Overview
As of 2025, agencies supporting individuals with intellectual and developmental disabilities (IDD) are navigating an increasingly complex Medicaid landscape. Regulatory expectations are rising. Documentation must be tighter. Compliance is no longer something you check in on once a year, it needs to be baked into the day-to-day.
These requirements aren’t meant to create obstacles, they’re designed to ensure high-quality, person-centered care. But for agencies already stretched thin, staying ahead of every detail can feel like a full-time job. The good news? With the right systems and practices, compliance can become more manageable, and even empowering.
Here’s what IDD providers need to know about Medicaid in 2025, and how to stay compliant without losing focus on the individuals you serve.
Documentation requirements
Accurate, timely documentation remains the cornerstone of Medicaid reimbursement. For each billed service, agencies must include required details: staff name and credentials, service type, exact start and end times, location, and a clear description of what took place. Most importantly, the service must be connected to an authorized plan of care.
In 2025, more states are using automated claim validation tools to flag vague or incomplete documentation. That means the margin for error is smaller—and real-time, structured notes are essential to avoid denials or delays.
EVV has evolved
The federal 21st Century Cures Act requires states to implement Electronic Visit Verification (EVV) for Medicaid-funded personal care services (PCS) and home health care services (HHCS). The deadlines have already passed, January 1, 2020, for PCS and January 1, 2023, for HHCS, but enforcement is ramping up in 2025.
In many states, EVV now also applies to home- and community-based services like habilitation and in-home respite. Providers must capture time, location, and staff identity through state-approved systems. Failure to do so can result in claim rejections or funding reductions. For staff, EVV needs to be mobile, fast, and built into the flow of their day—not an extra burden.
Detailed ISPs
One growing audit focus is whether services are truly aligned with the Individualized Service Plan (ISP). That means documentation can’t just say what happened, it must clearly show how that activity supported the individual’s goals, outcomes, and support needs.
This shift reinforces the move toward person-centered planning. Staff need to understand what each goal means and how their daily work ties back to it. Agencies must train teams on ISP alignment and use documentation tools that make it easy to reflect that connection in real time.
Staying audit ready
State and MCO audits aren’t rare events anymore, they’re regular checkpoints. Agencies need to be able to produce complete documentation at a moment’s notice, and that means paper systems or scattered spreadsheets are no longer viable.
Being audit-ready in 2025 means using digital tools that keep records complete, searchable, and consistent. It also means building internal review habits, supervisors regularly checking notes, catching gaps early, and using dashboards to stay ahead. Agencies with strong systems don’t just survive an audit, they’re ready before the notice arrives.
Outcome tracking and reporting
Medicaid and managed care organizations are increasingly asking for more than “Was the service provided?” They want to know: Did it work? Are individuals making progress? Are supports helping people live more independently or achieve their goals?
To meet this expectation, agencies need to track progress in a way that’s clear, measurable, and connected to service delivery. Digital platforms that allow providers to link services to specific outcomes – and pull reports across programs—will be far better equipped to demonstrate value and secure funding under outcome-based models.
Stay compliant with Giv
We understand how overwhelming it can feel to keep up with Medicaid requirements. Especially when your team’s priority is supporting individuals. That’s why we built a platform designed for IDD agencies from the ground up.
With Giv, staff can document services in real time—on their phones, in the field. Supervisors can see progress instantly and approve notes without chasing paper. EVV, ISP alignment, and billing reports are built into the system, not bolted on after the fact. Everything you need to stay Medicaid-compliant is connected, automatic, and designed to reduce the time and stress it usually takes.
When compliance flows naturally as part of the process, it eases the pressure on staff and gives time back to focus on what really matters: supporting individuals. Learn more by exploring our product here.
