on Nov. 1 that the state had not said publicly whether it would seek one.

What the freeze covers

Gov. Mike DeWine announced the moratorium in May as one of several Medicaid fraud-prevention steps. Others included immediate payment suspensions for providers whose billing shows "red flags" and GPS-based electronic visit verification. ODM put the freeze in place May 14. It cited the federal Medicaid moratorium rule, 42 CFR 455.470, and a CMS notice announcing nationwide moratoria on new home health and hospice enrollments.

The bulletin lists eight provider types in Ohio's Provider Network Management system. Two of them cover most developmental disability waiver providers:

• 45, Waivered Services Organization, the type used by provider agencies
• 55, Waivered Services Individual, the type used by independent providers

The other six are accredited and Medicare-certified home health agencies, non-agency personal care aides, non-agency home care attendants, private duty nurses and hospices.

The Ohio Department of Developmental Disabilities (DODD) carries the same notice on its pages for people applying to become a provider agency or an independent provider. The notice gives the dates as 5/14/2026 through 11/14/2026 and says ODM will not accept new enrollment applications for those types during that time.

What existing providers can and can't do

Under the ODM bulletin, providers that were already enrolled may:

• keep operating without interruption unless told otherwise
• keep submitting prior authorizations
• complete revalidation if it comes due
• update information for their existing locations in the self-service portal
• ask to add specialties by emailing ODM

They may not add new service locations while the freeze lasts. Managed care plans may contract only with providers whose ODM agreement took effect on or before May 13, 2026. Applications filed before May 14 that ODM had not processed were denied, with application fees refunded where they applied. The bulletin says those applicants can reapply once the moratorium is no longer in effect.

The freeze limits providers, not people. In a June member newsletter, the Ohio Provider Resource Association, which represents disability service providers, said the moratorium does not stop people from enrolling on waivers. It also said existing providers can keep accepting referrals, support people who move to a new apartment or home, and support people at new community employment sites. OPRA noted that this reflected its own reading of the guidance at the time and that state agencies could issue updates.

What happens on Nov. 14

The federal rule sets the timeline. A state must impose a moratorium for an initial six months. If it decides an extension is needed, it may extend in six-month increments, documenting in writing each time why the extension is necessary. Before imposing a moratorium of its own, a state must also determine that it would not hurt beneficiaries' access to care.

ODM's bulletin ties the Nov. 14 end date to CMS: the freeze ends then unless CMS authorizes an extension. If no extension is announced, the bulletin's guidance means applicants in the listed provider types, including those whose pending applications were denied in May, can apply again after that date.

A second change already in effect

Senate Bill 315, which DeWine signed in July, took effect Oct. 6. It makes a validated electronic visit verification (EVV) record a condition of payment for services that state or federal law already subjects to EVV, and it sets GPS-based clock-in and clock-out standards for in-home care. The new law's definition of "in-home care services" excludes, to the extent federal law allows, services under HCBS waivers for people with developmental disabilities, residential services billed at a daily rate, habilitation and transportation. A ban on paying family caregivers that was briefly added to the bill was removed before passage, the Statehouse News Bureau reported.

What this means for providers and DSPs

• Agencies planning to grow: a new service location still can't be added before Nov. 14. Watch ODM's moratorium page and DODD provider notices for an extension or a reopening date.
• New agencies and independent providers: if the freeze lapses, applicants whose filings were denied in May can reapply. DODD certification and ODM enrollment are separate steps, so check both.
• Existing agencies: under the ODM bulletin and OPRA's reading of it, existing providers can keep taking referrals, revalidating and supporting people who move. Medical Daily reported families' worries that when an aide leaves, replacements must come from a pool of providers that can't grow during the freeze.
• DSPs and independent providers: the freeze does not change work for providers who were already enrolled. Anyone planning to leave an agency and enroll as an independent provider (type 55) cannot do so until the moratorium ends.
• Questions: enrolled providers can call ODM's Integrated Help Desk at 1-800-686-1516. People receiving services can call the Medicaid Consumer Hotline at 1-800-324-8680 or contact their case manager or service and support administrator.