New York Payment Resources
Summary of payment program
New York State law provides for direct reimbursement to providers of forensic health care examination services. Reimbursement provides for the personal privacy of sexual assault patients and ensures that survivors are not billed for any forensic health care examination services, including a seven-day starter pack of HIV post-exposure prophylaxis.
Sexual assault survivors are encouraged to file a crime victims’ compensation application if other medical services (outside of the forensic exam) are needed. Also, sexual assault survivors should be advised that they may be eligible to recover reimbursement for loss of personal property, loss of earnings or support and expenses associated with counseling, in addition to medical care, if a regular application is filed.
New York State Executive Law (§631.13) provides for direct reimbursement by the Office of Victim Services (OVS) to providers of forensic sexual assault examination services. The law requires the medical provider to explain the victim’s billing choices to them. When a victim chooses to have the provider bill OVS directly for the forensic examination and its related charges, the provider shall use the Direct Reimbursement Program. Direct reimbursement from OVS to providers of forensic examination services ensures that a sexual assault survivor will not have to pay for her/his own forensic examination.
The reimbursement amount will be the amount of itemized charges, to be reimbursed at the Medicaid rate and which cumulatively shall not exceed the following, tiered reimbursement amounts:
- Tier 1 – $800 for an exam of a sexual assault survivor without the use of Sexual Offense Evidence Collection (SOEC) Kit
- Tier 2 – $1,200 for an exam of the sexual assault survivor with the use of an SOEC Kit
- Tier 3 – $1,500 for an exam of a sexual assault survivor who is eighteen years of age or older, with or without the use of a SOEC Kit, and with the provision of an initial 7-day supply of HIV PEP
- Tier 4 – $2,500 for an exam of a sexual assault survivor who is less than eighteen years of age, with or without the use of a SOEC Kit, and with the provision of the full regimen of HIV PEP
Coordination with healthcare
The term “forensic exam” means an examination provided to a sexual assault victim by medical personnel trained to gather evidence of a sexual assault in a manner suitable for use in a court of law. A list of the elements of a forensic examination is described in detail in the Department of Health’s Protocols for the Acute Care of the Adult Patient Reporting Sexual Assault. The Office of Victim Services will cover the cost of a forensic exam conducted beyond 96 hours for a child victim, or for any victim where good cause is shown for the delay.
New York State Coalition Against Sexual Assault – Find a local Crisis Center in New York