107 KAR 2:010. Payment schedule for sexual assault examinations.

 

      RELATES TO: KRS 216B.050, 216B.400, 314.142, Chapter 346, 403.707, Chapter 510

      STATUTORY AUTHORITY: KRS 216B.400

      NECESSITY, FUNCTION, AND CONFORMITY: KRS 216B.400 and 346.200 require that examinations for victims of sexual assault shall be paid for by the Crime Victims' Compensation Board at a rate determined by the board after consultation with the Sexual Assault Response Team Advisory Committee. This administrative regulation establishes the payment schedule for sexual assault examinations.

 

      Section 1. Definitions. (1) "Examination facility" means a sexual assault examination facility as defined in KRS 216B.015(26).

      (2) "HIV" means human immunodeficiency virus.

      (3) "Qualified medical professional" means any physician’s assistant or advanced practice registered nurse whose training and scope of practice include performance of speculum examinations.

      (4) "Sexual assault examination" means the forensic-medical examination and related services established by KRS 216B.400 and 502 KAR 12:010.

 

      Section 2. Reimbursement for performing a sexual assault examination shall be the actual amount billed and shall not exceed the following limits:

      (1) A physician, sexual assault nurse examiner, or another qualified medical professional performing the examination - $200;

      (2) An examination facility for use of an emergency or examination room - $250;

      (3) An examination facility or laboratory to perform diagnostic laboratory testing - $100; and

      (4) An examination facility for administered medications and pharmaceuticals prescribed as a result of the examination and as part of basic treatment - $100.

 

      Section 3. Reimbursement for additional services related to a sexual assault examination requiring HIV postexposure prophylaxis shall be the actual amount billed and shall not exceed the following limits:

      (1) Three (3) follow-up examinations - $150, not to exceed a total of fifty (50) dollars per examination;

      (2) Laboratory testing:

      (a) Initial testing conducted during the sexual assault examination in the examination facility - $150; and

      (b) Follow-up testing conducted during the three (3) follow-up examinations - $215, not to exceed:

      1. Fifty (50) dollars for testing conducted during day five (5) to day seven (7) of prophylactic treatment;

      2. Ninety (90) dollars for testing conducted after day twelve (12) of prophylactic treatment; and

      3. Seventy five (75) dollars for testing conducted near or at the end of prophylactic treatment; and

      (3) Medications:

      (a) Twenty-eight (28) day supply of HIV prophylaxis medication - $800, not to exceed:

      1. $200 for the first seven (7) day supply; and

      2. $600 for the remaining twenty-one (21) day supply; and

      (b) Twenty-eight (28) day supply of anti-nausea medication - not to exceed thirty (30) dollars. (30 Ky.R. 506; Am. 844; eff. 10-30-2003; 37 Ky.R. 1505; 2154; eff. 4-1-2011.)