Current through Register Vol. 63, No. 3, March 1, 2024
The Department shall calculate payment of eligible
crime-related medical expenses under ORS
147.005 to
147.367
as follows:
(1) When the victim of a
compensable crime has been awarded compensation and does not have insurance
benefits or any other prior resource to pay for crime-related medical or
counseling expenses, the Department shall pay crime-related medical and
counseling expenses at the rates in the Oregon Workers' Compensation medical
fee schedules set forth in OAR 436-009-0040 except in the following
circumstances:
(a) When crime-related medical
expenses are incurred in another state, payment is made at 75% of the billed
amount;
(b) Payment for medical
expenses involving dental work shall be calculated based on Oregon regional
dental charges using a Dental Customized Fee Analyzer, which is paid at the 75%
percentile for the specific procedure. The Dental Customized Fee Analyzer is
available for inspection at the offices of the Department, 1162 Court St NE,
Salem, Oregon, 97301, between the hours of 8:00 a.m. and 5:00 p.m. Monday
through Friday, excluding holidays;
(c) Ambulance and emergency transportation
services are paid at 75% of the billed amount;
(d) Counseling services must be provided by
one of the following counseling providers in order to be eligible for payment
by the Department, and shall be paid at the following hourly rates as of March
1, 2021:
(A) Qualified Mental Health
Professionals as defined in OAR 309-039-0510(10) shall be paid at the hourly
rate of $75.00;
(B) Counselors,
therapists, and social workers licensed by the Oregon Board of Licensed
Professional Counselors and Therapists under ORS
675.705
through
675.835
shall be paid at the hourly rate of $105.00;
(C) Psychologists licensed under ORS Chapter
675 shall be paid at the hourly rate of $130.00;
(D) Psychiatric nurses licensed under ORS
Chapter 678; shall be paid at the hourly rate of $130.00;
(E) Doctor of Medicine or Doctor of
Osteopathy licensed under ORS Chapter 677 shall be paid at the hourly rate of
$160.00.
(e) The
Department may pay for other counseling services based on the nature of the
victimization and the education, training and experience of the provider when
sufficient documentation establishing the provider's education, training and
experience is provided to the Department. The Department will determine the
hourly payment amount based on the supporting documentation.
(2) For the purposes of ORS
147.035(7) and
(8), "other expenses" related to the review
or hearing shall be paid as follows, up to the maximum amount of the award or
$3,000, whichever is less:
(a) Lodging
expenses shall be reimbursed at actual expense, not to exceed the current
federal per diem lodging rates for Oregon found at
http://www.gsa.gov/portal/content/104877,
if the location of the hearing or oral argument is more than 70 miles one-way
from the residence of the victim, survivor, dependent, or personal
representative, and upon submission of a valid receipt. Reimbursement will only
be provided for the number of nights necessary for the victim, survivor, or
dependent to attend or be involved in the hearing or oral argument, as
determined by the Department;
(b)
Other reasonable and necessary incidental expenses generally associated with
travel and necessary for the victim, survivor, dependent, or personal
representative to travel to the hearing or oral argument shall be paid at
actual expense, at the discretion of the Department, up to a total amount not
to exceed the current federal per diem incidental rates for Oregon found at
http://www.gsa.gov/portal/content/104877
and upon submission of a valid receipt;
(c) Mileage reimbursement shall be paid at
$0.50 per mile for actual round-trip travel from the residence of the victim,
survivor, dependent, or personal representative to the location of the hearing
or oral argument. In lieu of mileage reimbursement, the Department may, at its
discretion, reimburse reasonable and necessary round-trip car rental or bus,
train, or air fare, upon submission of a valid receipt.