Current through Register Vol. 63, No. 9, September 1, 2024
(1) For dates of service beginning July 1,
2019, the Fund will pay eligible medical services providers the costs incurred
for providing sexual assault medical services to victims of sexual assault up
to the following maximum amounts:
(a) $475.00
for a medical examination plus collection of forensic evidence using the Oregon
State Police SAFE Kit;
(b) $215.00
for a medical examination without collection of forensic evidence using the
Oregon State Police SAFE Kit;
(c)
$70.00 for emergency contraception (including pregnancy test);
(d) $125.00 for sexually transmitted disease
prophylaxis;
(e) Up to five (5)
days of HIV prophylaxis will be paid at 50% of the amount charged, up to a
maximum amount listed in 137-084-0020(h);
(f) $95.00 for services provided by a Doctor
of Medicine or a Doctor of Osteopathy;
(g) Payment for all other services provided
in conjunction with the sexual assault exam will be calculated using the Oregon
Workers Compensation Fee Schedule, up to a maximum amount listed in
137-084-0020(h); see section
137-084-0030 for examples of non-covered services;
(h) The combined maximum payment amount for
services listed in 137-084-0020(e) and (g) will not exceed $2,000.00;
(i) Payment for laboratory and radiology
services provided in conjunction with the sexual assault exam will be
calculated using the Oregon Workers Compensation Fee Schedule up to a combined
maximum amount of $500.00;
(j) Any
services provided after the date of the sexual assault exam will not be paid by
the SAVE Fund with the exception of 137-084-0020(k). Services after this date
may be covered by the Crime Victims' Compensation Program.
(k) Five (5) counseling sessions; counseling
sessions expire 18 months from the date of the sexual assault exam. Hourly
rates as of March 1, 2021:
(A) $160.00 per
hour for a Doctor of Medicine;
(B)
$130.00 per hour for a PhD, PsyD, or PMHNP;
(C) $105.00 per hour for an LCSW, LPC, or
LMFT;
(D) $75.00 per hour for a
QMHP.
(l) 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) An additional payment of $95.00 will be
made to eligible medical services providers who document that the medical
examination, as part of either a partial or complete medical assessment, was
conducted by a SANE/SAE as described in section
137-084-0001 of these
rules.
(3) The payment amounts set
out in this rule will be reviewed at least every four years by the Attorney
General or the Attorney General's designee to determine whether they should be
adjusted to meet current circumstances.
(4) An eligible medical services provider
(including subcontractor or other designee) who submits a bill to the Fund
under these rules may not bill the victim or the victim's insurance carrier for
a medical examination, collection of forensic evidence using the Oregon State
Police SAFE Kit, or other services provided in conjunction with the sexual
assault exam, except to the extent the Department is unable to pay the bill due
to lack of funds or declines to pay the bill for reasons other than untimely or
incomplete submission of the bill to the Fund under OAR
137-084-0030(2)(e).
Statutory/Other Authority: 2003 OL Ch. 789 (SB 752)
Statutes/Other Implemented: 2003 OL Ch. 789 (SB
752)
