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Arkansas Payment Resources
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Summary of payment program

Billing

The victim is not to be billed for medical forensic services. The Sexual Assault Reimbursement Program allows evidence to be collected after a sexual assault has been committed without the victim bearing burden of the expense, and it pays for ambulance services and medical or legal examinations.

 

Payment

For payment of the medical-legal examination:

  • Complete the Sexual Assault Reimbursement Form available on the Arkansas Attorney General’s Web site at: Application
  • Follow normal procedures in billing. Please note, however, that pursuant to the federal VOCA Crime Bill amendment, federally financed benefits programs such as Medicaid, Medicare, Champus, or VA must be billed in cases when the victim is covered by these benefits.
  • Submit the Sexual Assault Reimbursement Form along with the itemized statement to the Arkansas Crime Victims Reparations Board. Acceptance of payment of the expenses for the medical-legal examination by the Board shall be considered payment in full and bars any legal action for collection. Questions regarding payment procedures may be directed to the Board staff at (501) 682-1020 or (800)
    448-3014.

In order for a medical facility to seek reimbursement for the expenses incurred while performing the medical-legal examination, the victim must seek treatment within seventy-two (72) hours, except in the case of a minor. A request form for reimbursement must be completed and signed by a physician or sexual assault nurse examiner who performs the examination. On July 31, 2007 Act 676 of 2007 changed the law that required sexual assault victims to report and cooperate with law enforcement for reimbursement of the medical-legal examination. This law now states that a sexual assault victim does not have to participate in the criminal justice system or cooperate with law enforcement in order to be provided with a forensic medical exam and to be reimbursed for charges incurred. The reimbursement form and an itemized statement should then be submitted to the Attorney General’s Office.

 

The Sexual Assault Reimbursement Program will not cover expenses that are eligible to be paid by a federally financed benefits program, such as Medicaid, Medicare, TriCare or VA. In addition, this program will not cover expenses related to treatment of physical injuries that are directly related to the alleged assault or for a pre-existing injury.

 

Eligible expenses consist of the emergency room or facility fee, the physician or SANE fee, the ambulance fee, lab fees and colposcopy fee. In addition, medications for preventive measures are eligible.

 

The Arkansas Crime Victims Reparations Board instituted policies and procedures for the Sexual Assault

 Reimbursement Program that provides for the following maximum limits on the eligible expenses:

  • Facility fee (includes medications) $350.00
  • Physician or SANE fee $350.00
  • Ambulance fee $350.00
  • Lab fees $200.00 (outside lab facilities will be given priority)
  • Colposcopy fee $160.88

Medical facilities that transfer or receive a transferred patient alleging to have been sexually assaulted must complete the area on the sexual assault reimbursement form. In these instances, the Sexual Assault Reimbursement Program will not disburse any payments for eligible expenses to either medical facility until the necessary documentation and itemized billing statements are submitted from both the transferring and receiving facility. This documentation includes justification of the decision to transfer the alleged victim. In these instances, the medical facilities must share the allowable award ceilings outlined in the Sexual Assault Reimbursement Program’s Policies and Procedures. The Arkansas Crime Victims Reparations Board will determine the appropriate portion of the ceiling for each medical facility on a case-by-case basis.

In compliance with Arkansas Code Annotated 12-12-403, the medical facility or licensed health care provider shall not submit any remaining balance after reimbursement by the Arkansas Crime Victims Reparations Board to the victim. Additionally, acceptance of payment of the expenses of the medical-legal examination by the Arkansas Crime Victims Reparations Board shall be considered payment in full and bars any legal action for collection.

 

The Sexual Assault Reimbursement Program covers only the expenses involved in performing the medical-legal examination. The victim or authorized claimant would need to submit any expenses pertaining to other treatment to the Crime Victims Reparations Board for consideration of payment. For additional information or an application, please contact:

 

Arkansas Crime Victims Reparations Board

Office of Attorney General Leslie Rutledge

323 Center Street, Suite 200

Little Rock, Arkansas 72201

(501) 682-1020 or 800-448-3014 (outside Pulaski County)

 

Arkansas Crime Victims Compensation Application

Arkansas Crime Victims Compensation Brochure 

 

Coordination with healthcare

Arkansas Coalition Against Sexual Assault - Listing of Crisis Centers

 

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