Forensic Rape Exam (FRE) Frequently Asked Questions

Forensic Rape Exam (FRE) Frequently Asked Questions

If a sexual assault survivor used their insurance to pay for the cost of the exam, but insurance did not cover 100% of the bill, can the hospital or provider charge OVS for the balance?

If a sexual assault survivor used their insurance to pay for the cost of the exam, but insurance did not cover 100% of the bill, can the hospital or provider charge OVS for the balance?

No. Once private health care insurance is assigned, the hospital or healthcare provider may not bill the Direct Reimbursement Program for any balance due. A sexual assault survivor may file a regular claim application with OVS and if eligible, be reimbursed for any non-covered medical expenses related to the sexual assault.

I am a medical provider who performed a forensic exam in a hospital where I have privileges, how do I get paid for my services?

I am a medical provider who performed a forensic exam in a hospital where I have privileges, how do I get paid for my services?

You must request payment from the hospital. OVS will reimburse the hospital or facility in which the forensic examination was conducted. The hospital or facility in which the examination was conducted shall be responsible for proportionately allocating reimbursable expenses among service providers.

I am a private physician who conducted an FRE exam in my office. I did not use a Sexual Offense Evidence Collection Kit. Can I still be reimbursed?

I am a private physician who conducted an FRE exam in my office. I did not use a Sexual Offense Evidence Collection Kit. Can I still be reimbursed?

Yes, as long as the examination was conducted in accordance with Public Health Law §2805(i) and A National Protocol for Sexual Assault Medical Forensic Examinations and a diagnosis of sexual assault is indicated on the itemized bill.

Does a sexual assault survivor have to have a forensic examination performed right away? What is the timeframe?

Does a sexual assault survivor have to have a forensic examination performed right away? What is the timeframe?

Generally, a forensic exam must be performed within 96 hours of the assault in order to obtain essential evidence. However, the Office of Victim Services will cover the cost of a forensic exam conducted beyond 96 hours for a child survivor, or for any survivor where good cause is shown for the delay.

Will a sexual assault survivor be required to follow through with prosecution in order to secure payment for the forensic examination?

Will a sexual assault survivor be required to follow through with prosecution in order to secure payment for the forensic examination?

No. A sexual assault survivor will not be required by the Office of Victim Services to pursue prosecution in order to have the sexual assault forensic examination and related services paid for under the direct reimbursement program.

Can a hospital or other forensic examiner bill the victim for the remaining balance after direct reimbursement by the OVS?

Can a hospital or other forensic examiner bill the victim for the remaining balance after direct reimbursement by the OVS?

No. Once the survivor chooses that a provider bill OVS through this program, the provider and any other services providers that provided forensic exam related services, cannot bill the survivor or their insurance. Additionally, if the provider receives reimbursement through the program, the healthcare provider must accept the OVS reimbursement rate as payment in full for covered and submitted services. The purpose of this Direct Reimbursement Program is to ensure that the sexual assault survivor not be held responsible for the payment of the cost of the forensic examination.

Is follow-up or post-exposure HIV prophylaxis covered under this program?

Is follow-up or post-exposure HIV prophylaxis covered under this program?

No. Only costs for the initial 7-day supply of HIV PEP are intended to be reimbursed by the Direct Reimbursement Program. For reimbursement of the expenses associated with HIV PEP beyond the initial 7-day supply, an eligible survivor must file a claim with OVS. 

Effective June 15, 2020, HIV PEP will be covered as follows:

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