To clarify procedures and documentation for payment of forensic sexual assault examinations.

DEPARTMENT OF LEGAL AFFAIRS
Division of Victim Services and Criminal Justice Programs

RULE NO: RULE TITLE
2A-3.002: Application and Payment Procedures
PURPOSE AND EFFECT: To clarify procedures and documentation for payment of forensic sexual assault examinations.
SUMMARY: This rule provides the documentation requirements and procedures for claims for payment of the initial forensic medical examination for victims of alleged sexual offenses.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS: The agency has determined that this rule will not have an impact on small business. 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.
SPECIFIC AUTHORITY: 960.045(1)(b) 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 FAW.
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Gwen Roache, Chief, Bureau of Victim Compensation, Office of the Attorney General, PL-01, The Capitol, Tallahassee, FL 32399-1050

THE FULL TEXT OF THE PROPOSED RULE IS:

2A-3.002 Applicant and Payment Procedures.

Application and payment procedures for sexual assault examinations are provided on the form entitled “Sexual Battery Claim Form,” DVS-201, (Rev. 07/07), effective 1-16-08, which is incorporated in this rule by reference.

(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,

(d) Patient’s name,

(e) 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.

(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 Specific 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,_________.

NAME OF PERSON ORIGINATING PROPOSED RULE: Gwen Roache
NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Attorney General Bill McCollum
DATE PROPOSED RULE APPROVED BY AGENCY HEAD: May 25, 2010
DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: May 7, 2010