The proposed rule amendments are intended to clarify applicant and payment procedures for initial forensic physical exams for victims of sexual battery.

 

DEPARTMENT OF LEGAL AFFAIRS

Division of Victim Services and Criminal Justice Programs

RULE NO.:RULE TITLE:

2A-3.002Applicant and Payment Procedures

PURPOSE AND EFFECT: The proposed rule amendments are intended to clarify applicant and payment procedures for initial forensic physical exams for victims of sexual battery.

SUMMARY: This rule provides the application and documentation requirements and processes for payment of initial forensic physical exams for victims of sexual battery.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION: The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the Agency.

Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.

RULEMAKING AUTHORITY: 960.045(1) FS.

LAW IMPLEMENTED: 960.28 FS.

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN THE FAR.

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Michelle Crum, Chief, Bureau of Victim Compensation

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

2A-3.002 Applicant and Payment Procedures.

(1) The Bureau of Victim Compensation pays for medical expenses connected with the initial forensic physical examination of a victim of sexual battery as defined by 794.011 (h), F.S., or a lewd or lascivious battery or molestation as defined by 800.04 (4) or (5), F.S.

(2) Payments are awarded regardless of whether the victim is covered by health or disability insurance.  The victim must not be billed directly or indirectly for expenses associated with the examination.

(3) Payments are not contingent on the victim’s participation in the criminal justice system or cooperation with law enforcement.

(4) The claim form and invoice must be filed and received by the department within 120 days of the forensic examination. Corrections or technical defects in claim form or invoice shall not result in a change to the original filing date for purposes of complying with the filing deadline.

(5) The claim form and invoice shall be mailed to the Office of the Attorney General, Bureau of Victim Compensation, PL-01, The Capitol, Tallahassee, FL 32399-1050; faxed to [phone] or [phone]; or emailed to [e-mail], or submitted via the department’s web portal.  The form BVC100SB, Sexual Battery Forensic Examination Claim Form revised 10/15, is adopted and incorporated by reference at the following address: http://www.flrules.org/Gateway/reference.asp?No=Ref-______.  A copy of said form can be obtained at www.myfloridalegal.com or by contacting the Office of the Attorney General, Bureau of Victim Compensation.  Failure to submit a properly completed claim form and invoice will result in denial of benefits.

(6) For a faxed claim form and invoice to be timely received, the transmittal cover page must provide sufficient information to identify the claim for which payment is sought, and bear a faxed date stamp that is within 120 days immediately following the examination.

(7) Payment shall not exceed $500 with respect to any violation.  Separate invoices submitted for payment consideration of a single examination shall be divided in accordance with the direction and discretion of the department.

(8) The claim form shall include the following:

a. The victim’s name;

b. Optional demographic data for statistical purposes, including date of birth, race/ethnicity, gender, and national origin;

c. The date the sexual battery or lewd or lascivious battery or molestation as reported by the victim;

d. Indication whether or not the victim has reported the incident to law enforcement, and if so, what law enforcement agency took the report, and the case/report number, if applicable;

e. City, county, and state where the crime was committed according to the victim’s statement;

f. Whether or not the crime occurred while the victim was incarcerated or in custody;

g. The date the examination was completed;

h. Forensic facility information which includes the name of the facility where the examination was performed, the facility’s federal tax identification number, mailing address, email address (if applicable), and telephone number including the area code;

i. The name of another employee of the facility who was present at the time the examination was performed and shall henceforth be identified as the witness;

j. The witness must attest to the fact that the examination was performed on the victim at the location identified; and

k. The signature of the witness and date of signature;

l. Forensic examiner information which includes their name, title, and license number;

m. Certification by the forensic examiner to affirm that the initial forensic physical examination for which the claim is based was performed for the purpose of collecting forensic evidence from the victim on the date identified using practices consistent with the establish Adult and Child Sexual Assault Protocols; and

n. The signature of the forensic examiner and date of signature.

(9) The itemized invoice shall be prepared using industry standard forms or on the provider’s letterhead.  It must include the following:

a. Facility name, address, and tax identification number;

b. Date of the examination;

c. Victim’s name;

d. Examination diagnostic codes for observation following alleged rape or seduction (V71.5), encounter for examination and observation following alleged rape (Z044), encounter for examination and observation following alleged adult rape (Z0441), encounter for examination and observation following alleged child rape (Z0442); and

e. One or more of the following procedures:

i. Certified or board-eligible healthcare examiner’s office or other outpatient services;

ii. Emergency department services;

iii. Use of medical facility for the collection of forensic physical evidence;

iv. Venipuncture for the collection of blood samples;

v. Laboratory tests for baseline sexually transmitted disease and pregnancy; or

vi. Forensic evidence collection kit.

(10) Only medical expenses connected with the initial forensic physical examination shall be considered.

(1) Application for payment of the initial forensic sexual assault examination shall include the following:

(a) Patient Information: Name, date of birth, and gender of the individual being examined,

(b) Forensic Facility Information: Name of facility, federal identification number, mailing address and telephone number,

(c) Date of the offense (if known), and

(d) Date of the examination.

(2) The examination must be administered by a person authorized in Section 960.28(2), F.S., for whom the following must be provided:

(a) Typed or legible printed name of the forensic examiner,

(b) Examiner’s title and license number,

(c) Examiner’s signature, and

(d) Date of signature.

(3) The application must be witnessed (signed and dated) by another individual employed with the facility as verification the examination was performed. The witness’ name should be typed or printed below their signature.

(4) Application for payment must be accompanied by an itemized bill (CMS, HCFA, or UB health insurance form or other standardized invoice). The itemized bill must include the following:

(a) Name of the facility used for the examination,

(b) Date of the examination,

(c) Patient’s name, and

(d) Examination code V71.5 and any of the CPT codes noted below.

(5) Payment for the examination is limited to the International Classification of Disease (ICD-9) code for examination of the victim of sexual battery (V71.5), and some or all of the following:

(a) Physician/ARNP office or other outpatient services; emergency department services – CPT codes 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99281, 99282, 99283, 99284, 99285,

(b) Venipuncture for the collection of whole blood samples – CPT codes 36406, 36415,

(c) Laboratory tests for baseline sexually transmitted disease and pregnancy – CPT codes, 81025, 84702, 84703, 86280, 86317, 86592, 86593, 86631, 86781, 87070, 87081, 87110,

(d) Use of medical facility for the initial forensic physical evidence collection examination – CMS/HCFA Revenue Code 450 or 510, and

(e) Forensic evidence collection kit – CMS/HCGA Revenue Code 270.

(6) Applications must be mailed to the Office of the Attorney General, Bureau of Victim Compensation, PL-01, The Capitol, Tallahassee, Florida 32399-1050 or faxed to [phone], [phone] or [phone] within 120 days after the date of the initial forensic physical examination.

(7) Corrections or technical defects in an application shall not result in a change to the original filing date for purposes of complying with the filing deadline.

(8) A victim shall not be required to file a claim for the initial physical examination with a health or disability insurance carrier.

Rulemaking Authority 960.045(1) FS. Law Implemented 960.28 FS. History–New 11-1-92, Amended 9-13-94, 9-26-95, 6-19-96, 9-24-97, 2-3-00, 3-17-03, 1-16-08, 8-1-10, ­­­­_________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Michelle Crum, Chief, Bureau of Victim Compensation

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Attorney General Pam Bondi

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: October 21, 2015

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: September 2, 2015