ODMR 2627-0011 Provider Oversight RFI

The Ohio Department of Medicaid (ODM) has issued Request for Information (RFI) ODMR 2627-0011 to gather data on tools, services, and measures to enhance provider enrollment and oversight activities. The primary objective is to prevent fraud, waste, and abuse within the Medicaid program, specifically focusing on the management and revalidation of approximately 30,000 providers in Home and Community Based Services waiver programs. Proposed solutions must integrate seamlessly with the Ohio Medicaid Enterprise Solution (OMES) and align with CMS guidance to revalidate all Medicaid providers within a two-year window. The scope of the RFI includes seeking information on eligibility screening, the management of on-site visits for various risk levels, the tracking of initial and revalidation applications, and methods for verifying provider location clustering and shared square footage compliance. Requirements also touch upon the use of standard credentialing forms from the Council for Affordable Quality Healthcare and adherence to state and federal confidentiality and privacy laws. This is an information-gathering effort for planning purposes and does not constitute a formal solicitation or a contract award. Interested parties must submit their responses as a single PDF document via the OhioBuys portal by December 4, 2026, at 2:00 pm EST.