Current through Register No. 40, October 3, 2024
(a) The commission
shall consider and evaluate requests for compensation for mental health
expenses if the underlying facts of the claim meet the requirements of
Jus
605.01 and none of the circumstances resulting in
ineligibility described in
Jus 605.02
applies.
(b) A claimant submitting
a request for compensation for mental health expenses shall submit the
following information and documentation to support the request:
(1) The name and address of each licensed
mental health provider who provided crime-related treatment as identified on
any bills or invoices received for such treatment;
(2) An up-to-date release, insurance and
other collateral source information as described in
Jus
604.03;
(3) A completed "Insurance and Other
Collateral Financial Source Information for Vehicle Crimes" form as described
in
Jus
604.04, if the claim involves a vehicle
crime;
(4) A mental health
treatment plan signed by the licensed provider; and
(5) An authorization for the release of
mental health and related billing information that complies with all applicable
federal requirements for each provider.
(c) Once the unit has received the
information and documentation required pursuant to (b) above, the unit shall:
(1) Contact the licensed mental health care
provider to request a copy of the mental health treatment plan submitted by the
licensed mental health professional to the victim's insurance carrier, or if
the victim does not have insurance, the licensed metal health
provider-completed initial assessment and treatment plan;
(2) Contact the licensed health care provider
to request a copy of the mental health medication treatment plan created by a
health care provider licensed to prescribe medication;
(3) Contact the appropriate licensing body to
verify that the treating mental health care provider is in fact licensed in the
jurisdiction in which mental health treatment has been, is being, or will be
provided; and
(4) Contact the
licensed mental health care provider to request a copy of each bill or invoice
itemizing all charges for mental health services, including for medications and
medication management, the payment for which the victim is
responsible.
(d) The
following kinds of expenses shall be eligible for compensation under the
category of mental health expenses:
(1) The
actual cost of treatment, whether individual, group, or both, provided by
licensed mental health personnel, after first applying any available insurance
or other available collateral financial source, for mental health issues that
were directly caused by the crime;
(2) Mileage to and from appointments with
licensed mental health care providers, at the fee for service Medicaid rate.
Mileage shall be paid for trips over 10 miles round trip and shall be capped at
100 miles round trip; and
(3) All
other directly crime-related mental health expenses incurred, including
out-of-pocket expenses not already described above.
(e) Awards for compensation of mental health
expenses shall be limited pursuant to the following:
(1) The commission shall not award
compensation for mental health treatment or services provided by mental health
personnel who do not hold appropriate licensure for the kind of treatment
provided;
(2) The commission shall
award compensation up to $4,000 in total expenses, or 40 visits, whichever
comes first;
(3) The mental health
treatment shall be crime-related therapy;
(4) The commission shall award compensation
that does not exceed the portion of the cost of each individual therapy session
for which the victim is responsible, limited to the lesser of:
a.The Medicaid reimbursement rate applicable
to the licensed provider; or
b.The
amount billed by the licensed provider; and
(5) The commission shall award compensation
that does not exceed the portion of the cost of each group therapy session for
which the victim is responsible, limited to the lesser of:
a.The Medicaid reimbursement rate applicable
to the licensed provider; or
b.The
amount billed by the licensed provider.
(f) In circumstances in which a balance
remains after applying insurance, other collateral financial sources, and
compensation awards under this part, the commission shall contact the licensed
mental health care provider to whom the balance is owed and encourage that
provider to write off such balance.
#9553, eff 9-25-09
