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Okla. Admin. Code 317:30-3-34 - Electronic visit verification (EVV) system

OklahomaregulationOklahoma Health Care Authority (OHCA)· effective 2021-09-01

What this rule requires your agency to do

  • 1The provider must maintain EVV data for six years and implement secure data backup and recovery processes. (OAC 317:30-3-34(4))(Okla. Admin. Code 317:30-3-34 - Electronic visit verification (EVV) system)
  • 2The provider must submit claims using data from an OHCA-authorized and approved EVV system, because SoonerCare will not pay a claim unless the data comes from such a system. (OAC 317:30-3-34(5))(Okla. Admin. Code 317:30-3-34 - Electronic visit verification (EVV) system)
  • 3The provider must establish internal EVV policies and staff training, document manual visit modifications with justifications, and support required accessibility features and multiple users. (OAC 317:30-3-34(4))(Okla. Admin. Code 317:30-3-34 - Electronic visit verification (EVV) system)
  • 4The provider must use EVV for personal care services requiring an in-home visit, as defined in OAC 317:35-15-2. (OAC 317:30-3-34(2))(Okla. Admin. Code 317:30-3-34 - Electronic visit verification (EVV) system)
  • 5The provider must use an EVV system that verifies and documents the type of service (with code and modifiers), date of service, SoonerCare member ID, unique vendor/provider ID, service start and end locations, and service start and end times. (OAC 317:30-3-34(1))(Okla. Admin. Code 317:30-3-34 - Electronic visit verification (EVV) system)
  • 6The provider must recognize that EVV is not required for services delivered in community residential supports, group homes, congregate 24-hour settings, or settings where the member and service provider live in the same residence. (OAC 317:30-3-34(3))(Okla. Admin. Code 317:30-3-34 - Electronic visit verification (EVV) system)
  • 7The provider must use only OHCA-authorized and approved EVV systems and comply with HIPAA and applicable state reporting laws. (OAC 317:30-3-34(4))(Okla. Admin. Code 317:30-3-34 - Electronic visit verification (EVV) system)

Applies to: Personal care services requiring an in-home visit (as defined in OAC 317:35-15-2); home care / HCBS

Oklahoma requires providers of personal care services requiring an in-home visit to use an OHCA-authorized Electronic Visit Verification (EVV) system that captures the six federally mandated data elements (service type, date, member ID, provider ID, service locations, and service start/end times). Certain congregate and live-in settings are exempt, and SoonerCare will not reimburse claims lacking authorized EVV data.

Regulatory information, not legal advice — always confirm against the cited official source. Verification reduces error; it does not certify compliance.