802 Ky. Admin. Regs. 3:020

Current through Register Vol. 51, No. 5, November 1, 2024

Section 802 KAR 3:020 - Payment schedule for sexual assault examinations

RELATES TO: KRS 49.020, 49.490, 216B.015, 216B.400, 403.707

NECESSITY, FUNCTION, AND CONFORMITY: KRS 49.020(5) authorizes the commission to promulgate administrative regulations to carry out the provisions and purposes of the commission. KRS 49.490 and 216B.400(8) require the commission to administer the sexual assault victim assistance fund and pay the cost of a sexual assault examination. This administrative regulation establishes the reimbursement schedule for performing a sexual assault forensic medical examination.

Section 1. Sexual Assault Examination Program.

(1) Reimbursement for performing a sexual assault forensic-medical examination pursuant to 502 KAR 12:010 shall be for the actual amount billed and shall not exceed:

(a) $200 for a physician, sexual assault nurse examiner, or other qualified medical professional performing the examination;

(b) $250 for an examination facility for use of an emergency or examination room;

(c) $100 for an examination facility or laboratory that performed diagnostic laboratory testing; and

(d) $100 for an examination facility where administered medications and pharmaceuticals were prescribed as a result of the examination and as part of basic treatment.

(2) Reimbursement for additional services related to a sexual assault forensic-medical examination requiring HIV post-exposure prophylaxis shall be for the actual amount billed and shall not exceed the following limitations:

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

(b) Laboratory testing:

1. $150 for initial testing conducted during the sexual assault examination in the examination facility; and

2. $215 for follow-up testing conducted during the three (3) follow-up examinations, not to exceed:

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

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

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

(c) Medications:

1. $800 for a twenty-eight (28) day supply of HIV prophylaxis medication, not to exceed:

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

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

2. Thirty (30) dollars for a twenty-eight (28) day supply of anti-nausea medication.

802 KAR 3:020

44 Ky.R. 2167; 2329; eff. 6-1-2018.

STATUTORY AUTHORITY: KRS 49.020, 49.300(1), 49.490, 216B.400(8)